Magnetic Resonance Imaging (MRI) of the Bones, Joints, and Soft Tissues

Magnetic resonance imaging (MRI) uses a large magnet, radiofrequencies, and a computer
to
make
detailed pictures of organs and structures within the body. It is used to diagnose
health
problems.

The
MRI machine is a large, tube-shaped machine that creates a strong magnetic field around
the person being examined. Some look like narrow tunnels, while others are more open.
This magnetic field, along with a radiofrequency, briefly redirects the hydrogen atoms’
natural alignment in the body. Computers are then used to form
2-dimensional
(2D) images of a body structure or organ based on the activity of the hydrogen atoms.
Cross-sectional views can be done to show more details. MRI does not use ionizing
radiation, like X-rays or computed tomography
(CT)
scans. 

An
MRI scan
may be used to
look
at bones, joints, and soft tissues such as cartilage, muscles, and
tendons for things like:

  • Injuries, such as
    fractures
    or tears to a tendon,
    ligament,
    or
    cartilage
  • Structural abnormalities due to aging
  • Infection like
    osteomyelitis
  • Tumors
  • Inflammatory disease
  • Congenital abnormalities (those you’re born with)
  • Osteonecrosis (bone cell death caused by a poor blood supply to the area)
  • Bone marrow disease
  • Degenerative joint problems, like arthritis
  • Herniation or degeneration of
    disks
    of the spinal cord
  • Assessment after surgical procedures

There
may be other reasons for your healthcare provider to recommend an MRI
scan
of the bones, joints, or soft tissue.

There is no risk of exposure to radiation during an MRI
scan.

Due
to the use of the strong magnet,
an
MRI
scan
can’t be used for people
with:

  • Implanted pacemakers
  • Some older intracranial aneurysm clips
  • Cochlear implants
  • Certain prosthetic devices
  • Implanted medicine infusion pumps
  • Neurostimulators
  • Bone-growth stimulators
  • Certain intrauterine contraceptive devices (IUDs)
  • Any other type of iron-based metal implants
  • Internal metallic objects in certain areas, such as bullets or shrapnel, surgical clips, pins, plates, screws, metal sutures, or wire mesh

If
you are pregnant or think you may be, tell your healthcare provider. In general, there
is no known risk of MRI in pregnancy.
But
particularly in the first trimester, MRI should only be used to address very important
problems or suspected abnormalities.

If contrast dye is used, there is a risk for allergic reaction to the dye. If you are allergic to or sensitive to medicines, contrast dye, or iodine, tell your healthcare providers.

MRI
contrast may have an effect on other
conditions. These
include
allergies, asthma, anemia, low blood pressure, kidney disease, and sickle cell
disease. It can
also
affect
the baby if you are breastfeeding.

Nephrogenic systemic fibrosis (NSF) is a very rare but serious complication of MRI contrast use in people with kidney disease or kidney failure. If you have a history of kidney disease, kidney failure, kidney transplant, liver disease, or are on dialysis, be sure to tell the MRI technologist or radiologist before getting the contrast.

There
may be other risks depending on your specific
health
condition.
Talk
about any concerns with your healthcare provider before the
procedure.

Be
sure to tell the radiologist,
the
technician
(the
person
doing
the test),or your
healthcare provider if you:

  • Have
    ever had an
    imaging test
    (MRI
    or CT)
    with contrast
    dye
  • Are
    allergic to contrast dye, iodine, shellfish, or any
    medicines
  • Have
    a serious health
    problem, such
    as
    diabetes or kidney
    disease
  • Are
    pregnant or may be pregnant
    or
    are breastfeeding
  • Have
    any implanted devices, metal
    clips,
    or pins in your
    body

Your healthcare provider will explain the procedure to you and give you a chance to ask any questions.

If
your MRI scan
involves the use of contrast dye, you will be asked to sign a consent
form that gives permission to do the procedure. Read the form carefully and ask
questions if anything is not clear.

Generally, there is no special restriction on diet or activity before an
MRI
scan.

