LOWER LIMB MRI

HIP FEMUR TIB FIB ANKLE FOOT

Indication • Loose body • Tumors • Tumors • Tendonitis • Tumor
• Unexplained hip pain; e.g.: • Infection • Infection • Achilles tendon • Infection
AVN, mets. • Muscle tear • Muscle tear rupture • Bone trauma
• Suspected occult #. • AVN of talus
• Muscle tears. • Evaluation of lateral
• Soft tissue pathology. ligament complex
Equipment • Spine coil (post) and • Spine coil (post) and • Spine coil (post) and • Knee coil • Extremity coil/head
• Bilateral: Body coil/body • Body array coil (ant) • Body array coil (ant) • Immobilization pads coil
phased array (ant) • Immobilization pads • Immobilization pads & straps • Immobilization pads
• Unilateral: Small/large flex & straps & straps • Ear plugs & straps
coil (ant) • Ear plugs • Ear plugs • Ear plugs
• Immobilization pads &
straps
• Ear plugs
Positioning • Supine; head first • Supine; head first • Supine; feet first • Supine • Supine
• Legs straight • Legs straight • Legs straight • Foot & ankle within • Foot & ankle within
• Feet parallel to each other • Feet parallel to each • Feet parallel to each knee coil the coil
• Immobilized & straps both other other • Dorsiflex foot • Dorsiflex foot
feet • Immobilized & straps • Immobilized & straps • Elevate foot & ankle • Elevate foot & ankle
• Longitudinal light: midline both feet both feet • Longitudinal light: • Longitudinal light:
• Horizontal light: level of • Longitudinal light: • Longitudinal light: midline midline
femoral heads midline midline • Horizontal light: • Horizontal light: level
• Horizontal light: • Horizontal light: level malleoli of of ROI
midpoint of femur/ midpoint of tib fib/ interest
over ROI over ROI
*unilateral: offset ROI as *unilateral: offset ROI as
closed as possible to closed as possible to
isocenter isocenter
*palace oil-or water *palace oil-or water filled
filled marker (e.g.: fish marker (e.g.: fish oil
oil capsule) over capsule) over palpable
palpable lesion lesion
Sequences • Cor FSE T2 + FS/STIR: • Sag STIR: • Cor SE T1: • Ax SE T1: • Ax SE T1:
 Thin slices  Medium slices  As diagnostic seq  To evaluate tendon  To evaluate tarsal
 Frm post-ant margin  Slice orientation:  Medium slices of ankle, & metatarsal
of musculature of hip parallel to long axis  Frm post-ant aspect vasculature, nerves curvature
of femur of lower legs; whole  Thin slices  To provide clear
• Cor SE T1 (as above) tib fib  Frm origin if anatomical
• Cor SE T1: Achilles tendon to structures
• Ax SE T1:  Medium slices • Cor/Sag STIR: bottom of  Thin slices
 Thin slices  Frm ant-post skin  Medium slices calcaneum  Frm end of toe to
 Above articulator surface; entire  Slice orientation tarsal bones
portion of acetabulum femur along line of leg • Ax FSE PD/T2 +FS
to sup edge of lesser  Slice orientation:  Frm post-ant of calf;  Similar to Ax SE T1 • Ax FSE PD/T2 + FS:
trochanter parallel to long axis whole legs  Useful to classify  Demo jt effusion,
to femur tendon injury & mass lesion &
• Cor SE T1 identify jt effusions collections
• Ax SE T1:  Medium slices  FS useful to demo  FS enables
 Use to to localize  Slice orientation subtle trabecular visualization of
lesions along line of leg damage & cartilage subtle trabecular
 Medium slices  Frm post-ant of calf; damage in stress #
 Cover the entire whole legs of metatarsal
lesion seen on cor bones
& sag images • Ax SE T1:  Thin slices
 Useful to localize  Frm end of toe to
• Ax FSE T2 + FS: lesions tarsal bones
• Sag FSE T2 +FS  Use to to localize  Medium slices
 To demo flattening of lesions  Frm above & below
femoral head  Medium slices lesion seen in sag &
associated with AVN  Cover the entire cor planes • Sag SE T1/FSE PD
 Thin slices lesion seen on cor  To evaluate tendon
 Frm lat aspect of & sag images • Ax FSE T2+FS (as Ax & bony component
greater trochanter SE T1) of ankle
through the articular  Thin slices
potions of acetabulum  Frm lat – med of
ankle; whole foot &
ankle

• Sag FSE T2 +FS/ STIR

 Similar to Sag T1
 Useful to demo jt
effusion
tendonopathy & • Sag SE T1:
calcaneal or tarsal #  Thin slices
 Frm lat to medial of
• Cor SE T1/FSE PD/T2 foot; frm sole of
+FS foot to distal tibia
 To demo collateral • Sag FSE PD/STIR /T2 +
ligaments FS:
 To visualize distal  Thin slices
portion of post  Lat to med of foot ;
tibialis tendon frm sole to distal
 Thin slices tibia
 Frm Achilles tendon
to base of prox
metatarsal