Abstract
Many advances have been made in knee imaging, particularly in the field of magnetic resonance imaging (MRI). Today, MRI of the knee is the most frequently requested MR examination of the musculoskeletal system. It is common practice to acquire an MRI after clinical examination and radiographs in the workup of suspected knee derangement. Frequently, it is the definitive examination, providing critical information regarding the decision to treat conservatively or surgically. These factors have led to the wide acceptance by the clinical community of MR knee studies as a noninvasive replacement for diagnostic arthroscopy.
In this chapter, the spectrum of imaging modalities that are commonly used in the knee will be described first. Second, the most common knee disorders will be discussed, emphasizing the role of MRI.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- 2D:
-
Two-dimensional
- 3D:
-
Three-dimensional
- ACL:
-
Anterior cruciate ligament
- BME:
-
Bone marrow edema
- CR:
-
Conventional radiography
- CT:
-
Computed tomography
- DEFT:
-
Driven equilibrium Fourier transform
- DESS:
-
Double echo steady state
- DF:
-
Distance factor
- EFOVS:
-
Extended field-of-view ultrasound
- ETL:
-
Echo-train length
- FLASH:
-
Fast low-angle shot
- FOV:
-
Field of view
- FS:
-
Fat suppression
- GRE:
-
Gradient-recalled echo
- ITBS:
-
Iliotibial band friction syndrome
- IW:
-
Intermediate-weighted
- MCL:
-
Medial collateral ligament
- MPR:
-
Multiplanar reformat
- MRI:
-
Magnetic resonance imaging
- PAES:
-
Popliteal artery entrapment syndrome
- PAT:
-
Parallel acquisition technique
- PCL:
-
Posterior cruciate ligament
- PD-WI:
-
Proton density-weighted imaging
- PLC:
-
Posterolateral complex
- PS:
-
Pellegrini-Stieda
- SNR:
-
Signal-to-noise ratio
- SPACE:
-
Sampling perfection with application-optimized contrasts using different flip-angle evolutions
- SSFP:
-
Steady-state free precession
- ST:
-
Slice thickness
- T:
-
Tesla
- TA:
-
Acquisition time
- TE:
-
Time to echo
- TF:
-
Turbo factor
- TR:
-
Repetition time
- TSE:
-
Turbo spin-echo
- US:
-
Ultrasound
References
Abreu MR, Chung CB, Trudell D, Resnick D (2008) Hoffa’s fat pad injuries and their relationship with anterior cruciate ligament tears: new observations based on MR imaging in patients and MR imaging and anatomic correlation in cadavers. Skeletal Radiol 37:301–306
Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. AJR Am J Roentgenol 182:1283–1287
Bianchi S, Zwass A, Abdelwahab IF, Banderali A (1994) Diagnosis of tears of the quadriceps tendon of the knee: value of sonography. AJR Am J Roentgenol 162:1137–1140
Boles CA, Martin DF (2001) Synovial plicae in the knee. AJR Am J Roentgenol 177:221–227
Bolog N, Hodler J (2007) MR imaging of the posterolateral corner of the knee. Skeletal Radiol 36:715–728
Campbell SE, Sanders TG, Morrison WB (2001) MR imaging of meniscal cysts: incidence, location, and clinical significance. AJR Am J Roentgenol 177:409–413
Covey DC (2001) Injuries of the posterolateral corner of the knee. Current concepts review. J Bone Joint Surg Am 8-A:106–118
Cummings JR, Pedowitz RA (2005) Knee instability: the orthopedic approach. Semin Musculoskelet Radiol 9:5–16
De Filippo M, Bertellini A, Pogliacomi F et al (2009) Multidetector computed tomography arthrography of the knee: diagnostic accuracy and indications. Eur J Radiol 70:342–351
De Smet AA (2012) How I diagnose meniscal tears on knee MRI. AJR Am J Roentgenol 199:481–499
DeFranco MJ, Bach BR Jr (2009) A comprehensive review of partial anterior cruciate ligament tears. J Bone Joint Surg Am 91:198–208
