When using such a system to perform knee mri, other imaging parameters, such. Check the softtissues immediately superficial to the base of the lateral meniscus. This is a pdf file of an unedited manuscript that has been. If there are any inconsistencies with the medical office records, please elaborate in the comment section.
Include only the b70 series on the hip, knee, and ankle, leave cd in lees box with paperwork. The technical section will tell you how to manipulate parameters to produce good. Checklist for image quality figure 1 visionaire technology knee centered in fov. The t1 fat suppressed post arthrogram sequence is most beneficial for evaluation of postoperative menisci. Total knee replacement manual and therapyrehab protocol dr. Magnetic resonance imaging mri is a proven imaging modality for the detection, evaluation, assessment, staging, and followup of disorders of the knee. Mri protocols for wholeorgan assessment of the knee in osteoarthritis.
Above 9 years old use adult protocols, except for the newly added rapid swift for under 16 yrs old. Total knee arthroplasty protocol brigham and womens. Mri of the knee is highly accurate in evaluation of internal derangements of the knee. Msk mri protocol overview page 3 of 123 msk mri protocols march 2010 1. A three plane localiser must be taken in the beginning to localise and plan the sequences. Specific intervention should be based on the needs of the individual and should consider exam findings and clinical decision making. The episurf mri protocol knee for siemens mri machines consists of six or seven mri sequences. Recent advances in technology have led to high definition monitors and. Mri ordering guide these are general guidelines to assist in ordering an mri exam.
This technique allows the surgeon to have a clear view of the inside of the knee, which helps diagnose and treat knee problems. Axial t1 and pd fs use coronal loc and plane is straight horizontal if the shoulder is markedly angled, you can angle the axial images. Knee mri is typically not indicated in the first line work up of middleaged or. Improving mri knee protocol to best differenciate the two. Place the knee as close as possible to the epicenter of the main coil. Contents upper extremity page shoulder elbow wrist finger thumb lower extremity hip pelvis thigh knee lower extremityshin ankle foot special cases soft tissue mass metal protocol. 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. Radiologists work closely with ohsu mri techs in the art of creating optimal images from current technology. Magnetic resonance imaging mri, with its multiplanar capabilities and excellent.
Neuroradiology protocols currently applied in our mri section. Appropriate diagnostic tests 1 plain xrays 2 mri of knee by orthopedic specialist, rheumatologist, or physiatrist 3 bone scan 4 ct scan of knee 5 arthrogram of knee if mri is contraindicated b. Knee mri scan protocols, positioning and planning youtube. To report on the process and criteria for selecting acquisition protocols to include in the osteoarthritis initiative oai magnetic resonance imaging mri study protocol for the knee. The optimization of the study protocol of the knee by mri and its evaluation had as objective to evaluate the contribution of the proposed technique coronal oblique dp sequence in the study of the standard acl in the differentiation of the two bundles.
Pre and postcontrast foot mri mortons neuroma protocol. Failure to provide all relevant information may delay the determination. One significant requirement for a successful case is adhering to the mri scan protocol. Mri protocols are a combination of various mri sequences, designed to optimally assess a particular region of the body andor pathological process there are some general principles of protocol design for each area. Major knee sprains cases with positive clinical evidence of instability a. Image analysis, regardless of the sophistication and talent of the readers or the power of the imageprocessing. Order will specify right, left, or bilateral charge as lower extremity left or right wo contra burn cd to feinberg burner.
Conclusion knee mri can be performed on a large number of systems t1 and t2 with and without fat suppression are the main contrast mechanisms turbo fast spin echo is an important general purpose method. Procedure checkpoints important comment use a knee coil. Optim imaging 912 64453 or optim medical center tattnall 9125571204 cpt code exam to order 73221 upper extremity joint without contrast shoulder arthritis. Modeling oai incidence subcohort enrichment using risk factors appendix c. Mri protocols, mri planning, mri techniques and anatomy. Mri procedure manual for examinations of the knee and thigh.
Msk mri protocols updated 10112019 routine knee pubalgia pelvis achilles tendon wrist arthrogram mom knee 1. Referral for knee mri is generally only indicated in patients over 15 and less than 45 years of age with a bmi of less than 40. Mosher, md chief, musculoskeletal imaging and mri penn state university college of medicine hershey, pa. If patient has metal in opposite knee bend knee up out of scan range with pillows.
Body mri protocols updated 2019 abdomen pelvis limited abdomen and pelvis mrcp anal fistula prostate cancer staging basic limited abdomen pancreas routine female pelvis dynamic multiparametric prostate basic limited pelvis adrenal female pelvis mullerian appendicitis pregnant dynamic liver renal mass cervical ca staging defecography. Patient in supine position use dedicated knee coil. No prior diagnostic ultrasound or mri win 2 years new injury. The knee should be centered in the field of view fov and if there is any coil cutoff on the images, this should be evenly distributed between superior and inferior margins of the fov figures 1 and 2. Mri protocols for essr european society of musculoskeletal. Mri knee protocols and planning indications for mri knee. The intent of this physical therapy protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient who has undergone a total knee arthroplasty tka at brigham and womens hospital bwh. Autoalign knee functionality, a dedicated txrx knee coil, software version ve11m with application pack 01.
Guidelines for mr imaging of sports injuries european society of skeletal radiology sports subcommittee 2016 ara kassarjian, spain. Mri is of no benefit to patients included in appendix 1 referral criteria for mri referral for knee pain the patient must have the following signs and symptoms for direct access to mri. Often a t2 fs sequence is included as a replacement to pd fs in one plane, typically coronal. Msk mri protocols msk protocols msk mri protocols neuro protocols msk mri protocols body mri protocols 1. However, the specifics of a protocol are dependent on mri hardware and software, radiologists and referrers preference, patient factors e. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a meniscal repair. Mri knee protocols and planning indications for mri knee scan. Axials parallel to knee joint line include whole patella and fibular head. Wrist fingers hip knee ankle foot mortons nerves complete exams include long and short axis views unless otherwise indicated per protocol power or color doppler pd. The mri scanning protocol consists of 4 consecutive imaging sequences excluding localizers.
Rehabilitation guidelines for knee arthroscopy arthroscopy is a common surgical procedure in which a joint is viewed using a small camera. Properly performed and interpreted, mri not only contributes to diagnosis but also serves as an important guide to treatment planning and prognostication. For patients who are recovering from knee surgery, please refer to the following protocols as advised by your physical therapist. If you have questions, contact the referring physician. Mri knee protocol comprises a group of mri sequences to routinely assess the knee for internal pathology such as meniscal, ligament and cartilage injury. Mri knee protocol comprises a group of mri sequences to routinely assess the knee for internal pathology such as meniscal, ligament and cartilage injury as with most mr joint imaging, pd weighted sequences with and without fatsaturation are usually the mainstay. This section of the website will explain how to plan for an mri knee scans, protocols for mri knee, how to position for mri knee and indications for mri knee. Grade b figure 1 what is the role of knee mri in the assessment of a middleaged or older patient with a painful knee.