Lower Quarter Imaging

ABCs

Alignment

Bone density

Cartilage Spaces

Soft tissues

How long before most knee pain improves?

in 4-6 weeks

When is knee MRI appropriate?

- minimal role for immediate MRI

- surgical planning

Detrimental effects of knee MRI

- patient focus on MRI findings

- findings may be clinically irrelevant

- can distract from rehab process

T1:

view

anatomic view

T1:

sensitive

fat sensitive = high signal

T1:

bone

light

T1:

tendon/ligament

dark

T1:

cartilage

gray

T1:

muscle

dark gray

T1:

free fluid

= low signal intensity

T2:

sensitive

fluid = high signal intensity (white)

T2:

bone

dark

T2:

tendon/ligament

black

T2:

muscle

gray

T2:

cartilage

dark

T2:

fat suppressed

dark

Stroke Test:

zero

no wave produced on downstroke

Stroke Test:

trace

small wave on medial side and downstroke

Stroke Test:

1+

larger bulge on medial side with downstroke

Stroke Test:

2+

effusion spontaneously returns to medial side after upstroke (no downstroke necessary)

Stroke Test:

3+

so much fluid that is not possible to the move the effusion out of the medial aspect of the knee