What is more informative than MRI or ultrasound of the knee joint?

Previous Next In diagnostic centers in St. Petersburg, you can examine the knee joint using MRI and ultrasound, but which of them will better show this or that pathology is the topic of this article. Almost a third of the population suffers from joint diseases. Diseases of the musculoskeletal system affect absolutely all age categories, from children to mature and elderly people. Most often, knee joint damage occurs for the following reasons:

• injuries during sports and road accidents;
• degenerative joint diseases.

• MRI
• Ultrasound

MRI tomograph:

Siemens Magnetom C

Type:

Open (expert class)

What's included in the price:

Diagnostics, interpretation of images, written report from a radiologist, recording of tomograms on CD + free consultation with a neurologist or orthopedist after an MRI of the spine or joint

Ultrasound machine

SAMSUNG SONOACE R7

Class:

Expert (installation year 2019)

What's included in the price:

Diagnostics, interpretation of images, written diagnostic report

Ultrasound or MRI of the knee - what to choose?

With injuries and pain in the knee, the patient usually comes to see an orthopedic traumatologist, who issues a referral for an ultrasound or MRI of the knee joint. In most cases, adult patients are prescribed a tomography of the knee rather than an ultrasound or x-ray, since the informative and diagnostic value of an MRI of the knee is higher. Magnetic resonance imaging better and more accurately visualizes bone and soft tissue structures - ligaments, joint capsule, various cartilage discs, menisci and muscles. However, ultrasound of the knee joint also has its advantages:

• this examination allows you to see the joint in motion;
• Ultrasound is a priority method for examining joints in newborns and infants.

The final decision on the advisability of a particular type of diagnosis is usually made by the attending physician, based on the primary diagnosis and the purposes of the scan. If the patient himself has decided on the need to examine the knee for preventive purposes, it is better to start his diagnostic journey with a more comprehensive MRI of the knee joint.

Indications for ultrasound of joints are:

• trauma (fresh injury or history of injury);
• systemic diseases;
• autoimmune diseases;
• inflammatory, acute and chronic diseases;
• obesity;
• endocrine pathology;
• osteochondropathy (if suspected based on clinical manifestations or confirmed x-ray);
• pain in the joint(s);
• restriction of movements in the area of ​​the joint (joints);
• increase in the volume of the joint (joints), swelling;
• screening study of hip joints in newborns at risk;
• suspected hip dysplasia in newborns;
• suspicion of dislocation (subluxation) of the hip joint in newborns and children up to the first year of life;
• dynamic observation during therapy for dysplasia, dislocation, subluxation of the hip joint in children under the first year of life;
• muscle pain;
• palpable mass formations in the soft tissue area;
• dynamic observation during treatment for inflammatory diseases of joints and tendons (arthritis, tendinitis, tenosynovitis);
• dynamic observation during therapy of traumatic damage to muscles, tendons, ligaments (partial and complete ruptures, sprains);
• suspicion of Becker's cyst;
• suspected rupture of a Becker cyst;
• dynamic observation of bursitis (bursitis).

What is the difference between MRI and ultrasound of the knee joint?

Ultrasound and MRI of the knee joint are two fundamentally different examinations. On an ultrasound, the image is visualized by treating the area being diagnosed with ultrasonic waves. Magnetic resonance imaging is a method of in-depth examination of a joint with a detailed display of all muscle-bone tissues using the effect of nuclear magnetic resonance. During an MRI, the patient is placed in a tomograph where a powerful magnetic field is created. Then the radio frequency pulse sensors are turned on. Under the influence of a magnetic field and RF, the protons of hydrogen atoms in the body's cells begin to vibrate, and this resonance is picked up by the device's computer. It processes the received data and converts it into digital three-dimensional images. This is how a series of MRI images of the knee appear on the installation screen. Since soft tissue cells contain a lot of water, MRI of the knee shows the condition of ligaments, menisci, nerve endings, and tendons better than ultrasound. However, both ultrasound and MRI of the joint do not visualize bone well. They are best examined using x-rays or computed tomography.

How is the procedure performed?

For some musculoskeletal ultrasound examinations, the patient may sit on an examination table or swivel chair. For other ultrasound examinations, the patient is positioned face up or face down on a couch. The radiologist or sonographer may ask you to move or guide the limb being examined to evaluate the anatomy and function of the joint, muscle, ligament, or tendon.

Most ultrasounds of infants and children are performed with the child lying on his or her back on a couch, but a different position may be required.

Once you are on the examination table, a radiologist (a doctor specially trained to observe and interpret x-rays) or sonographer will apply a warm, water-based gel to the area of ​​the body being examined. The gel will help the sensor make safe contact with your body and eliminate air pockets between the sensor and your skin that could block sound waves from entering your body. The transducer is placed on the housing and moved back and forth across the area of ​​interest until the desired images are captured.

As a rule, there is no discomfort from pressure when pressing the sensor on the area being examined. However, if the scan is performed in an area that is too sensitive, you may feel pressure or slight pain from the transducer.

Once the image is acquired, clear ultrasound gel will be wiped off your skin. Any parts that are not washed dry quickly. Ultrasonic gel does not typically stain or discolor clothing.

Cost difference

The affordable price of joint ultrasound allows all patients to undergo examination. You just need to make an appointment for a scan at a time convenient for you. MRI of the knee joint is a more expensive test. However, the information content of MRI of joints is certainly higher than ultrasound examination.

How is soft tissue ultrasound performed?

