Summary: Intra-articular gadolinium for magnetic resonance arthrogram administered concurrently with a diagnostic intra-articular anesthetic injection can result in a false negative response to the diagnostic injection, but is not a negative predictor of short-term surgical outcomes after hip arthroscopy.

Introduction

Magnetic resonance arthrography (MRA) with intra-articular gadolinium and diagnostic intra-articular anesthetic injections (DIAI) are important tools in the evaluation of young patients with hip pathology and are often performed concurrently. However, some authors have questioned whether concurrent gadolinium administration can lead to false negative DIAI due to post-arthrography pain.

Methods

Patients receiving a series of two diagnostic intra-articular hip injections with anesthetic, the first with gadolinium for concurrent MRA and the second without gadolinium, were retrospectively identified. Pain response to diagnostic injection, injectate volume, local anesthetic volume, inclusion of corticosteroids, and method of injection were compared between injections. False negative injection was defined as <50% pain relief with concurrent gadolinium, but > or =50% pain relief with subsequent anesthetic injection without gadolinium. False negative injections in patients that ultimately underwent primary hip arthroscopy were identified from this cohort and matched in a 3:1 ratio to a control cohort to compare post-operative single assessment numerical evaluation (SANE) scores.

Results

Forty-three patients underwent a series of anesthetic injections with and without gadolinium and met inclusion and exclusion criteria. Pain response was significantly different in injections performed with and without gadolinium (18% vs. 81%; p<0.001). There were significant differences in total injectate volume, local anesthetic volume, corticosteroid use, and method of injection between injections, but these variables were not correlated with pain response based on Spearman's correlation tests. Fifteen patients had false negative responses to injection with gadolinium and were matched in a 3:1 ratio to a control cohort. There was no difference in post-operative SANE scores between the gadolinium-sensitive and control groups (81.6 vs. 80.0, p>0.05) collected at an average one year post-operatively.

Conclusion

Concurrent administration of intra-articular gadolinium with DIAI may result in a false negative response to anesthetic. Additionally, in patients with initial false negative DIAI with gadolinium followed by response to a second injection without gadolinium, short-term post-operative outcomes after hip arthroscopy are similar to a matched cohort.

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Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
Assessing The Risk Of Osteoarthritis Progression And Femoral Head Collapse Following Hip Corticosteroid/Anesthetic Injection Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Kirstin Small, MD, UNITED STATES Nehal Shah, MD, UNITED STATES Luis S Beltran, MD, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy Abstract Presentation 6 minutes J.W. Thomas Byrd, MD, UNITED STATES Kay S. Jones, MSN, RN, UNITED STATES
Midterm Outcomes Following Hip Labral Augmentation Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Rui Soares, BS, UNITED STATES Justin W. Arner, MD, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Maitland Martin, BS, UNITED STATES Spencer M Comfort, BS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Midterm Outcomes After Arthroscopic Hip Capsular Reconstruction Using Iliotibial Band Allograft Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Max Seiter, MD, UNITED STATES Rui Soares, BS, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Karen K. Briggs, MPH, MBS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Mid-Term Outcome and Strength Assessment after Proximal Rectus-Femoris-Refixation in Athletes ePoster Presentation Maximilian Hinz, MD, GERMANY Stephanie Geyer, MD, GERMANY Felix Winden, Cand Med, GERMANY Alexander Braunsperger, B.Sc., GERMANY Florian Kreuzpointner, PhD, GERMANY Benjamin Daniel Kleim, MBBS, MD, MRes, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Julian Mehl, MD, GERMANY
Are Femoral And Tibial Derotation Osteotomies Effective In Improving Hip And Knee Pain And Function? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Hip Osteochondroplasty May Benefit The Non-Ideal Patient With Femoroacetabular Impingement: Analysis From The Embedded Prospective Cohort Of The First Trial Abstract Presentation 6 minutes Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Diane Heels-Ansdell, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Cleft Sign and Bone Marrow Edema of the Pubic Synthesis are Associated with Sports Activity and Bony Morphology Related to Femoroacetabular Impingement in Symptomatic Patients with Labral Tears: A Cohort Study Abstract Presentation 5 minutes Keisuke Nakayama, MD, PhD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Soshi Uchida, MD, PhD, JAPAN
Similar Joint Space Measurements Are Obtained With Supine And Weightbearing Anteroposterior Pelvis Radiographs: Results Of A Prospective Study Abstract Presentation 5 minutes Blake M. Bodendorfer, MD, UNITED STATES Vishal A. Mehta, DO, UNITED STATES Austin M Looney, MD, UNITED STATES Kenneth Tepper, MD, UNITED STATES
Assessing Risk Of Osteonecrosis Of The Hip Following Intraarticular Injections: Hyaluronic Acid Versus Corticosteroid Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Ahab Chopra, BA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Cannabis Use Is Not Associated With Increased Opioid Use Or Costs After Hip Arthroscopy Abstract Presentation 5 minutes Christopher L. McCrum, MD, UNITED STATES Jacob Thomas Wood, BS, UNITED STATES Senthil Sambandam, MD, UNITED STATES
Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture ePoster Presentation George Bradley Reahl, MS, UNITED STATES Michael McTague, MPH, UNITED STATES Nishant Suneja, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
Amniotic Suspension Allograft Injection For Hip Osteoarthritis: Prospective Pilot Study With 1 Year Follow Up Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Molly Claire Meadows, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Shane Nho, MD, MS, UNITED STATES

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Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain?

Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain?

Introduction

Methods

Results

Conclusion

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Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain?

Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain?

Introduction

Methods

Results

Conclusion

More ISAKOS 2021: Global Content