Mri of knee joint pdf

The clinical necessity of performing a joint mri must be noted in the medical record or easily inferred from the medical record. Knee arthrogram the t1 fat suppressed post arthrogram sequence is most beneficial for evaluation of postoperative menisci. Delayed gadolinium enhanced magnetic resonance imaging of cartilage dgemric is a technique where an mri estimates joint cartilage glycosaminoglycan content after penetration of the contrast agent in order to detect cartilage breakdown. Ogden, ut 84405 suite 100 p 801 4754552 f 801 4754578.

Magnetic resonance imaging mri is a proven imaging modality for the detection, evaluation, assessment, staging, and followup of disorders of the knee. Mri characteristics of cysts and cystlike lesions in and. Intraarticular gadolinium helps differentiate between postoperative high signal that can be seen on pd sequences versus a retear of the meniscus. Magnetic resonance imaging mri knee magnetic resonance imaging mri of the knee uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the knee joint. Pdf evaluation of traumatic knee joint injuries with mri. Highresolution magnetic resonance imaging of the knee joint ajr.

In cases of tendinitissuch as that seen with jumpers kneean mri will usually reveal progressive knee injury in the form of scarring, inflammation, and malformations of the tendon. Out of total 100 patients, major cause of knee joint trauma was fall 32%, followed by road traffic accident 31%, sports injury 27% and twisting injury 10%. Mri joint without contrast upper extremity lower extremity 73221 73721 extremity, joint. Knee is more likely to be damaged than most other joints because it is subject to tremendous forces during vigorous activity. Optim imaging 912 64453 or optim medical center tattnall 9125571204 cpt code exam to order 73221 upper extremity joint without contrast shoulder arthritis labral tear may need mr arthrogram. C m c j o i n t m c p j o i n t i p j o i n t m e t a c a r p a l p r o x i m a l p h a l a n x. Magnetic resonance imaging of the knee and correlation with. The test helps your doctor visualize the anatomy of your.

It is typically used to help diagnose or evaluate pain, weakness, swelling or bleeding in and around the joint. Primary indications for mri of the knee include, but are not limited to, diagnosis, exclusion. Contents upper extremity page shoulder elbow wrist finger thumb lower extremity hip pelvis thigh knee. Pdf magnetic resonance imaging has become the imaging modality of choice for evaluation of. The single most common indication of performing a knee mri is to diagnose internal derangements in an injured knee. The purpose of this study was to correlate clinical, mri, and arthroscopic findings in diagnosing ligament and meniscus tears in knee joint injuries. Mri ordering guide these are general guidelines to assist in ordering an mri exam. Magnetic resonance imaging of the knee dr benjamin domb. Magnetic resonance imaging mri of the knee uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the knee joint. Mri of the knee joint with a 3d gradient echo sequence. This webpage presents the anatomical structures found on knee mri. From the chief of msk radiology, stanford university. Mri is able to directly visualize the whole joint in vivo, including articular cartilage, the menisci, the synovium and subchondral bone abnormalities.

Introduction the knee joint is one of the important weightbearing joints of the human body complex and extensive movements are performed, involving numerous active and passive mechanisms. Threedimensional 3 d gradient echo sequences offer the advantage of volume imaging within a few minutes scanning time and creating thin contiguous slices. The knee, a hingetype joint, is primarily composed of 3 articulating compartments. To evaluate the correlation between features of knee joint rheumatoid arthritis ra identified on mri and histological examination as a means of elucidating the pathogenesis of joint destruction in ra. Therefore not surprising that the knee is frequently affected by traumatic and degenerative conditions. Mri enables direct evaluation of the hyaline cartilage and reflects its biochemical and histological complexity. Your doctor may order an mri scan if they suspect any abnormalities within your knee joint. Mri of the knee is highly accurate in evaluation of internal derangements of the knee.

Mri of the knee for meniscal and anterior cruciate. It is considered to be the best noninvasive method for assessing the joint cartilage because of its high softtissue contrast2, 3, 4, 5. Stability of the joint is governed by a combination of static ligaments, dynamic muscular forces, meniscocapsular aponeurosis, bony topography, and joint load. Its a type of scan that uses a magnetic field, radio waves, and a computer to create detailed pictures of the inside of your body. Functionally, the knee comprises 2 articulationsthe patellofemoral and tibiofemoral. Table i basic pulse sequences for magnetic resonance imaging. A guide to evaluation and reporting is a wellthoughtout, easytoreference text that will be of value to radiologists, orthopedic surgeons, and sports medicine physicians as well as. Check the positioning block in the other two planes. In the majority of cases, clinical examination is as good as mri for diagnosis and management planning.

