Imaging of articular pathology: MRI, CT, arthrography

The purpose of this review article is to present the advantages and limitations of magnetic resonance imaging (MRI), computed tomography (CT) and arthrography for evaluating articular pathology. Techniques, patient selection, indications and contraindications for each modality are reviewed. MRI provides superior soft tissue contrast and image plane selection, making it the ideal technique for most articular abnormalities. However, obese patients and patients with certain electrical or metallic implants cannot be examined with MRI. CT provides superior detail for fine cortical bone and subtle calcifications, but lacks the soft tissue contrast provided by MRI. Arthrography is an invasive technique with minimal risk of allergy to contrast material or infection. This technique permits accurate measurement of capsular volume, allows for fluid aspiration for laboratory studies and permits injection of anesthetic and/or steroid compounds for purposes of treatment or confirming the site of the patient's pain. Magnetic resonance imaging, computed tomography and arthrography are useful techniques for evaluating articular pathology. Careful review of the clinical symptoms and patient's condition is necessary to select the most appropriate technique.