MSK Protocols

Contrast

All MSK exams will require Dotarem GBCA to be used unless otherwise indicated by radiologist.

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.

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

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