Can I Review an MRI of the Knee?
No, as an AI language model, I cannot review, interpret, or analyze actual MRI images—I can only provide clinical guidance about when and how MRI should be ordered and interpreted by qualified radiologists and clinicians. 1
What I Can Do
I can provide evidence-based guidance on:
When to order knee MRI – MRI without IV contrast is the appropriate next imaging study after negative radiographs when internal derangement (meniscal tears, ligament injuries) is suspected, according to the American College of Radiology 2
Clinical indications requiring MRI – Persistent knee pain ≥4 weeks with mechanical symptoms (locking, catching, giving way) warrants non-contrast MRI after radiographs exclude fracture 1
Proper ordering protocols – Always obtain plain radiographs (anteroposterior and lateral views) first to exclude fractures, degenerative disease, and loose bodies before proceeding to MRI 2, 1
What MRI can detect – Non-contrast MRI demonstrates meniscal tears with 96% sensitivity and 97% specificity, accurately depicts ACL/PCL tears, bone marrow contusions, cartilage defects, and joint effusions 2, 3
What Requires a Radiologist
Actual image interpretation must be performed by:
- Board-certified radiologists with expertise in musculoskeletal imaging 3, 4
- Radiologists use systematic approaches to evaluate ligaments, menisci, cartilage, bone marrow, and soft tissues across multiple pulse sequences and imaging planes 4
- MRI interpretation requires correlation with clinical history, mechanism of injury, and physical examination findings 1, 5
Common Clinical Scenarios
When MRI is indicated after negative radiographs:
- Suspected meniscal tear with mechanical locking and focal tenderness 2, 1
- Suspected ACL injury after twisting trauma with instability 2, 1
- Persistent effusion >10 mm on lateral radiograph in patients <40 years old 2
- Evaluation of bone marrow contusions that predict focal osteoarthritis development 2, 6
When MRI is NOT the initial study:
- Acute trauma meeting Ottawa criteria—start with radiographs 2
- Suspected fracture—radiographs first, then CT if fracture classification needed 2
- Post-surgical complications—radiographs first to assess hardware and alignment 2
Key Pitfall to Avoid
Never order MRI without recent radiographs—this represents inappropriate utilization and occurs in approximately 20% of chronic knee pain cases, as plain films must first exclude fractures, degenerative changes, and osseous pathology 1, 6