RT Book, Section
A1 Malone, Terry R.
A1 Hazle, Charles
A1 Grey, Michael L.
SR Print(0)
ID 5941201
T1 Chapter 9. The Knee
T2 Imaging in Rehabilitation
YR 2008
FD 2008
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-154946-2
LK accessphysiotherapy.mhmedical.com/content.aspx?aid=5941201
RD 2024/04/24
AB Imaging  of  the  knee  has  changed  dramatically  during  the  past  10  years  as  a  result  of  enhanced  imaging  capabilities  but  also  owing  to  a  better  appreciation  of  the  pathology  or  injury,  and  thus  planning  of  surgical  intervention  or  other  treatment.  The  primary  challenges  at  the  knee  include  multiple  joints,  weight-bearing  functions,  and  a  variety  of  anatomic  structures.  Because  clinicians  always  attempt  to  gain  the  greatest  assurance  of  detail,  they  have  often  accepted  the  use  of  magnetic  resonance  imaging  (MRI)  as  requisite  to  models  of  "best  practice."  Importantly,  the  use  of  plain  radiography  coupled  with  appropriate  physical  examination  provides  very  acceptable  levels  of  sensitivity  and  specificity  for  most  routine  clinical  examinations  (O'Shea,  1996).  The  use  of  MRI  is  best  applied  in  complex  patients  (multiple  injuries)  or  where  structural  tissue  differentiation  is  desired,  particularly  if  surgical  planning  can  be  enhanced.  The  most  common  approach  for  MRI  use  is  to  use  T1-weighted  images  to  outline  basic  anatomic  detail  and  T2-weighted  images  to  better  define  specific  structures  (particularly  soft  and  fibrous  tissues)  and  to  provide  greater  contrast.  A  very  exciting  evolution  is  to  use  additional  modifications  such  as  high-resolution  proton  density–fast  spin  echo  (FSE)  to  elucidate  and  map  articular  cartilage  changes  which  occur  early  in  the  "disease  process"  and  thus  permit  clinicians  hopefully  to  treat  patients  better  based  on  predicted  outcomes  (Figure  9–1).