Ultrasound scanning of soft tissue is a fairly simple procedure. A small amount of gel will be applied to the area to be examined. The sensor will then move across the skin and this will create images that will appear on the ultrasound monitor. These images are stored in a computer for further interpretation. This painless scan usually takes 10 to 15 minutes.

After the procedure is completed, the patient may receive a brief explanation of the results. A full description of the scan results is sent to the attending physician.

When is MRI of the knee better than ultrasound?

Any pathology of the structures of the knee joint can be clearly seen on MRI, which in its diagnostic value is superior to both radiography and ultrasound. X-rays do not show soft tissues, and very often a knee injury is associated with damage to these tissues. Tomography visualizes occult stress fractures much better than CT, since swelling is clearly visible, which does not appear at all on x-rays. An ultrasound of the knee cannot show the ligaments and cartilaginous structures with the same level of detail and does not show the bones very well. If you have any pain in your knee or have suffered an injury, it is better to immediately go to an orthopedist or emergency room for a magnetic resonance imaging scan without wasting time. It will help you accurately and quickly identify:

• all hidden fractures, dislocation and subluxation;
• ruptures of ligaments, tendons and muscles;
• damage to soft tissues, which are characterized by inflammation;
• some systemic diseases.

The tomography procedure does not require any special preparation. You just need to choose a diagnostic center and sign up for an examination in advance. The procedure itself will take 20-30 minutes of your time, and another 30-40 minutes of waiting will be required to receive the results of the study - a series of images and an expert opinion from the doctor. Unfortunately, if you do not have medical knowledge, it will be difficult for you to understand what exactly the radiologist wrote in the conclusion, so the RIORIT clinic offers a free express consultation after an MRI of the joints with an orthopedist who will explain what was revealed during the examination in a simple way, in a language that the patient can understand and recommend therapy if necessary.

Ultrasound of joints is used for:

Indications for ultrasound of joints

• identifying the presence of fluid in the joint cavity;
• diagnosis of injury (ligament ruptures, knee meniscal tears, etc.);
• diagnosis of arthrosis (destruction of joint tissue as a result of metabolic disorders);
• diagnosis of inflammatory diseases such as:
• arthritis or synovitis (inflammation of the synovium of the joint);
• bursitis (inflammation of the joint capsule);
• tendinitis (inflammation of the tendon);
• ligamentitis (inflammation of the ligament), etc.

Disadvantages of MRI of the knee joint

• MRI of the knee joint has a number of severe limitations. Tomography is contraindicated if the patient’s body has metal-containing implants, for example: a steel prosthesis, electronic pacemakers - neuro- or cardiac pacemakers.
• Disadvantages of MRI of the knee include the length of the procedure. It can last 30 minutes, and if the pathology is serious and contrast enhancement is required, then the scanning duration reaches 40-60 minutes.
• During the tomography of the knee joint, any movement is prohibited, as this will negatively affect the clarity and accuracy of the MRI images. Therefore, young children have to undergo MRI of the knee under anesthesia.
• MRI of the knee joint using a closed tomograph can be difficult for people suffering from claustrophobia, epileptic seizures and panic attacks.

When is a knee ultrasound better than an MRI?

For a doctor, the main diagnostic advantage of knee ultrasound is the ability to view the knee as it moves. During an ultrasound scan, the diagnostician may ask the patient to change the position of the knee and evaluate how the anatomical features of the knee joint change in a person in motion. Another significant advantage of this technique is that scanning and tracking of the cause of the disease takes place in real time. This means that the doctor can examine the problem area in more detail, spending more time on it, or in case of a unclear image, try to approach the problem from the other side. Unlike an x-ray, where the image may turn out unclear and therefore it will be difficult for the doctor to make a correct diagnosis and additional examination of the body will be required, ultrasound diagnosis of the knee can be quickly corrected during the scan. Ultrasound is the preferred method for examining the knee joint in young children. The fact is that MRI requires complete immobility of the patient, which is difficult to achieve in newborns and children under 5 years of age. Therefore, MRI of the knee in young children has to be performed under deep sedation, which is an undesirable burden on the child’s body. But an ultrasound of a child’s knee does not require any anesthesia and is very informative. Unlike MRI, ultrasound can be done on people with implants, prostheses, pacemakers and other metal-containing components of the body. The cost of joint ultrasound can also be counted as an advantage, since it is not high compared to MRI. Ultrasound of the knee joint does not require special preparation, except for the recommendation to remove hair from the area being examined for a smoother glide of the sensor. The knee scanning procedure takes place in a lying position. The patient lies on his back on a couch previously covered with a disposable diaper. The doctor applies a special gel to the sensor, and the same gel is applied to the patient’s knee joint. Next, the doctor moves the sensor sequentially in different directions along the front, side, and back sides of the knee. The back of the knee joint is examined while lying on the stomach. The procedure lasts approximately 15 minutes. In complex cases, the examination time may increase to 30 minutes. Ultrasound data of the knee joint are given to the patient with a doctor’s report immediately after the scan.

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Ultrasound of the ankle joint

The ankle joint is formed by the talus and the articular surface of the tibia. Its structure includes many ligaments that are necessary to provide stability. Also, along with an ultrasound of the ankle joint, an examination of the Achilles tendon is performed. The Achilles tendon is the most powerful tendon in the human body and the use of ultrasound to diagnose its pathology is the method of choice. The advantage of performing an ultrasound of the ankle joint is also that this research method uses duplex scanning of the surrounding vessels. This allows you to make an accurate diagnosis when it remains unclear whether the pain and swelling of the joint is caused by injury or a violation of the venous outflow.