Direct magnetic resonance arthrography. Pt. I. Shoulder and elbow

Magnetic resonance imaging has reached high acceptance in the diagnostic work-up of joint pathologies. Direct magnetic resonance arthrography extends the capabilities of conventional MR imaging and utilizes the natural advantages gained from joint effusion. The imaging technique has been applied in the shoulder, ellbow, hand, hip, knee and ankle joints. Besides technical aspects, this article wants to discuss indications for direct MR arthrography for clinical purposes. They are based on the recommendations of the 'Arbeitsgemeinschaft Muskuloskelettale Radiologie' of the German Radiology Society. This implies recognizing the inherent strengths and weaknesses of concurring imaging modalities as a basis for the distinguished clinical use of direct MR arthrography. Part I of this article describes the techniques of arthrography and MR imaging as well as magnetic resonance arthrography of the shoulder and elbow. At present, a final assessment of the technique at 3 T is not possible. However, it is anticipated that the possibilities of cartilage imaging may improve considerably so that MR arthrography at 3 T will replace CT-arthrography for detection of cartilage lesions especially in small joints. (orig.)