Document Title: Sanders-AJSM-Jan05.shtml
Article Title: A Systematic Approach to Magnetic Resonance Imaging Interpretation of Sports Medicine Injuries of the Knee
Authors: Timothy G. Sanders, MD, and Mark D. Miller, MD
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: January 2005
Volume 33, Number 1, pages: 131-148
Key Words: knee, magnetic resonance imaging (MRI/NMR), sports injury, ligaments, menisci, articular cartilage, diagnostic, noninvasive, ACL, PCL, MCL, LCL.

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Comments: This article provides a comprehensive and definitive overview of knee MRI-scan interpretation. Anyone who has undergone an MRI examination would be well-advised to obtain the complete set of scans (on CD) and review them. Interpreting MRI scans is a combination of art and science, and understanding the technical attributes and workings of MRI technology requires a reasonable understanding of physics. Granted, reading this article does not confer the extensive training and experience that a highly trained MRI radiologist would have, but taking the time to work through both this article and one's own MRI scans would prove valuable in that one could then see the basis of one's MRI report. Please bear in mind that MRI-scan images are typically cross-sectional slices. Therefore, a structure which happens to pass through a given imaging plane might appear strange merely because of the sharply oblique ankle at which the slice was taken. (It is also possible for the image to be distorted by slight movements of the patient during the imaging process, for example as a result of the patient coughing or sneezing. In such cases, the examination is usually redone. Other types of imaging artifacts are possible too, as the authors duly note.) Finally, keep in mind that it is possible for certain types of injuries to not appear on an MRI investigation; therefore, MRI results should be used in conjunction with other diagnostic avenues, including manual-manipulation testing (done under anesthesia, if inconclusive otherwise) and arthroscopic investigation.

ABSTRACT

Magnetic resonance imaging is performed more commonly on the knee than on any other joint, and it is an excellent diagnostic tool that can aid in the evaluation of a host of sports-related injuries involving the ligaments, tendons, menisci, osseous structures, and articular surfaces. A thorough evaluation of the images, however, can be a daunting task, as the study often contains dozens of images obtained with multiple pulse sequences and in several imaging planes. A systematic approach will facilitate an accurate and timely evaluation of this complex examination and will ensure that all of the clinically relevant structures are adequately assessed. This article will provide a systematic approach to the interpretation of a magnetic resonance examination of the knee. The normal imaging appearance of each anatomical structure will be described, and the optimal pulse sequence and imaging plane for the evaluation of each structure will be discussed. Finally, the signs of injury will be described and illustrated.

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