ESSR Planning images for Knee MRI

Image Sequences

Use of Each Imaging Plane

Sagittal:

  • Cruciate ligaments
  • Menisci
  • Articular cartilage
  • Quadriceps tendons
  • Patellar tendon
  • Bone marrow assessment
  • Joint fluid/ effusion
  • Proximal tibio-fibular joint

 

 

 

 

 

 

 

 

 

 

Axial:

  • Patello-femoral Joint
  • Joint fluid effusion.
  • Trochlear groove depth.
  • TTTG.
  • Collateral ligaments
  • Cruciate ligaments.
  • Popliteus tendon. Baker’s cyst
  • Pes anserine bursa
  • Fat pad impingement
  • Patellar retinacular/ medial patellofemoral ligament

 

 

Coronal:

  • Menisci
  • Collateral ligaments/ Iliotibial band
  • Cruciate ligaments
  • Articular cartilage

 

 

 

 

Coronal Oblique

ACL assessment. 

 

Ref: Grading anterior cruciate ligament graft injury after ligament reconstruction surgery: diagnostic efficacy of oblique coronal MR imaging of the knee.

Moon SG, Hong SH, Choi JY, Jun WS, Choi JA, Park EA, Kang HS, Kwon JW - Korean J Radiol (2008 Mar-Apr)

 

 

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Checklist

Menisci /Cartliage

Cruciate ligaments
  • Meniscal tear (Morphology: Vertical,  Horizontal, Radial, Longitudinal, Flap, Bucket handle, Displaced fragment)
  • Meniscal root tear
  • Parameniscal cyst
  • Meniscal ossicle
  • Discoid meniscus
  • Osteoarthritis.

 

 
  • ACL tear
  • (Midsubstance; Avulsion from femoral/tibial attachment)
  • PCL tear
  • ACL ganglion cyst/mucoid degeneration
  • ACL reconstruction
  • Cyclops lesion after ACL graft.

 

 

Collateral ligaments

Patellofemoral Joint
  • Pellegrini steida lesion
  • Segond or reverse avulsion
  • Arcuate fracture
  • ITB friction
  • Pes anserine bursitis
  • Tear
  • Posterolateral corner injury
  • Posteromedial corner injury
  • Joint Effusion
  • Osteoarthritis.

 
  • Lateral patellar dislocation
  • Lateral patellar tracking
  • Trochlear dysplasia
  • Patellar chondromalacia
  • Patellofemoral ligaments
  • Hoffa fat pad impingement
  • Abnormal TTTG

 

Various

Patellar tendon
  • Pes anserine bursitis
  • Baker’s cyst
  • Osteochondral lesions
  • Hoffa’s ganglion cysts
  • Marrow oedema
  • Loose bodies
  • Intra-osseous ganglion cysts

 
  • Proximal patellar tendinosis/ Jumper’s knee
  • Patellar tendon-lateral femoral condyle impingement/ friction
  • Patella alta/ baja
  • Osgood Schlatter

Text & media

 

D. STANDARD REPORTS

 

 

FINDINGS:

  • No joint effusion.
  • Preserved patellofemoral alignment with no trochlear dysplasia. Intact patellofemoral ligaments.  Normal extensor mechanism.
  • No meniscal tear seen. Intact cruciate ligaments.
  • Preserved chondral surfaces.
  • Normal posterolateral and posteromedial corner structures.
  • Intact collateral ligaments.
  • No focal bone lesions.
  • No popliteal fossa abnormality.

 

IMPRESSION:

Small joint effusion, otherwise unremarkable.

Intact menisci.

Intact cruciate ligaments.

 

REPORT 2:


FINDINGS:

  • Horizontal tear seen in the posterior horn of the lateral meniscus.
  • Intact medial meniscus.
  • Moderate joint effusion is present.
  • Intact medial and lateral collateral ligaments.
  • There is no bony injury.
  • Intact anterior and posterior cruciate ligaments.
  • IMPRESSION:

Lateral meniscus tear.

Joint effusion.

 

 

 

E. APPLIED RADIOLOGY

 

 

ACL Tear

            Check Bruising pattern

            Check Posterolateral corner injury

            Meniscal injury

Sulcus sign

Tibial translation

 

ACL graft – Check

            Loosening anchors in tunnels

            Check tibial tunnel angle and Blumensaat’s line

            Graft patency/ laxity

            Cyclops lesion

 

Meniscal tear

            Parameniscal cyst

            Bucket handle/ flipped fragment/ flap tear

            Meniscal root tear

 

OCD

            Size of lesion

            Stability

            Loose bodies

 

Marrow oedema

            Subchondral insufficiency/ stress fracture