MRI of the knee in children

Author(s): Dr S Hameed, Dr M Khanna

Hospital: Imperial College Healthcare NHS Trust

Reference: RAD Magazine, 40, 465, 24-26


The knee is the most frequent joint imaged with MRI in children. Common indications include assessment of internal derangement, pain, occult fractures, further evaluation of a radiographic abnormality and refusal to bear weight. Although initial investigation should always be with the plain radiograph, further imaging with MRI is often required for diagnosis and characterisation. MRI has many advantages including lack of ionising
radiation, multiplanar imaging capabilities and excellent resolution, allowing superior evaluation of the structures of the knee. It also provides excellent soft-tissue contrast and detail, allowing accurate assessment of the menisci, ligaments and cartilage.

Injuries in skeletally immature patients are different to adults due to open physes acting as weak points, changing biomechanics, differing ligamentous support and inherent characteristics of the osseous structures. Awareness of the differing injury patterns within skeletally immature patients as compared to those seen in adults, as well as normal variants and normal bone marrow signal evolution, is essential for correct image interpretation.

This review will focus on a few of the common injury patterns seen on MRI of the knee in children.

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