MRI Guidance of Musculoskeletal Interventions

Abstract

Magnetic resonance imaging (MRI) presents as an intriguing tool to direct diagnostic and therapeutic procedures performed in the musculoskeletal region and to steer patient management. Studies have demonstrated that MRI-guided procedures involving bone, soft tissue, joints and intervertebral discs are safe and in selected indications preferred action to manage clinical situation. Often these procedures are technically similar to other modalities for bone and soft tissue lesions. However, the procedural perception to the operator can be very different to other modalities due to the vastly increased data. MRI guidance is particularly advantageous should the lesion not be visible by other modalities, for selective targeting, intra-articular locations, cyst aspiration and locations adjacent to surgical hardware. Spine injections and pain management such as sacroiliac joint injections, selective nerve blocks and palliative ablation are a subset of procedures that are frequently performed under MRI. In this chapter we will describe in detail the technical aspects of performing MRI-guided MSK procedures as well as the clinical indications for diagnostic and most common therapeutic procedures and will also touch the new emerging methods for MRI-guided MSK procedures.