Related Experiment Videos
MR Arthrography of the Knee
Andrew H. Haims1, Lee D. Katz, Patrick A. Ruwe
1Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut.
Abstract:
The role of magnetic resonance imaging (MRI) in the evaluation of musculoskeletal injuries has been well documented during the last decade. There remain several important clinical situations in which noncontrast MRI has been disappointing. In the knee, magnetic resonance arthrography (MRA) can supplement noncontrast MRI in the evaluation of specific conditions, such as postoperative meniscus and osteochondritis dissecans. MRA significantly increases accuracy in the diagnosis of meniscal retear, as is seen in cases in which there has been a meniscal resection of more than 25% or after meniscal suturing. Also, in the evaluation of osteochondritis dissecans, the addition of intra-articular contrast has proved beneficial. Aside from assessing the integrity of the articular cartilage surface and documenting loose bodies, the contrast allows the clinician to distinguish fibrovascular granulation tissue from fluid partially or completely surrounding the osteochondritic fragment. These topics are discussed in this article.
Insights
Magnetic resonance arthrography (MRA) enhances knee imaging for specific injuries. MRA improves diagnostic accuracy for meniscal retears and osteochondritis dissecans evaluation when noncontrast MRI is insufficient.
Area of Science:
- Musculoskeletal Imaging
- Radiology
- Orthopedic Surgery
Background:
- Noncontrast magnetic resonance imaging (MRI) has limitations in evaluating certain knee pathologies.
- Clinical scenarios exist where standard MRI provides suboptimal diagnostic information for knee injuries.
Purpose of the Study:
- To evaluate the utility of magnetic resonance arthrography (MRA) in specific knee conditions.
- To demonstrate how MRA supplements noncontrast MRI for improved diagnostic accuracy.
Main Methods:
- Review of clinical situations where MRA offers advantages over noncontrast MRI.
- Discussion of MRA's role in diagnosing postoperative meniscal pathology and osteochondritis dissecans.
Main Results:
- MRA significantly increases diagnostic accuracy for meniscal retears, especially after resection or repair.
- Intra-articular contrast in MRA aids in evaluating osteochondritis dissecans by differentiating tissue types.
Conclusions:
- MRA is a valuable tool to augment noncontrast MRI for specific knee injuries.
- MRA improves the assessment of articular cartilage, loose bodies, and fibrovascular tissue in osteochondritis dissecans.