Assiut university researches
Role of MRI in evaluation of sport injuries in
knee joint
‫دور ال ت صوي ر ب ال رن ين ال م غ ناط ي سى ف ى ت ق ي يم‬
‫اإل صاب ات ال ري ا ض يه ال خا صه ب م ف صل ال رك به‬
Aml Atef Ahmed Abd-Elrahman
‫أمل عاطف أحمد ع بدال رحمن‬
Abd Elkareem Hassan Abd Allah, Mohamed Zidan Mohamed, Abu
Elhassan Hassib Mohamed
‫ أب و ال ح سن ح س يب محمد‬،‫ محمد زي دان محمد‬،‫ع بدال كري م ح سن ع بدهللا‬
Abstract:
Sports-related knee injuries are common, with contact sports
and sports involving twisting movements being the most
frequent causes. Sports injuries may affect any of the knee
structures, including ligaments, menisci, bones, and cartilage
and peri-articular soft tissues. However, relatively few injuries
involve isolated structures, with complexInjuries affecting
multiple structures being much more common: dislocation,
ligaments sprains and cartilage tears. Magnetic resonance
imaging (MRI) has an enormous impact on musculoskeletal
imaging and the knee is the most frequently visualized. MRI
of the knee is most commonly indicated in patients with
suspected injuries of the menisci and cruciate ligaments.
Plain radiographs have little value unless injury is due to
direct impact. Orthopaedic surgeons commonly examine
patients with knee pain; however, precisely diagnosing an
intra-articular cause of pain is difficult. MRI of the knee is
used to diagnose disorders of the knee because the high soft
tissue resolution allows precise imaging of intra-articular
structures. MRI of the menisci has proven useful for more
than 10 years. MRI has become a practical tool for the
evaluation of anterior cruciate ligament (ACL) injuries, with its
high levels of accuracy and sensitivity reported in the
literature. Intra-articular knee lesions are associated with
significant morbidity and frequently need surgical treatment
and rest. Although common, their correct diagnosis still is a
challenge. Clinical tests may be confusing, and delay in
diagnosis can result in socioeconomic problems and
sometimes a worse prognosis. Therefore, complementary
diagnostic tools are often necessary, mainly when suspecting
multiple lesions. MRI (Magnetic resonance imaging) of the
knee provides detailed images of structures within the knee
joint, including bones, cartilage, tendons, ligaments, muscles
and blood vessels, from many angles. MRI is a non invasive
medical test that helps physicians diagnose and treat medical
conditions. MRI uses a powerful magnetic field, radio
frequency pulses and a computer to produce detailed pictures
of organs, soft tissues, bone and virtually all other internal
body structures. The images can then be examined on a
computer monitor, transmitted electronically, printed or copied
to a CD. MRI does not use ionizing radiation (x-rays).
Benefits of MRI is: a noninvasive imaging technique that does
not involve exposure to ionizing radiation, MRI has proven
valuable in diagnosing a broad range of conditions, including
muscular and bone abnormalities, MRI can help determine
which patients with knee injuries require surgery, MRI may
help diagnose a bone fracture when x-rays and other tests
are inconclusive, MRI enables the discovery of abnormalities
that might be obscured by bone with other imaging methods
and MRI provides a noninvasive alternative to x-ray,
angiography and CT for diagnosing problems of the blood
vessels. Risks of MRI: the MRI examination poses almost no
risk to the average patient when appropriate safety guidelines
are followed, If sedation is used, there are risks of excessive
sedation. The technologist or nurse monitors your vital signs
to minimize this risk, although the strong magnetic field is not
harmful in itself, implanted medical devices that contain metal
may malfunction or cause problems during an MRI exam,
There is a very slight risk of an allergic reaction if contrast
material is injected. Such reactions usually are mild and
easily controlled by medication. If you experience allergic
symptoms, a radiologist or other physician will be available
for immediate assistance, Nephrogenic systemic fibrosis is
currently a recognized, but rare, complication of MRI believed
to be caused by the injection of high doses of gadolinium
contrast material in patients with very poor kidney function
and Manufacturers of intravenous contrast indicate mothers
should not breastfeed their babies for 24-48 hours after
contrast medium is given. However, both the American
College of Radiology (ACR) and the European Society of
Urogenital Radiology note that the available data suggest that
it is safe to continue breastfeeding after receiving intravenous
contrast. MRI and MR arthrography are the most commonly
used imaging techniques for evaluating the articular cartilage
of the knee joint in clinical practice. Despite significant
improvements in MRI technology over the past decade, a
major limitation of currently available sequences is their
inability to consistently detect superficial degenerative and
post traumatic cartilage lesions that may progress to more
advanced osteoarthritis. The relatively low sensitivity of these
sequences is mainly attributed to their suboptimal spatial
resolution. However, additional factors, such as partial
volume averaging, suboptimal tissue contrast, and inability to
evaluate articular cartilage in multiple planes, also play
important roles in limiting the sensitivity. In the future, the use
of high-field-strength scanners, multichannel coils, and more
SNR-efficient sequences may allow images of the knee joint
to be obtained with even higher spatial resolution and greater
tissue contrast in clinically feasible scanning times. These
sequences may further improve clinical cartilage imaging and
will allow better identification of patients with knee pain who
may benefit from early medical and surgical intervention.
