The assessment for vascular pathology should be a key component of ev ery radiologists search pattern when evaluating knee mri. There is a wide variety of variant vascular anatomy and vascular pathology that can occur around the knee, including an aberrant anterior tibial artery, vascular trauma that occurs with knee dislocation, popliteal artery entrapment. It is a good first read for the novice radiologist to use when reporting mri of the knee and even an expert reporter could find this useful as a reference. It is most commonly caused by trauma to the knee, either by a single acute instance or by chronic trauma over time. Prevalence of mri findings was high in symptomatic and asymptomatic population. To properly identify pathology we need to ask ourselves a few questions.
On the other hand, in case of coexistence of more than one knee pathology, decreased rates of accuracy of mri have been reported811. The orthopedic surgeon may not need an mri for the diagnosis or may feel the need for alternative studies. This section of the website will explain about different types of mri pathologies, how to report an mri scan. The knee joint is a modified hinge joint between the femur, tibia and patella. Appropriate use of mri for evaluating common musculoskeletal conditions. Efficacy of mri in comparison to arthroscopy has been studied and proved by many authors reporting high sensitivity and specificity of mri. Mri provides an accurate noninvasive assessment of knee pathology. Click on a link to get t1 coronal view t2fatsat axial view t2fatsat coronal view. The aim of this study is to determine the accuracy of noncontrast mri. To determine the associations between multifeature structural pathology assessed using magnetic resonance imaging mri and the presence of knee pain, and to determine the associations. 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. Wrist finger thumb lower extremity hip pelvis thigh knee. The key to diagnosis and management is a thorough history and examination to determine the primary pathology, which includes inflammation, infection or a structural abnormality in the knee. Magnetic resonance imaging versus arthroscopy in the diagnosis of.
This section of the website will explain about different types of mri abdominal pathologies, how to report an mri liver scan. Mri of the knee a guide to evaluation and reporting. Misnomer, mucoid degeneration of collagen fibres of tendon. In patients with juvenile idiopathic arthritis, diffusionweighted imaging of the knee was accurate and agreed with contrast materialenhanced mri. There is a wide variety of variant vascular anatomy and vascular pathology that can occur around the knee, including an aberrant anterior tibial artery, vascular trauma that occurs with knee dislocation, popliteal artery entrapment syndrome. Overuse injury to proximal aspect of patellar tendon.
Mri is the most commonly used imaging modality in the evaluation of the knee joint, and has an acceptable accuracy in the detection of meniscal and anterior cruciate ligament acl injury27. Analysis of lowfield magnetic resonance imaging scanners for. Magnetic resonance imaging of knee joint international. May 29, 2018 hip arthroscopy has led to a greater understanding of intraarticular hip pathology. The advent of mri has provided new opportunities for the radiologist to evaluate these anatomical structures and to demonstrate knee joint pathology. Mri of the knee is often performed for presumed musculoskeletal conditions. There are several types and can occur in an acute or chronic setting. The prevalence of radiographic and mridefined patellofemoral. Some vascular processes are limb threatening and affect. The insertion of this tendon is difficult to visualize on ultrasound due to its depth and mri may be more helpful in delineating pathology here. This study investigates potential risk factors for medial meniscal lesions or extrusion in middleaged and elderly persons. Mri of the knee, western ontario and mcmaster university osteoarthritis index. 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.
Knee joint examinations by magnetic resonance imaging. Mri examinations without intraarticular contrast were performed on 379 patients for knee pathologies over a 4year period. Initially, constructing a solid foundation consisting of a good understanding of basic mr imaging principles and imaging protocols as well as the. Apr 19, 2015 indications of mri occult fracture marrow abnormality ligament pathology tendon pathology muscular injury infection bone and soft tissue tumour 10. Navarro, md fourth year radiology resident department of medical imaging quirino memorial medical center mri of the knee most frequently requested mri joint study comprehensive examination of the. Meniscus pathology, osteoarthritis and the treatment. These waves are then translated into images we can use for diagnosis. Noncontrast magnetic resonance imaging mri is currently the gold standard in noninvasive imaging diagnosis, with high sensitivity in identifying labral pathology but equivocal results for ligamentum teres damage and chondral defects. To test the lateral meniscus it is the same hand positions but ensure you are palpating the lateral joint line. It is marked by swelling at the knee, which can be tender to the touch but which does not restrict the knee s range of motion. Mr imaging in patients with knee injury erasmus universiteit. The white matter areas of the brain are mainly composed of axons coated with myelin, while the gray matter areas are predominantly the cell bodies of the neurons. Mri pathology images pathologies mri brain pathology. Objectives meniscal pathology in which the aetiology is often unclear is a frequent finding on knee mri.
