US is also useful in evaluating medial plicae and following patients with iliotibial band syndrome [17,44]. More recently, shear wave elastography has been used to evaluate female patients with patellofemoral pain by demonstrating reduced contraction ratio in the vastus medialis oblique but not the vastus lateralis muscles [49]. Finally, US can diagnose a cyst and determine the vascularity of a mass [37]. Bone Scan Knee Radionuclide bone scan is usually not indicated when initial radiograph is negative or demonstrates a joint effusion. Chronic Knee Pain Image-Guided Aspiration Knee If an aspiration for crystals or atypical/low-grade chronic infection is indicated, it can be facilitated by US or fluoroscopy [10]. Variant 3: Adult or child greater than or equal to 5 years of age. Chronic knee pain. Initial knee radiograph demonstrates osteochondritis dissecans (OCD), loose bodies, or history of cartilage or meniscal repair. Next imaging procedure. Radiography Hip An ipsilateral hip radiograph is usually not indicated to evaluate patients with osteochondritis dissecans (OCD), loose bodies, or history of cartilage repair. CT Knee CT without IV contrast may be indicated to evaluate patients with OCD or a history of cartilage repair, especially to confirm loose bodies or when MRI is not definitive. CT with IV contrast is not usually indicated to evaluate patients with OCD, loose bodies, or history of cartilage repair. CT without and with IV contrast is not usually indicated to evaluate patients with OCD, loose bodies, or history of cartilage repair. CT Arthrography Knee CT arthrography may be used instead of MRI to evaluate the menisci, articular cartilage, and the presence of loose bodies [16]. MRI Knee In patients with OCD or subchondral insufficiency fracture on radiographs, MRI without IV contrast may be indicated if an additional injury is suspected clinically or to clarify the status of the overlying articular cartilage [41].
Chronic Knee Pain. US is also useful in evaluating medial plicae and following patients with iliotibial band syndrome [17,44]. More recently, shear wave elastography has been used to evaluate female patients with patellofemoral pain by demonstrating reduced contraction ratio in the vastus medialis oblique but not the vastus lateralis muscles [49]. Finally, US can diagnose a cyst and determine the vascularity of a mass [37]. Bone Scan Knee Radionuclide bone scan is usually not indicated when initial radiograph is negative or demonstrates a joint effusion. Chronic Knee Pain Image-Guided Aspiration Knee If an aspiration for crystals or atypical/low-grade chronic infection is indicated, it can be facilitated by US or fluoroscopy [10]. Variant 3: Adult or child greater than or equal to 5 years of age. Chronic knee pain. Initial knee radiograph demonstrates osteochondritis dissecans (OCD), loose bodies, or history of cartilage or meniscal repair. Next imaging procedure. Radiography Hip An ipsilateral hip radiograph is usually not indicated to evaluate patients with osteochondritis dissecans (OCD), loose bodies, or history of cartilage repair. CT Knee CT without IV contrast may be indicated to evaluate patients with OCD or a history of cartilage repair, especially to confirm loose bodies or when MRI is not definitive. CT with IV contrast is not usually indicated to evaluate patients with OCD, loose bodies, or history of cartilage repair. CT without and with IV contrast is not usually indicated to evaluate patients with OCD, loose bodies, or history of cartilage repair. CT Arthrography Knee CT arthrography may be used instead of MRI to evaluate the menisci, articular cartilage, and the presence of loose bodies [16]. MRI Knee In patients with OCD or subchondral insufficiency fracture on radiographs, MRI without IV contrast may be indicated if an additional injury is suspected clinically or to clarify the status of the overlying articular cartilage [41].