Diodrast Arthrography of the Knee

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DURING the past 20 years contrast arthrography of the knee has enjoyed varying degrees of popularity. For the most part the contrast medium employed has been air or oxygen. Enthusiasm has been discouraged in this type of examination because of the actual technical difficulty of obtaining adequate contrast by means of gas. In our experience poor contrast and poor filling have made accurate diagnosis practically impossible. As a result we had discarded contrast arthrography until recent months. Its revival was based on the valuable work of Lindblom,1 who has carried out some 6000 arthrograms employing parabrodil (diodrast) as the contrast media.

This article constitutes a preliminary report of our first 22 consecutive examinations of this type. To date the results have been good. The sharp contrast obtained with 35 per cent diodrast makes even the minimal pathologic change within the realm of accurate preoperative diagnosis (fig. 1a, b and c). This is partially explained on the ability of the iodine salt solution to mix with the synovial fluid and be imbibed on the cartilage and ligament surfaces. Sections of the synovia at surgery showed no microscopic evidence of reaction to the contrast media. The procedure is simple and requires no special equipment.

A number 20 needle is inserted into the knee joint from the lateral side, angling beneath the patella. Any synovial fluid present is aspirated and 10 cc. of 35 per cent diodrast is injected. The knee is then manipulated to spread the media over the joint surfaces. Compression. . .



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