Mark level of pain / symptoms / clinical concern.
NOTE: If this is a follow up scan for healing only, the first sequence below (wide FOV images of both thighs) is NOT necessary
• Wide FOV Coronal STIR both Thighs in their entirety (may require 2 scans)
- Then switch to affected side only for better resolution. Further scans of both sides are unnecessary
- Target the area of injury as shown by the wide FOV scan already completed (or marked symptomatic area if no injury is seen). Cover the full injury or 20cm whichever is larger. 3mm slice thickness please, unless injury is very extensive when 4mm thickness is acceptable.
• Axial Dixon (Water sensitive)
• Axial T1
• Sagittal FSPD
• Coronal FSPD
• Axial FSPD full length of hamstrings - hip to knee.
Quadriceps
• Wide FOV Coronal STIR both Thighs in their entirety (may require 2 scans)
-then switch to affected side only for better resolution
- Target the marked/symptomatic area. Cover the full injury or 20cm whichever is larger
• Axial STIR 3mm slices 20cm FOV
• Sagittal STIR 3mm slices 20cm FOV
• Coronal STIR 3mm slices 20cm FOV
• Axial FSPD 3mm
• Axial T1 3mm
Calf muscle injury
• Wide FOV Coronal STIR both Calves
-then switch to affected side only for better resolution. Cover all of the injury
• Axial STIR 3mm slices 20cm FOV
• Sagittal STIR 3mm slices 20cm FOV
• Axial FSPD 3mm
• Axial T1 3mm
Chest/Abdominal Wall Side Strain injury
Place marker.
Lie patient on symptomatic side to reduce chest wall movement.
• STIR coronal wider FOV to detect injury- include L/S Junction and pain marker
THEN REDUCE TO SMALL FOV FOR HIGH RESOLUTION OF THE INJURED AREA for the following
• Straight axial STIR covering the full extent of the injury
• Straight axial T1
• Tilted sagittal FSPD - align parallel to the injury as seen on axial images (or to nearest rib)
• Coronal oblique high res T2FS angled on sagittal, perpendicular to the closest rib to injury
Pectoralis muscle injury
The protocol is similar to the shoulder, but extends more inferiorly to include pec major tendon insertion. Make sure to cover 12cm below the top of the humeral head.
Begin with a wide FOV image of the pec major:
• STIR coronal wider FOV to detect injury
THEN REDUCE TO SMALL FOV FOR HIGH RESOLUTION OF THE TENDON ATTACHMENT for the following
• Axial FSPD
• Coronal FSPD tilted along the pec major tendon (see image alongside for left shoulder)
• Coronal T1 also tilted as above
• Sagittal oblique FSPD - perpendicular to coronals
• Sagittal oblique T1
Groin Athletic Pubalgia Sportsmans hernia
• Coronal wide FOV STIR pelvis - include sacrum and adductors, from umbilicus above to upper thigh
• Coronal T1 pelvis - include sacrum and adductors, and anterior to base of scrotum
• Sagittal FST2 (512 matrix) between lateral acetabular walls
• Sagittal T1 (512 matrix) smaller FOV between lateral acetabular walls
• Axial T2FS include both hips
• Oblique FSPD see adjacent image
• If necessary, extend the axial T2FS to include any areas of adductor muscle oedema
