Name of the Procedure:

Magnetic resonance imaging (MRI), any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences.

Summary

An MRI of any joint in the lower extremity (such as the knee, hip, or ankle) provides detailed images of the joint structures. It is performed first without contrast material and then with a contrast agent to enhance the visibility of tissues, followed by additional imaging sequences.

Purpose

The MRI aims to diagnose joint injuries or conditions such as tears, inflammation, or degeneration. It provides clear images of bones, cartilage, tendons, and ligaments, assisting in accurate diagnosis and treatment planning.

Indications

• Persistent joint pain or swelling
• Suspected ligament or tendon tear
• Unexplained joint instability
• Evaluation of joint deterioration due to arthritis
• Pre-surgical assessment or post-surgical evaluation

Preparation

• Remove all metal objects (jewelry, watches) before the procedure.
• Inform the healthcare provider of any metal implants or devices.
• Fasting is generally not required.
• Inform the radiologist of any allergies, particularly to contrast material.

Procedure Description

1. The patient is positioned on an MRI table.
2. An initial set of images is taken without contrast material.
3. A contrast agent is then injected intravenously to highlight specific tissues.
4. Additional MRI sequences are performed to enhance and clarify the images.
5. The entire process is monitored by a radiologic technologist.

Duration

Typically, the procedure takes about 45 to 90 minutes.

Setting

The MRI is performed in a radiology department of a hospital or an outpatient imaging center.

Personnel

• Radiologist
• Radiologic technologist
• Nurse or medical assistant (for contrast agent administration)

Risks and Complications

• Allergic reaction to the contrast material (rare)
• Claustrophobia or discomfort from the MRI machine
• Nephrogenic systemic fibrosis (extremely rare, related to kidney function)
• Temporary discomfort at the injection site

Benefits

• Provides detailed images of joint structures.
• Non-invasive with no radiation exposure.
• Helps in accurate diagnosis and treatment planning.
• Can prevent the need for exploratory surgery.

Recovery

• No recovery time is typically needed.
• Normal activities can be resumed immediately unless advised otherwise.
• Hydrate well to help flush out the contrast material.
• Follow-up appointments as necessary based on the results.

Alternatives

• X-rays: Less detailed, best for viewing bones.
• CT scans: Useful for complex bone fractures but with radiation exposure.
• Ultrasound: Good for soft tissue injuries but less clear than MRI.
• Physical examination and clinical history alone.

Patient Experience

• The patient may feel cold or warm sensations from the contrast injection.
• It is essential to lie still during imaging to ensure clear images.
• Loud noises from the MRI machine are common; ear protection is usually provided.
• Some patients may feel claustrophobic; sedation or open MRI machines are alternatives.

Pain management and comfort measures include providing cushions, blankets, and communication systems to stay in touch with the technologist during the procedure.