Pdf magnetic resonance imaging of variants of the knee. Magnetic resonance imaging of knee joint international. Slices must be sufficient to cover the knee joint from the tibial. Knee pathology meniscal pathology ligament injury cartilage. Mri knee protocols and planning indications for mri knee. Generalanatomy knee is the largest and more complex joint of the body complexity is the result of fusion of three joint lateral tibiofemoral joint medial tibiofemoral joint femoropatellar joint it is a compound synovial joint,incorporating two condylar joints between condyles of femur and tibia and one saddle joint between femur and patella. Acrsprssr practice parameter for the performance and. Elbow shoulder wrist ankle hip knee venous injection abscess cellulitis osteomylitis tumormass ulcer mri. Pdf evaluation of knee joint by ultrasound and mri. Cpt codes for mri scans murray center 5323 south woodrow street murray, ut 84107 suite 100 p 801 7600 f 801 7601 ogden center 1486 east skyline drive so. An optimized sequence fisp 3d 40 was evaluated for its potential to detect lesions of the menisci, cruciate ligaments, and articular cartilage in 80 patients compared to arthroscopy as the standard. Flair mri scan 8 demonstrating the view just left of midline 3 5 ontal lobe 2. Using mri, studies are beginning to explain the relationships between traditional and novel risk factors for oa, demonstrating how they influence changes in knee. An mri can be used to detect chronic tendinitis inflammation of the tendon or tendon ruptures although this is usually apparent on physical examination.

This book is divided into chapters that cover mri of all structures of the knee joint. Mri plays a role when the diagnosis is unclear and the level of patient disability or pain is such that. Expect to hold still for around 15 to 45 minutes, sometimes longer. The fclbiceps femoris bursa is found lateral to the distal fcl, and insinuates anterior and antero medial in relation to this ligament. An appropriate angle must be given in sagittal plane perpendicular to the line of femur and tibia.

A guide to evaluation and reporting is a wellwritten, uptodate book covering all imaging aspects of magnetic resonance mr imaging of the knee joint. Mri of the knee a guide to evaluation and reporting. A knee mri magnetic resonance imaging scan uses energy from strong magnets to create pictures of the knee joint and muscles and tissues. Magnetic resonance imaging mri can fully evaluate joint changes in oa, including osteophytes. If signs warrant, or if suspicion of meniscal lesions or instability arises from the. The ligaments of the knee are often involved in trauma and sportsrelated knee injuries. The authors intended audience is radiology residents, musculoskeletal fellows, and staff radiologists both. Magnetic resonance imaging mri is a useful tool to ident. If the answer says select one, selecting more than one answer can lead to technical denial regardless of how other questions are answered.

Normal mr imaging anatomy of the knee saifuddin vohra, do, george arnold, md, shashin doshi, md. Unlike an xray, which takes pictures of your bones, a knee mri lets your doctor see your bones, cartilage, tendons, ligaments, muscles. Evaluation of traumatic knee joint injuries with mri. However, a variety of potential pitfalls in interpretation of abnormalities related to the knee have been identified, particularly in evaluation of the menisci, ligaments, and articular cartilage. Properly performed and interpreted, mri not only contributes to diagnosis but also serves as an important guide to treatment planning and prognostication. The knee joint is a modified hinge joint between the femur, tibia and patella. The authors goals were to provide a standardized evaluation and reporting of knee mr imaging.

The advent of mri has provided new opportunities for the radiologist to evaluate these anatomical structures and to demonstrate knee joint pathology. The mr images are uptodate, well labeled, and pertinent to todays imaging practice. It is the largest synovial joint in the body and allows flexion and extension of the leg as well as some rotation in the flexed position. The knee is the joint most commonly imaged with mri in the pediatric population. Many static and dynamic internal derangements of the patellofemoral joint in these patients lead to various secondary mri findings.

Role of mri in evaluation of ligamentous injuries of knee 80 int j res med. Magnetic resonance imaging is the excellent non invasive investigation tool for knee injury due to excellent soft tissue contrast resolution and multiplanar imaging capabilities which provides the most detailed evaluation in cases of various soft tissue injuries of knee joint. Pawar and sushil ghanshyam kachewar and suhas ghule and dilip l. This article focuses on how to systematically approach. I understand that the answers marked on this questionnaire must be supported by the medical records.

Knee pain in young patients is a common indication for knee mri. Click on a link to get t1 coronal view t2fatsat axial view t2fatsat coronal view t2fatsat sagittal view. Pdf patella, femoropatellar joint, and infrapatellar fat pad. Normal anatomy of the knee ligaments, pathologic conditions, and postsurgical appearances of the anterior cruci. Normal anatomy and biomechanics of the knee fred flandry, md, facsw and gabriel hommel, md abstract. In this study, we studied mri of knee joints diagnosing cruciate and meniscal pathologies and pitfalls about t2w hyperintensity in cruciate and menisci and. The iliotibial band bursa is situated between the tibia and distal iliotibial band immedi ately proximal to its insertion on gerdys tubercle. Vacuum phenomenon can simulate a discoidtype meniscus or a torn discoid me niscus and is most commonly identified in the medial tibiofemoral joint. For a knee mri, youll go in feetfirst, and only your lower body will be in the tube. Mri of the knee joint can lead to improved health outcomes by reducing or eliminating the need for diagnostic arthroscopy. Imaging of knee osteoarthritis open access journal. The cost of the book is at the upper tier of similar works. Common indications include assessment of internal derangement, pain, and further investigation of a radiographic abnormality. Original article study of role of mri in evaluation of.