What are the normal reporting templates for musculoskeletal (Musculoskeletal) Magnetic Resonance Imaging (MRI)?

Normal MRI Reporting Templates for Musculoskeletal MRI

Standardized reporting templates should be used for all musculoskeletal MRI examinations to ensure comprehensive evaluation, improve communication with referring clinicians, and optimize patient care outcomes.

General Structure for MSK MRI Reports

Based on current guidelines, an effective musculoskeletal MRI report should follow this structure:

1. Clinical Information

• Patient demographics (age, sex)
• Relevant clinical history and symptoms
• Suspected diagnosis or clinical question
• Purpose of examination (primary diagnosis or follow-up)
• Previous imaging available for comparison 1

2. Technical Information

• MRI field strength
• Sequences performed with section orientation and thickness
• Whether fat suppression was applied
• Contrast administration (if used)
• Anatomic coverage
• Statement about image quality and any technical limitations
• Any artifacts that may affect interpretation 1

3. Findings Section

The findings section should be organized by anatomical compartments with appropriate headers rather than as completely free text or excessively itemized lists 2. This "middle ground" approach with headers for different anatomic regions is preferred by referring clinicians.

4. Conclusion/Impression

• Clear statement regarding presence or absence of pathology
• Differential diagnoses if applicable
• Recommendations for further imaging if needed 1

Specific Templates by Joint/Region

Knee MRI Template

TECHNIQUE:

• MRI of the knee performed on [field strength] Tesla scanner
• Sequences: [list sequences - typically sagittal PD, sagittal T2 FS, coronal PD, coronal T2 FS, axial PD FS]
• Slice thickness: [typically 3-4mm]
• [Contrast administration details if applicable]

FINDINGS:

Menisci:

• Medial meniscus: [normal or describe tear pattern/location]
• Lateral meniscus: [normal or describe tear pattern/location]

Cruciate Ligaments:

• ACL: [intact or describe tear/abnormality]
• PCL: [intact or describe tear/abnormality]

Collateral Ligaments:

• MCL complex: [intact or describe tear/abnormality]
• LCL complex: [intact or describe tear/abnormality]

Extensor Mechanism:

• Quadriceps tendon: [normal or describe abnormality]
• Patellar tendon: [normal or describe abnormality]
• Patella: [normal alignment or describe abnormality]

Cartilage:

• Patellofemoral compartment: [normal or describe defects]
• Medial compartment: [normal or describe defects]
• Lateral compartment: [normal or describe defects]

Bone Marrow:

• [Normal or describe bone marrow edema, fractures, lesions]

Joint Fluid:

• [Normal or describe effusion/synovitis]

Other Findings:

• Baker's cyst: [absent or describe if present]
• Other soft tissue abnormalities: [describe if present]

IMPRESSION:

• Summary of key findings
• Clinical correlation if needed

Shoulder MRI Template

TECHNIQUE:

• MRI of the shoulder performed on [field strength] Tesla scanner
• Sequences: [list sequences - typically axial T1/PD, coronal oblique T1/PD/T2 FS, sagittal oblique T2/PD]
• Slice thickness: [typically 3-4mm]
• [Contrast administration details if applicable]

FINDINGS:

Rotator Cuff:

• Supraspinatus tendon: [intact or describe tear/tendinopathy]
• Infraspinatus tendon: [intact or describe tear/tendinopathy]
• Subscapularis tendon: [intact or describe tear/tendinopathy]
• Teres minor tendon: [intact or describe tear/tendinopathy]

Biceps Tendon:

• Long head of biceps: [normal or describe abnormality]
• Biceps labral complex: [normal or describe abnormality]

Labrum:

• Superior labrum: [normal or describe SLAP lesion]
• Anterior labrum: [normal or describe Bankart lesion]
• Posterior labrum: [normal or describe abnormality]
• Inferior labrum: [normal or describe abnormality]

Glenohumeral Joint:

• Articular cartilage: [normal or describe defects]
• Joint fluid: [normal or describe effusion]
• Humeral head: [normal or describe Hill-Sachs lesion]
• Glenoid: [normal or describe bony Bankart]

Acromioclavicular Joint:

• [Normal or describe abnormality]

Subacromial Space:

• [Normal or describe impingement]

Bone Marrow:

• [Normal or describe edema/lesions]

IMPRESSION:

• Summary of key findings
• Clinical correlation if needed

Ankle and Foot MRI Template

TECHNIQUE:

• MRI of the ankle/foot performed on [field strength] Tesla scanner
• Sequences: [list sequences]
• Slice thickness: [typically 3-4mm]
• [Contrast administration details if applicable]

FINDINGS:

Tendons:

• Achilles tendon: [normal or describe abnormality]
• Tibialis anterior: [normal or describe abnormality]
• Tibialis posterior: [normal or describe abnormality]
• Peroneal tendons: [normal or describe abnormality]
• Flexor/extensor tendons: [normal or describe abnormality]

Ligaments:

• Lateral ligament complex: [normal or describe abnormality]
• Deltoid ligament: [normal or describe abnormality]
• Spring ligament: [normal or describe abnormality]

Joints:

• Tibiotalar joint: [normal or describe abnormality]
• Subtalar joint: [normal or describe abnormality]
• Talonavicular joint: [normal or describe abnormality]
• Calcaneocuboid joint: [normal or describe abnormality]

Bones:

• [Normal or describe fractures/edema/lesions]

Plantar Fascia:

• [Normal or describe abnormality]

Soft Tissues:

• [Normal or describe abnormality]

IMPRESSION:

• Summary of key findings
• Clinical correlation if needed

Standard Scan Protocols

For ankle and foot examinations, standard scans should include 1:

1. Anterior longitudinal scan
2. Anterior transverse scan
3. Perimalleolar medial longitudinal scan
4. Perimalleolar medial transverse scan
5. Perimalleolar lateral longitudinal scan
6. Perimalleolar lateral transverse scan
7. Posterior longitudinal scan
8. Posterior transverse scan

Best Practices for MSK MRI Reporting

1. Use standardized terminology to improve communication with referring physicians
2. Include measurements of relevant abnormalities
3. Compare with previous studies when available
4. Label key images for future reference 1
5. Use diagrams to illustrate lesion locations when appropriate 1
6. Save key images of significant findings and note this in the report 1
7. Avoid overly technical language that may confuse referring clinicians

Pitfalls to Avoid

1. Completely unstructured reports - These are less preferred by referring clinicians 2
2. Excessively itemized reports - While structure is important, over-itemization can fragment related findings 2
3. Failure to comment on clinically relevant structures - Always address the structures relevant to the clinical question
4. Inconsistent terminology - Use standard terminology for describing pathology
5. Missing incidental findings - Always evaluate all structures within the field of view

By following these standardized reporting templates, radiologists can ensure comprehensive evaluation of musculoskeletal MRI examinations and optimize communication with referring clinicians, ultimately improving patient care and outcomes.