By Adrian Baddar, MD, FAAOS
The importance of medical imaging cannot be overstated. The development of the simple X-ray at the turn of the century has profoundly affected medicine, especially orthopaedics. For the first time, we could image the bones inside a person by looking from the outside.
This technology has only continued to improve. With the development of CT, ultrasound and MRI, we can see internal structures with incredible precision and resolution. While each of these has its own special uses, MRI stands out for its ability to see structures down to millimeter resolution. Stronger and more powerful machines, such as those at 1.5 Tesla and higher, have significantly increased this performance. Each tissue, such as bone, tendon, ligament, muscle, nerve, fat and others, can be seen distinctively, and the smallest abnormality can be detected. MRI can detect rotator cuff tears in the shoulder, meniscus tears in the knee, labral tears in the hip and many others.
MRI uses a large magnetic field that penetrates the tissues to produce images in a non-harmful manner, unlike X-rays and CT, which use cancer-causing ionizing radiation. It is a painless procedure with no specific preparation that typically requires the patient to recline in a position of comfort. While claustrophobia has been an issue, newer machines have increased the size of the opening that a patient is placed into and has dramatically decreased the time needed for a scan. Most sequences can be completed in under 30 minutes with these newer, higher-powered models, such as the 3T (Tesla) MRI. While the MRI remains more expensive than other modalities, the cost has dropped dramatically over the past couple of decades.
MRI has become more commonly used as a screening tool due to its speed, efficiency, increased resolution and decreasing costs. With its millimeter accuracy, small tumors and metastases can be identified easily. Often, the type of the lesion can be determined from its appearance on imaging, which can aid in its identification and appropriate treatment. With early detection, these treatments have a much higher chance of eradicating issues before it is too late.
When used in orthopaedics, MRI is a versatile tool in treating musculoskeletal conditions, as it can be used to accurately see hard and soft tissues, including bones, muscles, joints, tendons, cartilage and nerves. Multiple studies have found MRI to be the best imaging technique for several different types of pathology. This technique allows orthopaedic providers to “see” inside a person to more thoroughly evaluate issues and guide treatment.
MRI is a gold-standard approach to visualizing the body’s anatomy and physiology. Through its high sensitivity and accurate imaging, it can provide vital information about the body that can lead to more accurate and often faster diagnosis, which can ultimately result in a better prognosis.
Adrian T. Baddar, MD, FAAOS, is a board certified orthopaedic surgeon at Hampton Roads Orthopaedics Spine and Sports Medicine specializing in minimally invasive joint replacement surgery, complex joint revisions, sports medicine, arthroscopy, and general orthopaedics. hrosm.com
