KNEE PROTOCOLS
A Check the clinical indication and choose the correct protocol
B Read any scanning notes to ensure correct positioning and orientation
C Perform the sequences in the order indicated - this is important to ensure a diagnosis in the event the scan is abandoned
Protocols are available for
• Routine meniscal or general ligament injury
• Pattern of OA
• Previous ACL reconstruction
• Previous knee replacement
• MR arthrogram
• Athlete / Professional Sports ?ACL rupture
• Athlete / Professional Sports ?Posterolateral corner injury
• Patellar tracking
IMPORTANT SCANNING NOTES
• The protocols below also indicate slice thickness and FOV to be used where possible
• FSPD (fat saturated proton density) requires a TE of greater than 40ms **
• Slice thickness 3mm or better FOV 12-14cm unless otherwise stated
Routine meniscal or general ligament injury
• Sagittal FSPD
• Coronal FSPD
• Axial FSPD
• Sagittal Sag T1 Drive / Restore
• If under 35 y/o: replace drive with Sagittal T2*
• If previous menisectomy: add Sagittal T2
Pattern of OA
• Sagittal FSPD
• Coronal FSPD
• Axial FSPD
• Sagittal Sag T1 Drive / Restore
• Sagittal Sag T2
Previous ACL reconstruction
• Sagittal T2
• Sagittal PD
• Coronal STIR
• Axial T2
Previous knee replacement
• Sagittal T2
• Sagittal PD
• Coronal STIR
• Axial T2
• Coronal PD
MR arthrogram
• Sagittal FSPD
• Sagittal FST1
• Coronal FSPD
• Coronal FST1
• Axial FSPD
Athlete / Professional Sports ?ACL rupture
• Sagittal FSPD
• Coronal FSPD
• Axial FSPD
• Sagittal Sag T1 Drive / Restore
• Coronal oblique T2 along ACL
Athlete / Professional Sports ?Posterolateral corner injury
• Sagittal FSPD
• Coronal FSPD
• Axial FSPD
• Sagittal Sag T1 Drive / Restore
• Coronal oblique T2 along PCL
Patellar tracking
Both knees flexed >20 deg.
Set up axial rapid GRE T2* dataset to cover the entire patella allowing for its proximal movement as the patient extends.
Run this set repeatedly as the patient extends against resistance using dedicated apparatus or 'inflated beach ball' method (see images 2 and 3 above).
Select the axial image closest to the equator of the patella from each dataset and compile these into a new sequence.
Label this Axial Dynamic Right/Left. A different set is required for each side.
