In this method requires the use of stress device.The limb is placed in the frame to widen the side of the joint space.This widening of intra-structural space permits better distribution of contrast around the meniscus.

When contrast arthrograms are to be made, the patient is turned to prone position and the centering point for each side of the joint is fluroscopically localized.The images obtained of each side of the joint usually consist of direct frontal projection and 20-degree right & left oblique position. The oblique position of the leg rotation or central ray angulation.

Following completion of these studies the frame is removed for lateral and an intercondyloid fossa position.

* Double-Contrast Arthrography of Knee
Horizontal Ray Method

The horizontal ray method of performing double-contrast radiography was first described by Andren and Wehlin and later by Freiberger, Killoran and Cardona.Using horizontal position and comparatively small amount of each of the two contrast agents, improved double-contrast delimneation of the knee joint structures.

Freiberger, killovan and Cardona recommend that six images be taken each meniscus.

A) Medial meniscus
1. The patient is adjusted in semiprone position the places posterior aspect
of medial meniscus uppermost.

2. To widen the joint space the knee is manually stressed.

3. The central ray is directed along the line the is drawn on the medial side
of the knee and centered to the meniscus.


With rotation toward supine position, the leg is turned 30 degrees for each of succeeding five exposures.The central ray is directed along the localization line.


B) Lateral Meniscus
Position of patient: Semiprone that places posteriot aspect of lateral
meniscus.
* To widen the joint space knee is manually stressed.
* Movement toward supine position, leg is rotated 30 degrees for each
consecutive exposures.
CR: Angulation is adjusted to direct it along the localization line.


Note: Continued on the next post...