Keywords:
Trauma, Athletic injuries, Structured reporting, Imaging sequences, Audit and standards, Plain radiographic studies, MR, Musculoskeletal system, Musculoskeletal joint, Bones
Authors:
C. Bishop, P. G. White; Torquay/UK
DOI:
10.26044/essr2019/P-0132
Conclusion
Discussion and Conclusions:
We found a significant variation in cartilage reporting / grading in MRI reports at our institution,
- Numerical
- Mild / moderate / severe
- Descriptive
The cartilage was not mentioned at all in 22% of the knee MRI reports included in our study.
50% of the cases with bone marrow oedema and subchondral cysts,
important indicators of osteoarthritis,
were not reported as such.
Research groups have reported that bone marrow oedema correlates well with pain [3],
therefore it is essential to accurately identifiy this on MRI and to include this in the report.
OA is almost always 1 grade worse on MRI than on plain radiograph,
due to
- Cartilage loss is worse
- Bone marrow oedema
- Subchondral cysts
Recommendations made on the basis of our quality improvement project results:
A systematic review of cartilage in each compartment is a fundamental component of knee MRI interpretation,
we recommend providing a cartilage grade for each compartment in the report.
Raise awareness amongst non-musculoskeletal radiologists of cartilage sensitive MRI sequences.
Ensure the use of a simple grading system for OA in MRI knee reports (mild,
moderate and severe)
Repeat quality improvement study in 6 months to monitor improvement