Kinematic MRI of the Joints: Functional Anatomy, Kinesiology, and Clinical Applications PDF

Preface

"Kinematics" is the branch of mechanics dealing with the study of motion. While traditional kinematic analyses (i.e., motion analysis systems that utilize external markers) form the cornerstone to the biomechanical assessment of joint function, interpretation of such data is limited with respect to identifying the internal factors contributing to abnormal joint motion (pathokinematics) and dysfunction. On the other hand, kinematic magnetic resonance imaging (MRI) provides a means by which the intricacies of joint function can be evaluated for both diagnostic and research purposes. The fact that images can be obtained during active motion provides the ability to thoroughly evaluate the interactions of osseous structures and the contribution of muscle action and other soft tissues to joint function.

Kinematic MRI techniques were developed in recognition of the fact that certain pathologic conditions that affect the joints are position-dependent and/or associated with stressed or "loaded" conditions. Information obtained using kinematic MRI procedures often serves to definitively identify and characterize the underlying abnormality or to supplement the information acquired with standard MRI techniques. Combining kinematic MRI with routine MRI views of the joint provides a means of conducting a more thorough examination and can improve the diagnostic yield of the imaging procedure.

The inspiration for this book came from our perceived need for a comprehensive text that would be the definitive resource on this topic. Because the development of most of the kinematic MRI techniques has been the result of the collaborative efforts of radiologists, biomechanists, physical therapists, orthopedic surgeons, and MR physicists, Kinematic MRI of the Joints was written by a carefully selected, international panel of leading experts in these various fields.

This book is organized into separate sections for each joint. The first chapter of each section provides information on pertinent functional anatomy and kinesiology, which serves as the foundation for understanding the abnormal conditions that may be assessed using kinematic MRI. Next, each section has one or more chapters devoted specifically to kinematic MRI, which describe the techniques and protocols, as well as a discussion of normal kinematics and pathokinematics seen using this imaging method. Notably, multiple case examples are provided to illustrate the usefulness of kinematic MRI for diagnosis or elucidation of pathologic conditions.

Kinematic MRI of the Joints was written primarily for two audiences: radiologists and clinicians. For the radiologist, this book is designed to be a reference text that guides the technical and practical aspects of performing and interpreting kinematic MRI examinations. For the clinician, this book provides a concise review of normal and abnormal joint function and describes how information obtained from kinematic MRI can be used to better interpret clinical findings and guide appropriate treatment of common orthopedic conditions. Additionally, we feel that orthopedic surgeons will find particular value in this book insofar as the use of MRI is a daily part of their clinical practice. Orthopedic surgeons should become familiar with the spectrum of kinematic MRI applications that exist, which will enable them to improve therapeutic decisions.

The final section of this book describes unique and emerging applications of kinematic MRI (Chapter 17, Kinematic MRI of the Knee: Preliminary Experience Using the Upright, Weight- Bearing Technique and Chapter 18, The Extremity MR System: Kinematic MRI of the Patellofemoral Joint). Finally, we included a Glossary that provides definitions of common terms from the fields of biomechanics and radiology used in this book.

We hope that this book serves to expand the clinical use of kinematic MRI procedures and to stimulate additional research and development that will further contribute to the understanding of normal and pathological joint function.