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Magnetic resonance imaging of the knee 

Magnetic resonance imaging of the knee
Chapter:
Magnetic resonance imaging of the knee
Author(s):

Ryan Shulman

, Adrian Wilson

, and Delia Peppercorn

DOI:
10.1093/med/9780199550647.003.008003
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date: 12 December 2019

♦ ACL tear: abnormal fibres, tibial translation, PCL/patella tendon buckling, bone bruising

♦ Meniscal tear: signal change to free edge

♦ Bone bruising:

• Reticular—not continuous subarticular bone

• Geographic—extends to subarticular bone

♦ Posterolateral corner:

• Oblique slices through fibular head

• Consists of lateral collateral ligament, popliteus, popliteofibular ligament, and arcuate complex.

Magnetic resonance imaging (MRI) has revolutionized the investigation and treatment of the painful knee. It is non-invasive and avoids patient exposure to ionizing radiation. MRI has the advantage of establishing diagnoses in a painful knee without the morbidity of surgical intervention. It is now widely available and has moved from a simple diagnostic adjunct into a key planning tool. It offers improved management of theatre resources and it allows for more accurate planning of postoperative rehabilitation.

The role of MRI in management of the injured knee is determined by its cost-effectiveness and its ability to augment the diagnostic accuracy of clinical examination. Accuracy of clinical examination by specialist orthopaedic surgeons is comparable to MRI when interpreted by specialist radiologists (Table 8.3.1). Increasingly, MRI has been shown to be cost neutral. Whilst costs are high, diagnostic information reduces the need for unnecessary surgery.

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