Magnetic resonance imaging of injuries to bone and articular cartilage. Emphasis on radiographically occult abnormalities

Abstract

Magnetic resonance imaging (MRI) has emerged as the premier noninvasive imaging method for evaluation of the musculoskeletal system. Among the most widely recognized and accepted applications of MRI is that of trauma-related imaging. While the initial emphasis on MRI was directed toward the assessment of soft-tissue structures previously difficult to image (eg, knee menisci and cruciate ligaments), it has become increasingly apparent that MRI is superbly suited to the depiction of a wide spectrum of injuries to bone and articular cartilage. MRI has proved capable of depicting abnormalities ranging from clinically innocuous bone bruises to posttraumatic osteonecrosis. Many of the abnormalities that have been detected by MRI have been radiographically occult and often clinically unsuspected. MRI has become established in the assessment of chondral and osteochondral injuries, insufficiency and stress fractures, occult proximal femoral fractures, tibial plateau fractures, and scaphoid injuries. This review will attempt to present the current state of the art with respect to the application of MRI to the assessment of injuries to bone and articular cartilage. Particular emphasis will be placed on radiographically occult abnormalities.