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Knee MRI
 
Knee MRI, with its high soft tissue contrast is one of the main imaging tools to depict knee joint pathology. MRI allows accurate imaging of intra-articular structures such as ligaments, cartilage, menisci, bone marrow, synovium, and adjacent soft tissue.
Knee exams require a dedicated extremity coil, providing a homogenous imaging volume and high SNR to ensure best signal coverage. A complete knee MR examination includes for example sagittal and coronal T1 weighted, and proton density weighted pulse sequences +/- fat saturation, or STIR sequences. For high spatial resolution, maximal 4 mm thick slices with at least an in plane resolution of 0.75 mm and small gap are recommended. To depict the anterior cruciate ligament clearly, the sagittal plane has to be rotated 10 - 20° externally (parallel to the medial border of the femoral condyle). Retropatellar cartilage can bee seen for example in axial T2 weighted gradient echo sequences with Fatsat. However, the choice of the pulse sequences is depended of the diagnostic question, the used scanner, and preference of the operator.
Diagnostic quality in knee imaging is possible with field strengths ranging from 0.2 to 3T. With low field strengths more signal averages must be measured, resulting in increased scan times to provide equivalent quality as high field strengths.
More diagnostic information of meniscal tears and chondral defects can be obtained by direct magnetic resonance arthrography, which is done by introducing a dilute solution of gadolinium in saline (1:1000) into the joint capsule. The knee is then scanned in all three planes using T1W sequences with fat suppression. For indirect arthrography, the contrast is given i.v. and similar scans are started 20 min. after injection and exercise of the knee.
Frequent indications of MRI scans in musculoskeletal knee diseases are:
e.g., meniscal degeneration and tears, ligament injuries, osteochondral fractures, osteochondritis dissecans, avascular bone necrosis and rheumatoid arthritis.
See also Imaging of the Extremities and STIR.
 
Images, Movies, Sliders:
 Sagittal Knee MRI Images T1 Weighted  Open this link in a new window
      

 Anatomic MRI of the Knee 2  Open this link in a new window
    
SlidersSliders Overview

 Knee MRI Coronal Pd Spir 001  Open this link in a new window
 Sagittal Knee MRI Images STIR  Open this link in a new window
      

 Axial Knee MRI Images T2 Weighted  Open this link in a new window
 Anatomic MRI of the Knee 1  Open this link in a new window
    
SlidersSliders Overview

 
Radiology-tip.comArthrography,  Bone Scintigraphy
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Radiology-tip.comMusculoskeletal and Joint Ultrasound,  Sonography
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• Related Searches:
    • Short T1 Inversion Recovery
    • Fat Suppression
    • Inversion Recovery
    • Shoulder MRI
    • Proton Density
 
Further Reading:
  Basics:
Musculoskeletal MRI at 3.0 T: Relaxation Times and Image Contrast
Sunday, 1 August 2004   by www.ajronline.org    
Knee, Anterior Cruciate Ligament Injuries (MRI)
Tuesday, 28 March 2006   by www.emedicine.com    
  News & More:
Changes of the Posterior Meniscal Horn Height During Loading: An In Vivo Magnetic Resonance Imaging Study
Thursday, 10 January 2008   by www.orthosupersite.com    
Financial Interest May Motivate Higher Knee MRI Referral
Wednesday, 4 December 2013   by www.doctorslounge.com    
Study: MRI scans of knees can be used for biometric identification
Wednesday, 23 January 2013   by www.wired.co.uk    
MRI Resources 
PACS - MRI Physics - Examinations - Musculoskeletal and Joint MRI - Shoulder MRI - Safety Products
 
Shoulder MRI
 
MRI of the shoulder with its excellent soft tissue discrimination, and high spatial resolution offers the best noninvasive way to study the shoulder. MRI images of the bone, muscles and tendons of the glenohumeral joint can be obtained in any oblique planes and projections. MRI gives excellent depiction of rotator cuff tears, injuries to the biceps tendon and damage to the glenoid labrum. Shoulder MRI is better than ultrasound imaging at depicting structural changes such as osteophytic spurs, ligament thickening, and acromial shape that may have predisposed to tendon degeneration.
A dedicated shoulder coil and careful patient positioning in external rotation with the shoulder as close as reasonably possible to the center of the magnet is necessary for a good image quality. If possible, the opposite shoulder should be lifted up, so that the patient lies on the imaged shoulder in order to rotate and fix this shoulder to reduce motion during breathing.
Axial, coronal oblique, and sagittal oblique proton density with fat suppression, T2 and T1 provide an assessment of the rotator cuff, biceps, deltoid, acromio-clavicular joint, the glenohumeral joint and surrounding large structures. If a labral injury is suspected, a Fat Sat gradient echo sequence is recommended. In some cases, a direct MR shoulder arthrogram with intra-articular injection of dilute gadolinium or an indirect arthrogram with imaging 20 min. after intravenous injection may be helpful.
See also Imaging of the Extremities.
 
Images, Movies, Sliders:
 Anatomic Imaging of the Shoulder  Open this link in a new window
      

Courtesy of  Robert R. Edelman

 
Radiology-tip.comArthrography
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Radiology-tip.comLow Intensity Pulsed Ultrasound,  Musculoskeletal and Joint Ultrasound
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• View the DATABASE results for 'Shoulder MRI' (3).Open this link in a new window


• View the NEWS results for 'Shoulder MRI' (1).Open this link in a new window.
 
Further Reading:
  Basics:
MRI of little value in shoulder pain
Tuesday, 29 October 2013   by www.rheumatologyupdate.com.au    
  News & More:
MRI costs wide-ranging
Thursday, 14 April 2011   by www.chieftain.com    
MRE Could Provide A Definitive Diagnosis For People With Muscle Pain, Study Shows
Friday, 30 November 2007   by www.sciencedaily.com    
Peer-Reviewed Study Concludes The FONAR UPRIGHT™ MRI Could Serve as the “Standard Procedure of Care” for Pediatric Shoulder Malady
Wednesday, 30 May 2007   by www.fonar.com    
Shoulder pain? Don't rush to get an MRI
Thursday, 10 October 2013   by bangordailynews.com    
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PET-MRI is :
a valuable new tool 
worth to develop more 
unnecessary 
too expensive 
only for research 
the replacement for PET-CT 
for vets only 

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