Direct MR arthrography: A review of current use

Magnetic resonance imaging has become established as the most effective radiological tool in the assessment of joint disorders and, in conjunction with arthroscopic advances, has led to a greater understanding of joint anatomy and internal derangement. More recently, the usefulness of MR arthrography has gained increasing acceptance. This is particularly interesting, given that conventional MR imaging initially replaced arthrography for many applications. While MR arthrography is invasive, it can provide additional information about the integrity of joint structures, especially cartilaginous and ligamentous abnormalities. This has proved valuable in the shoulder where most of the interest and research has been directed. The demonstration of subtle lesions of the labral-ligamentous complex is important to the surgeon considering arthroscopic repair. MR arthrography can be considered as supplemental to a conventional MR study or, depending on the clinical question to be answered, may be the preferred initial examination. This article seeks to review the current role of MR arthrography. More emphasis is given to the shoulder where its role has become well established. However its use in other joints is addressed and the relevant aspects of anatomy, techniques and applications are considered.