Magnetic Resonance Imaging of the Knee

Magnetic Resonance Imaging of the Knee

This abundantly illustrated atlas of MR imaging of the knee documents normal anatomy and a wide range of pathologies
In addition to the high-quality images, essential clinical information is presented in bullet point lists and
diagnostic tips are included to assist in differential diagnosis Concise explanations and guidance are also provided
on the MR pulse sequences suitable for imaging of the knee, with identification of potential artifacts This book will
be an invaluable asset for busy radiologists, from residents to consultants It will be ideal for carrying at all times
for use in daily reading sessions and is not intended as a reference to be read in the library or in non-clinical
settings



xv
Anatomy of the Knee 1
Sagittal Views 1
Coronal Views 6
Axial Views 8

2 MRI Technical Considerations 11
Positioning and Fixation of the Knee 11
Acquisition of Images in the Sagittal Plane 11
T1-Weighted and Proton Density-Weighted Fast Spin-Echo Sequences 12
Magic Angle Effect 14
In-Phase and Out-of-Phase Imaging 16
Usefulness of Axial Images 16
Techniques for Fat Suppression 16
Metallic Artifacts 17
Magnetization Transfer Contrast (MTC) Method, MT Effect 19
Imaging Techniques for Cartilage 19

3 Anterior Cruciate Ligament (ACL) 25
Anatomy 25
Image Acquisition 27
MRI Findings of Normal ACL 29
Characteristics of ACL Tear 29
Complete Tear of ACL 30
Partial Tear of ACL 31
Acute Tear of ACL 32
Chronic Tear of ACL 32
Loss of ACL 32
Discontinuous Band 34
Continuous Band with Elongation 36
Degeneration of ACL 37
Secondary Signs Suggesting ACL Tear 38
Fracture of the Intercondylar Eminence 41
ACL Reconstruction 42
MRI Findings of Reconstructed ACL 44
ACL Graft Tear and Its Complications 45
Post-arthroscopic Changes of Infrapatellar Fat Pad 49
Conservative Therapy of Torn ACL 51
Contents

xvi Contents

4 Posterior Cruciate Ligament (PCL) 53
Anatomy 53
PCL Tear 55
MRI Findings of PCL Tear 56

5 Medial Collateral Ligament (MCL) 63
Anatomy 63
MCL Tear 65
Pellegrini-Stieda Syndrome 68

6 Lateral Supporting Structures Including Lateral
Collateral Ligament (LCL) 71
Anatomy 71
LCL Tear 78
Avulsion Fracture of the Fibular Head 79
Segond Fracture 81
Avulsion Fracture of the Gerdy’s Tubercle 82
Iliotibial Band Friction Syndrome 83
Popliteus Musculotendinous Injury 84

7 Meniscus 85
Anatomy 85
Medial and Lateral Menisci 85
Delineation of Meniscal Lesions by MRI 87
Meniscal Tear 88
Bucket-Handle Tear of the Meniscus 99
Meniscal Lesions in the Elderly 102
Peripheral Meniscal Tear and Meniscocapsular Separation 104
Discoid Meniscus 108
Meniscal Calcification, Ossicles, and Vacuum Phenomenon 110
Meniscal Calcification 110
Ossicles 111
Vacuum Phenomenon 112
MRI Findings of Postoperative Menisci 113
Pitfalls for Imaging of Meniscal Lesions 117

8 Fracture, Subluxation, and Muscle Injury 123
Tibial Plateau Fracture 123
Patellar Fracture 126
Patellar Dislocation 127
Tangential Osteochondral Fracture 130
Patellar Sleeve Fracture 131
Osteochondritis Dissecans 132
Traumatic Hemarthrosis 135
Stress Fracture and Fatigue Fracture 135
Bone Bruise 136
Musculotendinous Injury 137

Contents xvii

9 Pediatric and Adolescent Disorders of the Knee 141
Distal Femoral Cortical Irregularity 141
Femoral Condylar Irregularity 143
Painful Patella Partita 145
Dorsal Defect of the Patella 148
Osgood-Schlatter Disease 149
Sinding-Larsen-Johansson Disease 151
Jumper’s Knee 152
Blount Disease 153
Congenital Absence of the ACL 155

10 Osteoarthritis and Bone Marrow Signal Changes 157
Osteoarthritis 157
Spontaneous Osteonecrosis/Subchondral Insufficiency Fracture 159
Bone Marrow Reconversion 163

11 Disorders of Synovium and Plica 165
Pigmented Villonodular Synovitis (PVS) 165
Giant Cell Tumor of Tendon Sheath 166
Synovial Osteochondromatosis 167
Synovial Hemangioma 168
Lipoma Arborescens 169
Hoffa’s Syndrome 169
Amyloidosis 174
Plica Syndrome 175
Suprapatellar Plica 176
Mediopatellar Plica 177
Infrapatellar Plica 179

12 Cystic and Cyst-Like Lesions of the Knee 181
Intra-articular Ganglion 181
Meniscal Cyst 183
Popliteal Cyst (Baker’s Cyst) 185
Posterior Capsular Area of the Knee 188
Bursa and Bursitis 191
Prepatellar Bursa 192
Superficial Infrapatellar Bursa 193
Deep Infrapatellar Bursa 194
Pretibial Bursa 195
Pes Anserine Bursa 196
Iliotibial Bursa 197
Periarticular Ganglion 198

Index 199