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Process for Orthopedist MRI Evaluation, Diagnosis Described

Correlating T1- and T2-weighted images and clinical findings key to optimal diagnosis

TUESDAY, Dec. 14 (HealthDay News) -- A systematic approach to the interpretation of magnetic resonance imaging (MRI) scans of musculoskeletal conditions can help orthopedic surgeons develop more complete and accurate patient diagnoses, according to an article published in a supplement to the Dec. 1 issue of the Journal of Bone & Joint Surgery.

Payam Farjoodi, M.D., of the Johns Hopkins Bayview Medical Center in Baltimore, and colleagues note that most orthopedic surgeons do not receive formal instruction on magnetic resonance image evaluation and rely mainly on experience, which can result in incomplete or missed detection of abnormalities. The authors explain MRI pulse sequences and the different uses of T1- and T2-weighted images. They also describe a process to correlate image and clinical findings to arrive at a diagnosis.

Initially, the evaluator should look for an area known to contain fluid (such as intra-articular or cerebrospinal fluid), which is bright in a T2-weighted image and dark in a T1-weighted image. Then, after distinguishing the T1- and T2-weighted images, areas of signal intensity can be identified and correlated for a complete picture of anatomical abnormalities. Finally, the imaging studies should be combined with lab tests, patient history, and physical examination to produce the diagnosis.

"Correlating the clinical findings with an accurate and systematic interpretation of the MRI studies will allow the orthopedic surgeon to better evaluate the patient with a musculoskeletal condition or injury," the authors write.

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