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This abundantly illustrated atlas of MR imaging of the knee documents normal anatomy and a wide range of pathologies. In addition to the high-quality images, essential clinical information is presented in bullet point lists and diagnostic tips are included to assist in differential diagnosis. Concise explanations and guidance are also provided on the MR pulse sequences suitable for imaging of the knee, with identification of potential artifacts. This book will be an invaluable asset for busy radiologists, from residents to consultants. It will be ideal for carrying at all times for use in daily reading sessions and is not intended as a reference to be read in the library or in non-clinical settings.



1. Anatomy of the Knee

Sagittal view is the basis for knee MRI including ACL evaluation. To improve delineation of ACL, the knee is slightly flexed (see Chap. 3 for more details). If the slice thickness is 3 mm or so, it is not possible to visualize ACL and PCL in their entire lengths in one plane. Menisci are depicted as bow-tie-shaped structure with homogeneous hypointensity.
Mamoru Niitsu

2. MRI Technical Considerations

It is not possible to diagnose ACL pathology using sagittal MR images acquired with fully or overextended knees.
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3. Anterior Cruciate Ligament (ACL)

ACL is an intra-articular extrasynovial structure.
Mamoru Niitsu

4. Posterior Cruciate Ligament (PCL)

Its mean length is 38 mm and mean width is 13 mm. It becomes thinner as it approaches the tibia, and it is partially embedded within the joint capsule. Its tibial attachment site is located 1 cm below the articular surface.
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5. Medial Collateral Ligament (MCL)

Layer I: Thin sheet that overlies the two heads of the gastrocnemius and the structures of the popliteal fossa.
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6. Lateral Supporting Structures Including Lateral Collateral Ligament (LCL)

The lateral supporting structure of the knee is a compound of several ligaments and tendons and thus is more complex than the medial supporting structure.
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7. Meniscus

Menisci are thought to play a role in maintaining the stability of the tibiofemoral joint, spreading the mechanical weight, shock absorption, and protection of cartilage. It is thought that menisci transmit 60–70% of mechanical weight to the femur and tibia.
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8. Fracture, Subluxation, and Muscle Injury

Tibial plateau fracture (fracture of proximal end of tibia) is one of the most common traumatic fracture of the knee joint.
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9. Pediatric and Adolescent Disorders of the Knee

>Irregular appearance of the distal femur on radiograph.
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10. Osteoarthritis and Bone Marrow Signal Changes

Osteoarthritis (OA) is a joint disease represented by degeneration of cartilage, meniscus, subchondral bone, and other tissues due to ageing and mechanical load, abnormal proliferation of synovium, and bone and cartilage overgrowth.
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11. Disorders of Synovium and Plica

Villous and nodular synovial proliferative disease.
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12. Cystic and Cyst-Like Lesions of the Knee

The lesion has a well-defined border, and its wall is lined by spindle shaped cells.
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