Farjoodi P, Mesfin A, Carrino JA, Khanna AJ (2010) Magnetic resonance imaging of the musculoskeletal system: basis science, pulse sequences, and a systematic approach to image interpretation. J Bone Joint Surg Am 92(Suppl 2):105–116
Felson DT, Chaisson CE, Hill CL et al (2001) The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 134:541–549
Figueroa D, Calvo R, Vaisman A, Carrasco MA, Moraga C, Delgado I (2007) Knee chondral lesions: incidence and correlation between arthroscopic and magnetic resonance findings. Arthroscopy 23:312–315
Fleckenstein JL, Archer BT, Barker BA et al (1991) Fast short-tau inversion-recovery MRI. Radiology 179:499–504
Fox MG (2007) MR imaging of the meniscus: review, current trends, and clinical implications. Radiol Clin North Am 45:1033–1053
Gold GE, Han E, Stainsby J, Wright G, Brittain J, Beaulieu C (2004) Musculoskeletal MRI at 3.0T: relaxation times and image contrast. AJR Am J Roentgenol 183:343–351
Gold GE, Busse RF, Beehler C et al (2007) Isotropic MRI of the knee with 3D fast spin-echo extended echo-train acquisition (XETA): initial experience. AJR Am J Roentgenol 188:1287–1293
Grover JS, Bassett LW, Gross ML et al (1990) Posterior cruciate ligament: MR imaging. Radiology 174:527–530
Gupta H, Calder SJ, O’Connor PJ (2011) Imaging of extra-articular injuries of the knee. Semin Musculoskelet Radiol 15:59–68
Hargreaves BA, Gold GE, Beaulieu CF, Vasanawala SS, Nishimura DG, Pauly JM (2003) Comparison of new sequences for high-resolution cartilage imaging. Magn Reson Med 49:700–709
Jung JY, Yoon YC, Kwon JW, Ahn JH, Choe BK (2009) Diagnosis of internal derangement of the knee at 3T MR imaging: 3D isotropic intermediate-weighted versus 2D sequences. Radiology 253:780–787
Kalke RJ, Di Primio GA, Schweitzer ME (2012) MR and CT arthrography of the knee. Semin Musculoskelet Radiol 16:57–68
Kijowski R (2010) Clinical cartilage imaging of the knee and hip joints. AJR Am J Roentgenol 195:618–628
Kijowski R, Gold GE (2011) Routine three-dimensional magnetic resonance imaging of joints. J Magn Reson Imaging 33:758–771
Kijowski R, Davis KW, Woods MA et al (2009) Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging – diagnostic performance compared with that of conventional MR imaging at 3T. Radiology 252:486–495
Kijowski R, Blankenbaker DG, Woods M, Del Rio AM, De Smet AA, Reeder SB (2011) Clinical usefulness of adding 3D cartilage imaging sequences to a routine knee MR protocol. AJR Am J Roentgenol 196:159–167
Kijowski R, Choi J, Shinki K, Del Rio AM, De Smet AA (2012a) Validation of MRI classification system for tibial stress injuries. AJR Am J Roentgenol 198:878–884
Kijowski R, Davis KW, Blankenbaker DG, Woods MA, Del Rio AM, De Smet AA (2012b) Evaluation of the menisci of the knee joint using three-dimensional isotropic resolution fast spin-echo imaging: diagnostic performance in 250 patients with surgical correlation. Skeletal Radiol 41:169–178
Kim HK, Shin MJ, Kim SM, Lee SH, Hong HJ (2006) Popliteal artery entrapment syndrome: morphological classification utilizing MR imaging. Skeletal Radiol 35:648–658
Krampla W, Roesel M, Svoboda K, Nachbagauer A, Gschwantler M, Hruby W (2009) MRI of the knee: how do field strength and radiologist’s experience influence diagnostic accuracy and interobserver correlation in assessing chondral and meniscal lesions and the integrity of the anterior cruciate ligament? Eur Radiol 19:1519–1528
Lance E, Deutsch AL, Mink JH (1993) Prior lateral patellar dislocation: MR imaging findings. Radiology 189:905–907
