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All MSK exams will require Dotarem GBCA unless otherwise specified by a radiologist.
Guidelines for MSK MRI
Guidelines for MSK MRI
If you don’t know, then ask.
We would much rather answer questions up front than try to compensate for a bad scan after the fact.
During the day, start with the MSK reading room (4-5739, 4-6547, 5-9076). Overnight, the second call radiology resident is responsible.
Pay attention to the localization, and use the localization guides.
Look for metal, and adjust the protocol accordingly (see Metal Imaging section).
Be sure you are covering the entire area of concern. This is especially important for tumor and infection cases.
Pay attention to the fat saturation. Poor fat suppression can render some of these exams almost uninterpretable. Use additional STIR or Dixon sequences if the fat saturation is incomplete.
If you don’t know, then ask.
Metal Imaging (Rods, Plates, Arthroplasties, Etc.)
Metal Imaging (Rods, Plates, Arthroplasties, Etc.)
Scan patient on 1.5T magnet, not 3T
Increase bandwidth
Substitute STIR for all T2 fat sat sequences
Substitute PD Dixon or STIR for all PD fat sat sequences
If with contrast:
Axial or Coronal T1 fat sat pre-contrast
Axial or Coronal T1 fat sat post contrast (same plane as T1 fat sat pre-contrast)
T1 post contrast without fat sat in the other two planes.
MSK Positioning/Localizer Technique
Shoulder (Routine)
Shoulder MR Arthrogram
Pectoralis Major
Chest Wall
Sternum
Elbow (Routine)
Elbow MR Arthrogram
Wrist (Routine)
Wrist MR Arthrogram
Hand
Finger or thumb
Long Bone Infection or Tumor
Pelvis (MSK)
Pelvis (Athletic Pubalgia, Sports Hernia, Symphysis)
Hip (Routine)
Hip MR Arthrogram
Sacrum
Knee (Routine)
Knee MR Arthrogram
Ankle (Routine)
Ankle MR Arthrogram
Foot (Hindfoot)
Foot (Midfoot or Forefoot)
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