report cartilage 1

Practical Reporting of Musculoskeletal Imaging Studies: MRI Knee James F Griffith Lecture series  Practical reporting  Everyday clinical scenarios  Informal, my opinion  Interactive We’re not going to talk about  Imaging protocols  Didactic discussion on specific abnormalities Knee  Get a history  Don’t rely on request form  Ask radiographers to request history Report  Should be commensurate with the clinical status  Must address and concentrate on answering clinical question Grade ……… Don’t mention any feature without grading it Qualitative measure : Minimal, mild, moderate, severe Quantitative measure: Small, medium, large (mm long x mm deep x mm wide) This talk : outline  Effusion  Cartilage injury  Meniscal injury  ACL injury  PCL injury Effusion Normally the knee contains a very small amount of fluid “No knee joint effusion” Effusion If slightly more than this: “Slight increase in knee joint fluid” Small Effusion If see more than this: “small”, “medium-sized” or “large” joint effusion Partial ACL tear oblique axial view Partial AM with complete PL tear Mucoid degeneration & ganglion cyst Mucoid degenn Mucoid degenn Ganglion cyst  Preservation of linear striations  ‘Celery stick sign’ How you know it is mucoid degeneration?  Typical appearances  Intraosseous ganglion cysts or fluid leakage  PCL also shows mucoid degeneration PCL tear Complete or partial - intrasubstance Acute or chronic Bone bruising (grade) Associated injury (posterolateral corner) PCL tear complete Discontinuity Diffuse oedema & discontinuity Diffuse oedema & discontinuity  Swelling & discontinuity main signs of complete PCL tear PCL partial tear Partial Partial Partial  Swelling without discontinuity → partial PCL tear PCL tear vs ‘double PCL’ sign Longitudinal split Double PCL sign  Some partial tears may manifest as longitudinal split  Don’t confuse with ‘double PCL’ sign PCL tear & PL corner injury G LCL FFL SMR PT AL PFL PCL tear & LCL tear Popliteofibular ligament Intact Torn Popliteus tendon partial tear Arcuate ligament injury Posterolateral corner capsular injury PCL has propensity for healing Healed PCL Healed PCL  In healed PCL tears, the ligament may elongate  Remains clinically lax Thank you ... articular cartilage Normal articular cartilage Cartilage injury - fibrillation Cartilage injury - fibrillation Cartilage injury - mild OA Mild osteoarthritis with mild (20-25%) irregular diffuse cartilage. .. compartment” Focal cartilage injury - location Focal cartilage injury - location Focal cartilage defect (mild) Focal cartilage defect (moderate) Focal cartilage defect (severe) Focal cartilage defect... articular cartilage mainly at the lateral patellar facet” Cartilage injury - Mild OA “ Mild (10 -25% ) cartilage thinning is present on the weightbearing areas of the medial femorotibial compartment” Cartilage