MSK MRI Protocols

Contrast

  • All MSK exams will require Dotarem GBCA unless otherwise specified by a radiologist.

Guidelines for MSK MRI

  • If you don’t know, then ask.

    • We would much rather answer questions up front than try to compensate for a bad scan after the fact.

    • During the day, start with the MSK reading room (4-5739, 4-6547, 5-9076). Overnight, the second call radiology resident is responsible.

  • Pay attention to the localization, and use the localization guides.

  • Look for metal, and adjust the protocol accordingly (see Metal Imaging section).

  • Be sure you are covering the entire area of concern. This is especially important for tumor and infection cases.

  • Pay attention to the fat saturation. Poor fat suppression can render some of these exams almost uninterpretable. Use additional STIR or Dixon sequences if the fat saturation is incomplete.

  • If you don’t know, then ask.


Metal Imaging (Rods, Plates, Arthroplasties, Etc.)

  • Scan patient on 1.5T magnet, not 3T

  • Increase bandwidth

  • Substitute STIR for all T2 fat sat sequences

  • Substitute PD Dixon or STIR for all PD fat sat sequences

  • If with contrast:

    • Axial or Coronal T1 fat sat pre-contrast

    • Axial or Coronal T1 fat sat post contrast (same plane as T1 fat sat pre-contrast)

    • T1 post contrast without fat sat in the other two planes.


MSK Positioning/Localizer Technique


MSK MRI protocols August 2022

  • Shoulder (Routine)

  • Shoulder MR Arthrogram

  • Pectoralis Major

  • Chest Wall

  • Sternum

  • Elbow (Routine)

  • Elbow MR Arthrogram

  • Wrist (Routine)

  • Wrist MR Arthrogram

  • Hand

  • Finger or thumb

  • Long Bone Infection or Tumor

  • Pelvis (MSK)

  • Pelvis (Athletic Pubalgia, Sports Hernia, Symphysis)

  • Hip (Routine)

  • Hip MR Arthrogram

  • Sacrum

  • Knee (Routine)

  • Knee MR Arthrogram

  • Ankle (Routine)

  • Ankle MR Arthrogram

  • Foot (Hindfoot)

  • Foot (Midfoot or Forefoot)