By Murray K. Dalinka M.D. (auth.)

In contemporary years, arthrography of the knee, this sector, defining for the reader the intricacies shoulder, and hip has develop into more and more of the radiologic reviews and detailing the real within the assessment of the varied nuances of method that may expedite the problems which impact those significant joints. the standard of the exam and improve the radiologist has assumed the basic position now not diagnostic acumen of the radiologist. This basically in supplying for the orthopedic clinician paintings, as well as its different many invaluable a correct analysis of abnormalities of those good points, is actually a "how to do it" treatise for joints, but additionally in defining anatomical information within the radiologist. a fashion hitherto unavailable or even un­ of serious curiosity are the chapters which deal suspected. actually, it can be acknowledged that the with arthrography in joints and parts usually now not constructing radiologic options in arthrog­ thought of a big a part of the diagnostic armamentarium of the radiologist or maybe raphy have partially rewritten the anatomical texts on the subject of the traditional joints. considered by way of the orthopedic clinician. those during this first-class paintings by way of Murray okay. Dalinka, comprise the ankle, hindfoot, elbow, wrist, and M. D. , arthrography of a couple of significant joints small joints of the hand and foot. The bankruptcy is taken into account intimately. Dr. Dalinka, a recog­ on arthrotomography of the temporomandib­ nized authority in skeletal radiology and par­ ular joint by way of Dr.

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1-28. An oblique tear with gas (arrow) and a small amount of contrast medium within the undersurface of the posterior horn of the medial meniscus. Fig. 1-30. Gas (arrow) within tear of the anteriorhorn of the medial meniscus. (Dalinka MK, Bonavita J A: Arthrography: Practice of Surgery. ) Knee Arthrography 23 Fig. 1-32. Torn midportion of the medial meniscus with an abnormal shape (arrow) and cleft within body of meniscus. Fig. 1-31. Torn midportion of the medial meniscus with an abnormal shape (arrow) and gas within meniscus (arrowhead).

Note inferior recess (arrow). F. Anterior to E. Note the lateral extension of the fat pad (large arrow), closeness of condyles (small arrows), and inferior recess (open arrow). Knee Arthrography The posterior horn of the lateral meniscus is attached to the capsule by two small synoviallined meniscal capsular ligaments in the region of the popliteus bursa. McIntyre (139) has referred to these attachments as struts while Jelaso (104) has called them fascicles. A defect in the superior attachment is a constant finding and an inferior opening is usually present.

The early enthusiasm of our clinical colleagues for arthrography was in part due to the confirmed diagnosis of unsuspected lateral meniscal pathology. This enthusiasm has persisted and the use of knee arthrography has now almost reached the status of preoperative myelography: surgery is rarely performed without an arthrogram or in the presence of a normal arthrogram. Fig. 1-53. Longitudinal section demonstrating lateral meniscus (black arrowhead) separated from the capsule by the popliteal hiatus (white arrowhead) and the popliteus muscle (arrow).

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