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ECR 2019 / C-2064
How to take-on Metal-on Metal in MRI: A Step-By-Step Guide to read Musculoskeletal MRI with Metallic implants.
Congress: ECR 2019
Poster No.: C-2064
Type: Educational Exhibit
Keywords: Arthritides, Imaging sequences, MR, Musculoskeletal joint
Authors: S. RAJAN1, V. Venugopal1, M. Barnwal2, V. Mahajan2, H. Mahajan 2; 1NEW DELHI, DELHI/IN, 2New Delhi/IN

Findings and procedure details

Systematic Approach to read MRI images with metal associated artifacts


1. Don’t Panic


2. Look at the signal on two different planes

  • If it seen on only one plane, and not the other, it might be artefactual.
  • If it is seen on two planes, it is more likely real. (fig 3)

3. Look at the signal on two different sequences 


  • Bright signal on STIR, bright signal on T1 implies an artefact 
  • Bright signal on STIR, dark signal on T1 implies real signal abnormality. (Fig 3)

4. If there is fluid around the joint, look at the lining 

  • Effusion with bright synovial lining & surrounding edema- infection / synovitis 
  • Effusion with dark synovial lining - metallosis  

5. Other finding to look for-

  • Injury to adjacent ligaments 
  • Nerve and vascular injuries  
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