Now a days, Knee injuries are a common source of morbidity as a result of increasing sports and gym activities and if overlooked may result in chronic functional impairment.

Magnetic resonance (MR) imaging of the knee has become the most commonly performed musculoskeletal MR examination and is an indispensable tool in the appropriate management of the injured athlete.

Internal derangement of knee joint is the most frequent indications for surgical intervention and an understanding of the anatomy, biomechanics, mechanisms of injury, and patterns of injury are all critical to accurate diagnosis and appropriate management.

MSK 1 Part(2) Imaging of Knee Joint course provides a fundamental knowledge of –

• MRI protocol and MRI anatomy of knee joint.
• MRI imaging of internal derangement of knee joint.
• Knee Radiographs.
• Radiographs of knee osteoarthrosis with classification.
• Patellofemoral instability with trochlear dysplasia.
• Cruciate, meniscal and collateral pathologies.
• Posterolateral corner structures.      

After completing this course, the participants will be better able to:

• Understand common clinical scenarios and imaging appearances of knee joint   
• Document imaging details relevant to management.

The provided text discusses the common radiographs used in musculoskeletal imaging, focusing on knee X-rays. It begins by mentioning the indications for knee X-rays, which are typically done for patients experiencing knee pain. The common causes of knee pain, such as osteoarthritis, trauma, or tumors, are briefly mentioned. The text then describes the different views used in knee X-rays, including the AP (anteroposterior) view, lateral view, and skyline view. It emphasizes the importance of obtaining weight-bearing radiographs for evaluating osteoarthritis. The correct positioning and interpretation of these views are explained.

The text further discusses the approach to reading knee X-rays. It suggests starting with the lateral radiograph and tracing the cortices of the femur, tibia, fibula, and patella. The extensor mechanism and important soft tissue structures are also examined. The normal appearance of the Suprapatellar recess and other fat pads is highlighted. The frontal radiograph is then examined, focusing on the joint spaces and identifying any abnormalities in the medial or lateral compartments.

Specific abnormalities that can be identified on knee X-rays are mentioned. These include osteochondritis dissecans (OCD) in the medial femoral condyle, meniscal ossicles, and thickening of the medial collateral ligament. The importance of correlating radiographic findings with patient history and physical examination is emphasized.

Overall, the text provides an overview of the indications, techniques, and approach to interpreting knee X-rays, with a focus on identifying common abnormalities.

In summary, the speaker discussed various findings in knee radiographs. They mentioned the presence of effusion in both radiographs, indicating an underlying issue. They pointed out the deep sulcus sign, which can suggest an ACL injury but cautioned against overcalling it without considering the patient's history and other factors. The speaker also mentioned Segond fracture, fibular collateral ligament avulsions, and sulcus terminalis depression, all of which are associated with ACL and PCL injuries.

Moving on to the anterior compartment, the speaker mentioned a patellar sleeve avulsion fracture, which is more common in children. They highlighted the importance of considering the patient's history before making any conclusions based on the radiograph.

The speaker briefly touched upon osteoarthritis, emphasizing the significance of joint space narrowing in diagnosing the condition. They described the Kellgren Lawrence grading system, which categorizes osteoarthritis based on the presence of osteophytes, joint space narrowing, and subchondral sclerosis. They emphasized the importance of comparing the affected knee with the opposite knee and considering meniscus pathology as a possible cause of joint space narrowing.

The speaker mentioned that while X-rays play a crucial role, an MRI may be necessary to determine the appropriate management for the patient. They concluded by mentioning the use of scanograms to measure varus valgus LDFA and MTTA angles, which are relevant to the treatment options discussed later in the presentation.

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