:‫ال م لخص‬
‫ن أك ثر اإل صاب ات ت ع ت بر إ صاب ات ال رك بة مع األل عاب ال ري ا ض ية م‬
‫ش يوعا ف هى ت حدث ل لري ا ض ين وك ذل ك ل أل شخاص ال عادي ين ال ذي ن ال‬
‫ وي ع ت بر م ف صل ال رك بة من أك ثر ال م ناطق عر ضة‬.‫ي مار سون ال ري ا ضة‬
‫ل هذه اإل صاب ات ح يث أن ه ي ح توى ع لى أرب طة وغ ضاري ف سري عة‬
‫ال تأث ر ألى حرك ات خاط ئة وال تى ت حدث عامة أث ناء ممار سة ال ري ا ضة أو‬
.‫ي ع ت بر ال ت صوي ر ب ال رن ين ال م غ ناط ي سى من أهم ح تى ب دون ها‬
‫ال و سائ ل ال م س تخدمه ل ت شخ يص إ صاب ات م ف صل ال رك بة ل ما ل ه دور‬
‫ ال غ ضاري ف‬, ‫ف عال ف ى ت و ض يح أى من أجزاء م ف صل ال رك بة من أرب طة‬
‫ال هالل ية ‪ ,‬ال عظام واألن سجة ال رخوة حول ال م ف صل‪ .‬عادة ما ي فح صون‬
‫ل رك بة ول كن جراحى ال عظام ال مر ضى ال ذي ن ي عان ون من األم ا‬
‫الي س تط ي عون ت حدي د أ س باب األل م اذا ك ان ت ب س بب إ صاب ات داخل‬
‫ال م ف صل وه نا ي أت ى دور ال ت صوي ر ب ال رن ين ال م غ ناط ي سى‪ .‬وق د ث بت‬
‫أهم ية ال ت صوي ر ب ال رن ين ال م غ ناط ي سى م نذ أك ثر من ‪ 01‬س نوات ف ى‬
‫ال عدي د من األب حاث ال ع لم ية خا صة ف ى ت ق ي يم إ صاب ات ال رب اط‬
‫ف ى و ا صاب ات ال غ ضاري ف ال هالل ية و ال ص ل ي بى األمامى و ال خل‬
‫ارت شاح ال رك بة ح يث أن ه ي حظى ب م س توي ات عال ية من ال دق ة‬
‫وال ح سا س ية‪ .‬عادة ما ت ح تاج اإل صاب ات داخل ال رك بة ال ى ال تدخل‬
‫ال جراحى وال راحة ال سري ري ة ول كن مازال ال ت شخ يص ال صح يح ل إل صاب ه‬
‫ي ة ي م ثل ت حدي ا ك ب يرا‪ .‬وي ع ت بر ال تأخر ف يه ي ؤدى إل ى م شاك ل إج تماع‬
‫وإق ت صادي ة‪ .‬ال ت صوي ر ب ال رن ين ال م غ ناط ي سى هو ف حص ط بى غ ير‬
‫م تداخل وي ساعد األط باء ف ى ت شخ يص وع الج اإل صاب ات ال خا صة‬
‫ب م ف صل ال رك بة ك ما أن ه ي حدد اذا ك ان ال م صاب ي ح تاج إل ى ت دخل جراحى‬
‫أم ال‪ .‬ي وف ر ال ت صوي ر ب ال رن ين ال م غ ناط ي سى إت احة ال صور ل م ف صل‬
‫ي م كن ن قل هذه ال صور ع بر شا شات ال رك بة من عدة زواي ا مخ ت ل فة و‬
‫ال حا سوب وي م كن إر سال ها إل ك ترون يا أو ط ب عها ع لى أق راص م ض غوطة‪.‬‬
‫ال هدف من ال عمل ‪ • :‬معرف ة أ ش كال اإل صاب ات ال ري ا ض ية ال مخ ت ل فة‬
‫ال خا صة ب م ف صل ال رك بة ب وا سطة ال ت صوي ر ب ال رن ين ال م غ ناط ي سى‪.‬‬
‫صيخشت ىف ىسيطانغملا نينرلاب ريوصتلا رودو ةيمهأ نايب •‬
‫ت حدي د طرق ال عالج ف ى اإل صاب ات ال ري ا ض ية ال خا صة ب م ف صل و‬
‫ال رك بة‪.‬‬