Optimizing techniques for musculoskeletal imaging of the postoperative patient

Knowledge of imaging principles and parameter modifications of advanced imaging techniques--nuclear medicine, ultrasound, CT, and MR--aid musculoskeletal radiologists in selecting the appropriate examination for clinical questions; tailoring imaging parameters results in better image quality, thus more confident diagnoses. CT can evaluate for subtle fractures often better than conventional radiographs. Adjusting the area of interest, increasing the peak kilovoltage (kVp), and viewing images with postprocessing software allow better CT image quality. Proper modification of MR imaging parameters also provides useful information including visualizing the extent of osteolysis better than conventional radiographs. Fast spin echo imaging should be used, gradient echo avoided, and fast inversion recovery used instead of frequency-selective fat suppression.