Link TM, Sell CA, Masi JN et al (2006) 3.0 vs 1.5T MRI in the detection of focal cartilage pathology – ROC analysis in an experimental model. Osteoarthritis Cartilage 14:63–70
Link TM, Stahl R, Woertler K (2007) Cartilage imaging: motivation, techniques, current and future significance. Eur Radiol 17:1135–1146
Lotysch M, Mink J, Crues JV, Schwartz SA (1986) Magnetic resonance imaging in the detection of meniscal injuries. Magn Reson Imaging 4:94
Magee T (2007) Three-Tesla MR imaging of the knee. Radiol Clin North Am 45:1055–1062
Magee T, Williams D (2006) 3.0- T MRI of meniscal tears. AJR Am J Roentgenol 187:371–375
Masi JN, Sell CA, Phan C et al (2005) Cartilage MR imaging at 3.0 versus that at 1.5T: preliminary results in a porcine model. Radiology 236:140–150
Mendes LF, Pretterklieber ML, Cho JH, Garcia GM, Resnick DL, Chung CB (2006) Pellegrini-Stieda disease: a heterogeneous disorder not synonymous with ossification/calcification of the tibial collateral ligament-anatomic and imaging investigation. Skeletal Radiol 35:916–922
Messieh SS, Fowler PJ, Munro T (1990) Anteroposterior radiographs of the osteoarthritic knee. J Bone Joint Surg Br 72:639–640
Milewski MD, Sanders TG, Miller MD (2011) MRI-arthroscopy correlation: the knee. J Bone Joint Surg Am 93:1735–1745
Moore SL (2002) Imaging the anterior cruciate ligament. Orthop Clin North Am 33:663–674
Muhle C, Ahn JM, Yeh L et al (1999) Iliotibial band friction syndrome: MR imaging findings in 16 patients and MR arthrographic study of six cadaveric knees. Radiology 212:103–110
Mutschler C, Vande Berg BC, Lecouvet FE et al (2003) Postoperative meniscus: assessment at dual-detector row spiral CT arthrography of the knee. Radiology 228:635–641
Notohamiprodjo M, Horng A, Pietschmann MF et al (2009) MRI of the knee at 3T: first clinical results with an isotropic PDfs-weighted 3D-TSE-sequence. Invest Radiol 44:585–597
Oei EH, Nikken JJ, Verstijnen AC, Ginai AZ, Hunink MG (2003) MR imaging of the menisci and cruciate ligaments: a systematic review. Radiology 226:837–848
Peetrons P (2002) Ultrasound of muscles. Eur Radiol 12:35–43
Ramnath RR (2006) 3T MR imaging of the musculoskeletal system (part II): clinical applications. Magn Reson Imaging Clin N Am 14:41–62
Ramnath RR, Magee T, Wasudev N, Murrah R (2006) Accuracy of 3-T MRI using fast spin-echo technique to detect meniscal tears of the knee. AJR Am J Roentgenol 187:221–225
Rasenberg EI, Lemmens JA, van Kampen A (1995) Grading medial collateral ligament injury: comparison of MR imaging and instrumented valgus-varus laxity test-device. A prospective double-blind patient study. Eur J Radiol 21:18–24
Recht MP, Goodwin DW, Winalski CS, White LM (2005) MRI of articular cartilage: revisiting current status and future directions. AJR Am J Roentgenol 185:899–914
Rennie WJ, Saifuddin A (2005) Pes anserine bursitis: incidence in symptomatic knees and clinical presentation. Skeletal Radiol 34:395–398
Ristow O, Steinbach L, Sabo G et al (2009) Isotropic 3D fast spin-echo imaging versus standard 2D imaging at 3T of the knee – image quality and diagnostic performance. Eur Radiol 19:1263–1272
Roemer FW, Crema MD, Trattnig S, Guermazi A (2011) Advances in imaging of osteoarthritis and cartilage. Radiology 260:332–354
Saddik D, McNally EG, Richardson M (2004) MRI of Hoffa’s fat pad. Skeletal Radiol 33:433–444
Savoye PY, Ravey JN, Dubois C et al (2011) Magnetic resonance diagnosis of posterior horn tears of the lateral meniscus using a thin axial plane: the zip sign – a preliminary study. Eur Radiol 21:151–159
