Normal MRI of the knee

Normal MRI of the knee

Normal MRI of the knee


Introduction

This e-Anatomy anatomical module is dedicated to the anatomy of the knee showing the normal MRI appearance of the ligaments, menisci, tendons and other structures of the knee joint on a high-resolution 3T MRI (multiplanar PD-FS and T1 images).

Magnetic resonance imaging (MRI) of the knee is indicated for various clinical scenarios, particularly when initial radiographs are inconclusive or when detailed soft tissue evaluation is required. The American College of Radiology (ACR) provides comprehensive guidelines on the appropriate use  of MRI for different knee conditions.
1. Chronic Knee Pain: MRI is indicated when initial radiographs are normal or show joint effusion, but pain persists. It is particularly useful for detecting effusions, synovitis, popliteal cysts, subchondral cysts, articular cartilage, and meniscal pathologies.
2. Acute Trauma: In cases of acute knee trauma with negative radiographs, MRI is valuable for the diagnosis of soft tissue injuries, including ligament tears (e.g., anterior cruciate ligament [ACL], posterior cruciate ligament [PCL]), meniscal tears, and bone marrow contusions. It can also identify occult fractures and internal derangements.
3. Suspected Osteoarthritis: MRI can be used to assess the extent of osteoarthritis, particularly when evaluating cartilage loss, bone marrow lesions, and other degenerative changes not well visualized on radiographs.
4. Meniscal and Articular Cartilage Lesions: MRI is indicated for diagnosing meniscal tears and articular cartilage lesions.
5. Anterior Knee Pain: MRI is useful for evaluating anterior knee pain, which may be due to chondral lesions, patellar instability, tendinopathies, and other soft tissue or osseous abnormalities.
6. Postoperative Evaluation: MRI is indicated for evaluating complications after knee surgeries, such as total knee arthroplasty, and to assess soft tissue abnormalities, including tendinopathy, arthrofibrosis and periarticular masses.
These indications highlight the utility of MRI in providing detailed imaging of knee structures, facilitating accurate diagnosis and guiding appropriate management.

 

Material and methods

This MRI of the knee was performed on a healthy female patient using a Siemens 3T MRI.

Magnetic resonance imaging (MRI) of the knee employs various sequences and planes to provide comprehensive evaluation of joint structures. The primary sequences used include:

1. Proton Density with fat suppression (PD-FS): for evaluating meniscal tears, ligament injuries, and cartilage abnormalities and providing high contrast between different tissues.

2. T1 turbo spin echo (TSE): better delineation of some  anatomical structures like muscles and tendons.

The primary imaging planes used in knee MRI are:
1. Sagittal Plane: for evaluating the anterior and posterior cruciate ligaments, menisci, and cartilage.
2. Coronal Plane: for assessing the collateral ligaments, menisci, and overall joint alignment.
3. Axial Plane: used to evaluate the patellofemoral joint, menisci, and the extent of any soft tissue abnormalities.

The anatomical structures were labeled by Antoine Micheau M.D. (Radiologist, Montpellier – France), following Terminologia Anatomica 2.

There is no content here

  • ACR Appropriateness Criteria Chronic Knee Pain.Fox MG, Chang EY, Amini B, et al.Journal of the American College of Radiology : JACR. 2018;15(11S):S302-S312. doi:10.1016/j.jacr.2018.09.016
  • ACR Appropriateness Criteria® Acute Trauma to the Knee.Taljanovic MS, Chang EY, Ha AS, et al.Journal of the American College of Radiology : JACR. 2020;17(5S):S12-S25. doi:10.1016/j.jacr.2020.01.041.
  • MR Imaging of the Knee: Improvement of Signal and Contrast Efficiency of T1-Weighted Turbo Spin Echo Sequences by Applying a Driven Equilibrium (DRIVE) Pulse.Radlbauer R, Lomoschitz F, Salomonowitz E, Eberhardt KE, Stadlbauer A.European Journal of Radiology. 2010;75(2):e82-7. doi:10.1016/j.ejrad.2009.12.008.
  • Usefulness of Turbo Spin-Echo MR Imaging in the Evaluation of Meniscal Tears: Comparison With a Conventional Spin-Echo Sequence.Escobedo EM, Hunter JC, Zink-Brody GC, et al.AJR. American Journal of Roentgenology. 1996;167(5):1223-7. doi:10.2214/ajr.167.5.8911185.
  • Terminologia anatomica: international anatomical terminology By the Federative Committee on Anatomical Terminology (FCAT).  Stuttgart:  Georg Thieme Verlag.  ISBN-10: 3-13-114361-4. ISBN-13: 978-3-13-114361-7
  • Pocket Atlas of Human Anatomy: 5th edition - W. Dauber, Founded by Heinz Feneis
  • Netter, Frank H. (2011) Atlas of human anatomy /Philadelphia, PA : Saunders/Elsevier