Methods prospective cohort study using populationbased subjects from birmingham, alabama and iowa city, iowa, usa the multicenter osteoarthritis study. As such, prepatellar bursitis commonly occurs among individuals whose professions require frequent kneeling. Saggital lateral to medial axial from above downward position for knee mri knee in full extension and 5 degree of internal rotation 11. Protocol for the management of acute injuries to the knee introduction the majority of knee injuries result from trauma to the joint as a result of direct, torsional or angulatory forces. Knee pathology meniscal pathology ligament injury cartilage lesions bony and tendinous lesions. Labral pathology instability without ability to do a direct. It is marked by swelling at the knee, which can be tender to the touch but which does not restrict the knees range of motion. Click on a link to get t1 coronal view t2fatsat axial view t2fatsat coronal view t2fatsat sagittal view. Common indications include assessment of internal derangement, pain, and further investigation of a. These injuries vary in severity from simple ligamentous sprains to complex pathologies that involve ligamentous disruption, meniscal damage.
Diagnosing knee injury with an mri verywell health. Magnetic resonance imaging mri is a technology often used to investigate the sources of knee problems. Magnetic resonance imaging, knee, acl, pcl, meniscus. The acutely swollen knee is a common presentation of knee pathology in both primary care and the emergency department.
Peter mullaney, rad magazine, october, 2015 this book aims to cover most knee pathology, including the important area of postoperative appearance. Magnetic resonance imaging versus arthroscopy in the. Papers were included if they were based on the knee pathology and used mri and arthroscopies in some of their patients. Pain and or a click indicate a torn medial meniscus. Patients who undergo knee mri for presumed musculoskeletal disease can have unexpected vascular findings or pathology in the imaged field. Most commonly involved is the semimembranosus tendon which presents with pain in the posteromedial aspect of the joint. It has a very high negative predictive value and may assist in avoiding unnecessary knee arthroscopy. Normal mr imaging anatomy of the knee saifuddin vohra, do, george arnold, md, shashin doshi, md, david marcantonio, md there are several keys to successfully interpreting mr imaging examinations. It is typically used to help diagnose or evaluate pain, weakness, swelling or bleeding in and around the joint. The mri defined structural pf damage in knee pain or symptomatic population was 32% and 52% based on bone marrow lesion and cartilage defect, respectively.
As you extend the knee, push the knee inwards varus and turn the foot inwards. Mri of the knee and common pathologies free download as powerpoint presentation. It works by emitting magnetic waves that bounce off tissue, bones, and organs in different ways. Unexpected vascular findings on knee mri can range from incidental to symptomatic and can include such processes as variant anatomy, aneurysm, traumatic injury, and neoplasm. An illustrated guide for common pathologies pdf free download for free. This webpage presents the anatomical structures found on knee mri. Magnetic resonance imaging of the knee and correlation with. Pathology acute meniscal tears occur after the rotat. Efficacy of mri in comparison to arthroscopy has been original article abstract introduction. This knowl edge can be then applied to ones understanding of pathology. May 22, 2012 mri can be used to view the menisci and detect pathology. As an mri detective, pathologies follow specific rules that we can logically determine what it is. Conclusion one half of people with knee pain or radiographic oa have patellofemoral involvement.
Pdf the meniscal pathology of the knee is one of the clinical realities the orthopedic surgeon must daily confront with. Indications for mri introduction in most cases, referral of the patient to the orthopedist is more costeffective than ordering an mri scan prior to the referral. Magnetic resonance imaging mri is the gold standard in noninvasive investigation of knee pain. Appropriate use of mri for evaluating common musculoskeletal. Internal derangement of the knee is a blanket term used to cover a group of disorders involving destruction of the normal. The knee is the joint most commonly imaged with mri in the pediatric population. Jan 17, 2016 other tendons around the knee may also become tendinopathic and may rarely rupture. There is a wide variety of variant vascular anatomy and vascular pathology that can occur around the knee, including an aberrant anterior tibial artery, vascular trauma that occurs with knee dislocation, popliteal artery entrapment syndrome, popliteal artery aneurysm, popliteal vein thrombosis, cystic adventitial. Magnetic resonance imaging mri appears to be the most accurate. Overuse causes include forced rotation of the knee and down hill running. Role of magnetic resonance imaging mri in the diagnosis of knee lesions has now become more evident. Mri swelling of proximal aspect of tendon with internal high signal intensity. Meniscal tears are the failure of the fibrocartilaginous menisci of the knee. Pdf mri evaluation of acute internal derangement of knee.