Steckel H, Vadala G, Davis D, Fu FH (2006) 2D and 3D 3-tesla magnetic resonance imaging of the double bundle structure in anterior cruciate ligament anatomy. Knee Surg Sports Traumatol Arthrosc 14:1151–1158
Subhas N, Kao A, Freire M, Polster JM, Obuchowski NA, Winalski CS (2011) MRI of the knee ligaments and menisci: comparison of isotropic resolution 3D and conventional 2D fast spin-echo sequences at 3T. AJR Am J Roentgenol 197:442–450
ter Braak BP, Vincken PW, van Erkel AR et al (2007) Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age? Skeletal Radiol 36:1129–1139
Tol JL, Spiezia F, Maffulli N (2012) Neovascularization in achilles tendinopathy: have we been chasing a red herring? Knee Surg Sports Traumatol Arthrosc 20:1891–1894
Trattnig S, Domayer S, Welsch GW, Mosher T, Eckstein F (2009) MR imaging of cartilage and its repair in the knee – a review. Eur Radiol 19:1582–1594
Tuite MJ, Daffner RH, Weissman BN et al (2012) ACR appropriateness criteria ® acute trauma to the knee. J Am Coll Radiol 9:96–103
Umans H, Wimpfheimer O, Haramati N, Applbaum YH, Adler M, Bosco J (1995) Diagnosis of partial tears of the anterior cruciate ligament of the knee: value of MR imaging. AJR Am J Roentgenol 165:893–897
Van Dyck P, Vanhoenacker FM, Gielen JL et al (2011) Three-tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears? Skeletal Radiol 40:701–707
Van Dyck P, De Smet E, Veryser J et al (2012a) Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging. Knee Surg Sports Traumatol Arthrosc 20:256–261
Van Dyck P, Gielen JL, Vanhoenacker FM et al (2012b) Diagnostic performance of 3D SPACE for comprehensive knee joint assessment at 3T. Insights Imaging 3:603–610
Van Dyck P, Gielen JL, Vanhoenacker FM, Wouters K, Dossche L, Parizel PM (2012c) Stable or unstable tear of the anterior cruciate ligament of the knee: an MR diagnosis? Skeletal Radiol 41:273–280
Vande Berg BC, Lecouvet FE, Poilvache P et al (2002) Spiral CT arthrography of the knee: technique and value in the assessment of internal derangement of the knee. Eur Radiol 12:1800–1810
Weinberg EP, Adams MJ, Hollenberg GM (1998) Color Doppler sonography of patellar tendinosis. AJR Am J Roentgenol 171:743–744
Weng L, Tirumalai AP, Lowery CM et al (1997) Ultrasound extended-field-of-view imaging technology. Radiology 203:877–880
West AT, Marshall TJ, Bearcroft PW (2009) CT of the musculoskeletal system: what is left is the days of MRI. Eur Radiol 19:152–164
Wijdicks CA, Griffith CJ, Johansen S, Engebretsen L, LaPrade RF (2010) Injuries to the medial collateral ligament and associated medial structures of the knee. Current concepts review. J Bone Joint Surg Am 92:1266–1280
Yao L, Dungan D, Seeger LL (1994) MR imaging of tibial collateral ligament injury: comparison with clinical examination. Skeletal Radiol 23:521–524
Yoo WJ, Lee K, Moon HJ et al (2012) Meniscal morphologic changes on magnetic resonance imaging are associated with symptomatic discoid lateral meniscal tear in children. Arthroscopy 28:330–3336
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Van Dyck, P., Desbuquoit, D., Gielen, J.L.M.A., Parizel, P.M. (2015). Radiologic Imaging of Knee Injuries. In: Glaudemans, A., Dierckx, R., Gielen, J., Zwerver, J. (eds) Nuclear Medicine and Radiologic Imaging in Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46491-5_29
Download citation
DOI: https://doi.org/10.1007/978-3-662-46491-5_29
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-46490-8
Online ISBN: 978-3-662-46491-5
eBook Packages: MedicineMedicine (R0)