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Knee MRI: Procedure, Indications and Findings

A knee MRI is a non-invasive imaging procedure used to produce detailed images of knee structures such as menisci, ligaments, and cartilage. It is radiation-free and highly accurate.

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Things worth knowing about "MRI Knee"

A knee MRI is a non-invasive imaging procedure used to produce detailed images of knee structures such as menisci, ligaments, and cartilage. It is radiation-free and highly accurate.

What Is a Knee MRI?

Magnetic Resonance Imaging (MRI) of the knee is an advanced diagnostic imaging technique that uses powerful magnetic fields and radio waves to generate detailed cross-sectional images of the knee joint. Unlike X-rays or computed tomography (CT), MRI does not use ionizing radiation and is therefore particularly well suited for visualizing soft tissue structures such as ligaments, tendons, menisci, and cartilage.

When Is a Knee MRI Performed?

A knee MRI is typically recommended when clinical examination and X-rays do not provide a sufficient diagnosis. Common indications include:

Meniscus tears: Injuries to the medial or lateral meniscus
Ligament injuries: Such as tears of the anterior or posterior cruciate ligament
Cartilage damage: Wear or injury to the articular cartilage (chondropathy)
Bone marrow edema: Fluid accumulation in bone after injury or illness
Osteoarthritis: Advanced degenerative joint changes
Tumors or cysts: Such as a Baker cyst behind the knee joint
Inflammatory conditions: Such as rheumatoid arthritis or synovitis
Unexplained knee pain: To identify the underlying cause

How Is a Knee MRI Performed?

Before the scan, patients are asked to remove all metallic objects and jewelry. Any metallic implants or pacemakers must be disclosed to the referring physician in advance. The knee is placed inside a dedicated knee coil (receiver coil), which optimizes image quality. The patient lies still on the examination table, which is moved into the MRI scanner. The scan typically takes 20 to 40 minutes. Loud knocking or thumping noises are produced during imaging, so patients are usually provided with earplugs or headphones.

Contrast Agent in Knee MRI

In most cases, a knee MRI is performed without contrast agent. For specific clinical questions -- such as suspected tumors, inflammatory conditions, or post-surgical evaluation -- a gadolinium-based contrast agent may be administered intravenously to better visualize certain structures.

What Does a Knee MRI Show?

MRI provides high-resolution images of the following knee structures:

Menisci (medial and lateral meniscus)
Cruciate ligaments (anterior and posterior) and collateral ligaments
Cartilage (articular cartilage on the femur, tibia, and patella)
Bone (bone structure, edema, fractures)
Tendons (e.g., patellar tendon, quadriceps tendon)
Bursae and joint fluid
Soft tissue surrounding the knee

Advantages and Limitations of Knee MRI

Advantages

No ionizing radiation
Excellent visualization of soft tissue and cartilage
Early detection of injuries and pathologies
Painless and non-invasive procedure

Limitations

Longer examination time compared to X-ray or ultrasound
Not suitable for patients with certain metallic implants or non-MRI-compatible pacemakers
Enclosed scanner can be problematic for patients with claustrophobia (open MRI systems are an alternative)
Higher cost compared to other imaging modalities

How Are the Results Interpreted?

MRI images are analyzed by a radiologist, who produces a written report. This report is shared with the referring physician (e.g., orthopedic surgeon or trauma specialist), who discusses the findings in the context of the patient's clinical symptoms and determines the appropriate course of treatment.

References

Stoller DW. - Magnetic Resonance Imaging in Orthopaedics and Sports Medicine, 3rd Edition, Lippincott Williams and Wilkins, 2007.
Deutsch AL, Mink JH. - MRI of the Musculoskeletal System, Raven Press, 2011.
American College of Radiology (ACR) - ACR Appropriateness Criteria: Acute Trauma to the Knee, available at: www.acr.org

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