Targeted MRI of the Joints

Diseases of the joints can lead to painful movement restrictions, which significantly reduce the quality of life of the affected persons. An early and accurate diagnosis is necessary in order to be able to identify the early stages of joint diseases and to treat them effectively.

In our Institute for Preventive Medicine in Witten the whole-body magnetic resonance tomography provides high resolution anatomical and functional imaging of the different joints. The bony parts of the joints, the ligaments, the tendons, the articular cartilage as well as the adjacent muscles are visualised.

In the following, we give you an exemplary overview of possible anatomical abnormalities or illnesses in these parts of the body.

Osteoarthritis / Arthritis

Osteoarthritis is a wear-induced, chronic-degenerative joint disorder that can lead to movement restrictions and pain in the joints with increasing severity. Not only the elderly are affected, but even younger people can develop osteoarthritis due to overuse of the joints or repetitive microtrauma.

Patients who suffer from osteoarthritis show a gradual degeneration of the joint cartilage. Furthermore, the bone condenses below the cartilage, showing form anomalies, developing bone cysts or inflammation.

The MRI already detects early stages of joint cavity reduction, bone thickening or bone cysts. A misalignment of the bones involved can also be visualised with the help of the MRI.

Furthermore, we are able to display early stages of arthritis. This is an inflammatory joint disorder in which the joints swell, heat up and ache.

Various basic diseases can cause arthritis, e.g. rheumatic disease patterns can trigger joint inflammation.

During the whole-body MRI, first signs of inflammation can be depicted very well, allowing early and effective therapy.

Cartilage Damage / Meniscus / Intervertebral Discs

Cartilage damage to the joints can only be insufficiently detected by X-rays whereas MRI is a useful tool for measuring and analyzing the smallest cartilage damages and pathological changes of the meniscus (internal and external meniscus of the knee).

A torn meniscus in the knee is one of the standard indications for the MRI examination. Menisci are cartilage discs which act as shock absorbers in the joints. If damage to these structures is not detected, osteoarthritis may occur.

Even the smallest structural changes of the articular cartilage or the menisci can be visualised by MRI and, if necessary, treated by a fast and efficient therapy.

We describe the MRI of the intervertebral discs in the chapter of the pelvis.

Bone Changes

In particular, we make proof of the typical characteristics of the osteochondritis dissecans – a disease of the articular bone-cartilage-tissue of unclear origin. This disease is triggered in some movement-related cases due to injuries of the joint. Joint pains and effusions may occur. MRI imaging supports the evaluation of the accompanying joint effusion, the bony, less vascularized areas and the articular cartilage. Thanks to the MRI, different stages of this bone-cartilage disease can be distinguished from each other.

Furthermore, in addition to the detection of the smallest bone fractures, it is possible to diagnose bone infarcts with the MRI based on an insufficient vascularization of the bone tissue. Making use of a contrast agent helps to improve the quality of diagnostically conclusive images. These infarcts can be caused by blood vessel stenoses.

Bone infarcts often develop without any symptoms, but play a role within patients who need to take cortisone on a regular basis. In these cases the impaired vascularization of the bone tissue is more frequent.

Tumors

Moreover, benign or malignant tumors of the joints’ soft and hard tissues can be detected by MRI. In terms of structural changes of the joints due to malignant tumors, there may be metastases from other tumors (primary tumors) which infiltrate the joints.

In these cases, the MRI is to be used as an objective assessment tool for localisation, visualisation and quantification of the tumor, also taking the adjacent soft tissue and anatomical structures into account.

Inflammation

In recent years, MRI has been established as a diagnostic method for assessing early stages of joint inflammation (see arthritis).

Both inflammation-induced bone changes as well as inflammatory processes of the involved joint structures such as tendons and ligaments can be detected at an early stage with the help of MRI.

We perform these examinations with para-magnetic contrast agents which improve the visibility of internal structures during MRI.

Early diagnosis of a rheumatic joint disease has a positive effect on the disease process. Medication can be adapted in such a way that the progression of rheumatic inflammatory processes can be reduced.

Ligaments

The MRI provides excellent imaging of bone and cartilage as well as of ligaments and tendons. Torn ligaments in the knee or ankle are perfectly visualised.

Joint Effusion

A joint effusion is a fluid accumulation in the joint due to excessive liquid production of the joint’s lining. The effusion occurs as a symptom and can be caused by various diseases and injuries of the joints.

The MRI makes it possible to visualise the liquid accumulation as well as the source of this disorder.

Even the smallest joint effusions can be detected and, if necessary, treated as quickly and appropriately as possible.

Joint Capsule

Each of our joints is surrounded by a stabilizing joint capsule. A capsular rupture can be caused by overuse, hard bumps or falls. Athletes often suffer capsular ruptures of the fingers, toes, knees or feet.

Furthermore, structural changes from joint capsule tumors are visualised (e.g. synovial chondroma = benign cartilage tumor, synovia = joint liquid). Even the first stages of the tumor can be detected with the MRI.

Muscles

Pain within the joint does not always result from diseases of the joint structures. The surrounding muscles might also be the cause of discomfort.

The MRI plays a pivotal role in the diagnosis of soft tissue diseases. It allows a very good tissue characterisation, e.g. small bleedings of the muscles adjacent to the joints can be identified at an early stage.

Overuse-Related Irritations / Disorders

The MRI diagnostics is used as an objective assessment tool for localisation, visualisation and quantification of soft tissues within joints.

Overload-induced irritations of the joints, especially, of the tendons, ligaments and muscles, are reflected in the MRI as non-inflammatory, degenerative diseases, resulting in pain, swelling and functional limitations of the joints. Due to ligament or muscle fiber rupture, the joints also lose their stability.

As an example, we would like to mention the patellar tendinosis (patella = kneecap) – a degenerative disease of the tendon and enthesis, which leads to pain conditions and movement restrictions. In this respect, the MRI monitors the ossification of the enthesis and detects the calcification of the tendon.

For more details, we are happy to answer your questions at the Institute for Preventive Medicine in Witten. Please make an appointment!

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