Direct MR arthrography of the shoulder: Is exercise prior to imaging beneficial or detrimental?

PURPOSE: To define the beneficial and detrimental effects of adding exercis e to direct magnetic resonance (MR) shoulder arthrography. MATERIALS AND METHODS: Direct, intraarticular, gadolinium arthrography of t he shoulder was performed in 41 patients, who underwent 1.5-T MR imaging be fore and after 1 minute of arm swinging. Fourteen milliliters of dilute gad olinium solution was injected. Two readers blinded to exercise independentl y graded the randomly distributed images with a five-point scale for capsul ar contrast material resorption; extraarticular contrast material leakage; rotator cuff, glenoid labrum, and anterior capsule conspicuity; and partial -thickness or full-thickness rotator cuff tear and labral tear detectabilit y. The sign test was performed to evaluate the significance of differences between preexercise and postexercise grading for each reader. A second revi ew was performed, with direct side-by-side comparison of preexercise and po stexercise images. RESULTS: There was evidence of increased capsular resorption after exercise but no alteration in the depiction of the rotator cuff tendons or glenoid labrum. There was no significant extraarticular contrast material leakage a fter exercise and no alteration in depiction of the anterior capsule. There was no difference in the detectability of rotator cuff or labral tears. CONCLUSION: Exercise with direct shoulder MR arthrography has no beneficial or detrimental effect on image quality or on the depiction of rotator cuff or labral tears.