Purpose or Case Report: MR shoulder arthrography is a frequently ordered study in the pediatric population for shoulder symptoms relating to sports injuries. The traditional technique for injecting contrast into the shoulder joint has been with fluoroscopy. Following principles of ALARA, we set out to find ways to reduce or eliminate radiation from the procedure. Ultrasound has been utilized increasingly for diagnosing musculoskeletal pathology and is a well-established technique in the adult population to guide joint injection of medication. This educational exhibit aims to discuss how we implemented this technique at our hospital, outline tips and pitfalls we learned along the way, and discuss benefits and drawbacks with the procedure.
Methods & Materials: We reviewed the current literature about joint ultrasound techniques and utilization. Radiation dose using fluoroscopy will be compared to radiation dose using our ultrasound technique. Our experience performing ultrasound-guided shoulder joint injection in the pediatric population will be discussed utilizing case examples.
Results: By using ultrasound over fluoroscopy for injecting contrast into the shoulder joint in our pediatric patient population, we were able to reduce radiation exposure normally associated with MR shoulder arthrogram examinations.
Conclusions: Ultrasound-guided injection of contrast into the shoulder joint for MR shoulder arthrography is a viable alternative over fluoroscopy to reduce radiation, especially in the pediatric patient population.