Before the MRI
scan, it is
very
important that you
tell
the technologist if any of theseapply
to you:

  • You are
    claustrophobic and think that you will be unable to lie still inside the scanning
    machine, in which case you may be given a
    sedative.
  • You
    have a pacemaker or have had heart valves
    replaced.
  • You have
    any type of implanted pump, such as an insulin
    pump.
  • You
    have metal plates, pins, metal implants, surgical staples, or aneurysm
    clips.
  • You have
    any metallic fragments anywhere in the
    body.
  • You
    have permanent eyeliner or
    tattoos.
  • You are
    pregnant or think you may be
    pregnant.
  • You
    ever had a bullet
    wound.
  • You have
    ever worked with metal (for example, a metal grinder or
    welder).
  • You
    have any body
    piercings.
  • You have
    an intrauterine device
    (IUD).
  • You are
    wearing a medicine
    patch.

There
is a possibility that you may get a sedative before the procedure.So
you should plan to have someone drive you home afterward.

Based on your
health
condition, your healthcare provider may
ask
for other specific
preparations.

MRI may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your healthcare provider’s practices.

Generally, MRI of the bones, joints, or soft tissue follows this process:

  1. You will be asked to remove any clothing, jewelry, eyeglasses, hearing aids, hairpins, removable dental work, or other objects that may get in the way of the procedure.
  2. If you are asked to remove clothing, you will be given a gown to wear.
  3. If you
    are to have an MRI
    scan
    with contrast, an intravenous (IV) line will be started in your
    hand or arm for injection of the contrast dye.
  4. You will lie on a narrow table that slides into the large circular opening of the scanning machine. Pillows and straps may be used to help prevent movement during the scan.
  5. The
    technologist will be in another room where the scanner controls are located.
    But
    you will be in constant sight of the technologist through a window.
    Speakers inside the scanner allow the technologist to talk to you and hear you. You
    will have a call button so that you can let the technologist know if you have any
    problems during the scan. The technologist will be watching you at all times and will
    be in constant communication.
  6. A loop of conducting material called a surface coil may be placed over the area to be examined if it is a relatively small area, such as a joint.
  7. You will be given earplugs or a headset to wear to help block out the noise from the scanner. Some headsets may provide music for you to listen to. During the scanning process, you will hear clicking and thumping noises as the magnetic field is created and pulses of radio waves are sent from the scanner.
  8. It will be important for you to stay very still during the exam. Any movement could cause distortion and affect the quality of the scan.
  9. At certain times, you may be told to hold your breath, or to not breathe for a few seconds, depending on the body part being examined. You will then be told when you can breathe. You should not have to hold your breath for longer than a few seconds.
  10. If contrast dye is used, you may feel some effects when the dye is injected into the IV line. These effects include a warm flushing sensation or a feeling of coldness, a salty or metallic taste in the mouth, a brief headache, itching, or nausea. These effects usually only last for a few moments.
  11. Tell
    the technologist right away if you have any
    trouble
    breathing,
    sweating, numbness, or heart palpitations.
  12. Once the scan is done, the table will slide out of the scanner and you will be helped off the table.
  13. If an IV line was put in, it will be removed.

While the MRI
scan
itself causes no pain, having to lie still for the length of the procedure might cause
some discomfort or pain, particularly if you’ve recently been injured or had surgery.
The technologist will use all possible comfort measures and
do
the
scan
as quickly as possible to minimize any discomfort or pain.

On
occasion, some people with metal fillings in their teeth may
feel
some slight tingling of the teeth during the
scan.

Move
slowly when getting up from the scanner table
so
you don’t have any dizziness or lightheadedness from lying flat for
the length of the procedure.

If
any sedatives were used for the
scan,
you may need to rest until the sedatives have worn off. You will also need someone to
drive you home.

If
contrast dye is used, you may be
watched
for some
time
for any side effects or reactions to the contrast dye, such as itching, swelling, rash,
or trouble breathing.

If
you notice any pain, redness, or swelling at the IV site after you go home, tell your
healthcare provider.This
could be a sign of infection or other type of reaction.

Otherwise, there is no special type of care required after a MRI scan of the bones, joints, and soft tissues. You may go back to your usual diet and activities, unless your healthcare provider tells you differently.

Your healthcare provider may give you other instructions after the procedure, depending on your particular situation.

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and
    how
    you
    will
    get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much
    you
    will
    have to pay for the test or procedure