Sport Specific MRI. The symptoms of the majority, if not all sports injuries are experienced when upright, and weight-bearing

Transcription

1 Sport Specific MRI The symptoms of the majority, if not all sports injuries are experienced when upright, and weight-bearing A complete, accurate MRI assessment can only be made when in the position of maximal pain or discomfort This is NOT possible lying down in a MRI scanner but is easily assessed when weight-bearing or in the position of maximal discomfort in our truly open Upright MRI Scanner

2 Sport Specific weight-bearing Positional MRI, images each joint in the position of maximal pain

3 Sport Specific Positional weight-bearing MRI Imaging demonstrates the full extent of athletic injury, which is not possible in conventional supine scanners

4 Extension

5 Flexion

6 Lateral Bending

7 Extension Flexion

8 Extremity Positioning Versatility

9

10 Feet and Ankles

11 Standing MRI - Sagittal plane T1 Weighted Fat Suppressed Water Suppressed

12 Standing MRI - Coronal plane T1 Weighted Fat Suppressed Water Suppressed Ganglion cyst of the flexor tendon of the third toe, lying between 3 rd and 4 th metatarso-phalangeal joint

13 Intermediate Cuneform malaccia T1 Weighted T2 Weighted T2 Weighted

14 Ankle joint ligaments Posterior Talo-fibular ligament Calcaneo-fibular ligament Posterior intermalleolar ligament Posterior Talo-fibular ligament Calcaneo-fibular ligament

15 Ankle joint ligaments Healing tear Tibio-calcaneal ligament

16 Weight-bearing MRI Pronation of the hindfoot Accurate angular measurements prior to surgery

17 Upright low magnetic field strength MRI Minimal artefact from surgical screws and plates

18 Surgical screw in calcaneum Low-field strength magnet (0.6Tesla) Gives less ferro-magnetic susceptibility artefact than at higher magnetic field strength (1.5 Tesla). T1 Weighted T2 Weighted

19 Standing Weight-bearing MRI Bare foot In Running Shoe Shoe + Orthotic

20 Standing - Weight-bearing MRI Bare foot In Running Shoe Shoe + Orthotic

21 Weight-bearing knee and ankle examination SE TE = 30 TR = mm FOV = 16 cm 3:27 Weight-bearing Extremity Scanning

22 Knees Weight-bearing X-rays Why not weight-bearing MRI?

23 T2 Weighted Fat Suppression Water Suppression Smith/Carter Fat and Water separation imaging sequence Unique to MEDSERENA Upright MRI Centres

24 Osteochrondritis Dessicans T2 Weighted Fat Suppressed Water Suppressed Smith/Carter Fat and Water separation imaging sequence Unique to MEDSERENA Upright MRI Centres

25 Patellar tendinitis

26 Sequestered osteochondral fragment

27 Contusion PCL Fat Suppressed Water Suppressed

28 Medial meniscus tear

29 O Donahue s Terrible triad ACL rupture Meniscal tear MCL tear + Bone bruising

30 Dynamic weight bearing MRI Extension Flexion

31 Hips Weight-bearing Dynamic Imaging

32 Painful Left Hip 17 year old boy with treated left SUFE Now complains of painful clicking left hip Standing on both legs

33 Painful Left Hip Flexed left hip. i.e. Standing right leg

34 Painful Left Hip Flexed right hip Flexed left hip Treatment. Arthroscopic debridement of the anterior labrum

35 Sport Specific MRI improves diagnostic accuracy resulting in improved treatment planning

36 Medserena Upright MRI - Review The Ultimate in truly open weight-bearing MRI Unique Patient Positioning System Translate, Rotate, Elevate Positional Imaging Flexion, Extension, Lateral Bending, Rotation Standing, Sitting, Upright, Weight-bearing Scan patients in the position that generates pain Patient positioning plays a critical role in detecting otherwise occult pathology