SSR white paper: guidelines for utilization and performance of direct MR arthrography

Area of Science:

• Musculoskeletal Radiology
• Medical Imaging Techniques
• Diagnostic Procedures

Background:

• Direct magnetic resonance arthrography (dMRA) is a leading imaging modality for intra-articular structures.
• Current utilization and performance standards for dMRA lack widespread consensus.
• The Society of Skeletal Radiology (SSR) identified a need for standardized guidelines.

Purpose of the Study:

• To establish consensus recommendations for the utilization and performance of dMRA.
• To provide guidance based on a comprehensive review of scientific literature and expert opinion.
• To address variability in dMRA application across different joints.

Main Methods:

• An ad hoc committee of twelve SSR members with dMRA expertise was formed.
• A thorough review of published literature on dMRA was conducted.
• Recommendations were developed through group consensus for various joint regions.

Main Results:

• The literature review covered clinical indications, technical aspects, safety, protocols, and complications of dMRA.
• Focus areas included the shoulder, elbow, wrist, hip, knee, and ankle/foot.
• Gaps in current knowledge regarding dMRA were identified.

Conclusions:

• The panel recommends a more selective application of direct MR arthrography.
• dMRA remains a valuable tool for musculoskeletal radiologists.
• It is particularly useful when conventional MRI findings are indeterminate or conflict with clinical assessment.