Musculoskeletal Imaging in the Pregnant and Postpartum Patient

Abstract

Musculoskeletal (MSK) imaging in the pregnant and postpartum patient includes advanced magnetic resonance imaging (MRI) with fluid-sensitive sequences which depict bone and muscle injuries not detected by other MRI studies and ultrasound. Neither produces ionizing radiation and, in most cases, intravenous contrast is not needed limiting risks even in pregnant patients. With MSK-specific MRI, new insights can be gained on stress injuries/fractures in the pelvis and pain syndromes, osteitis pubis, osteitis condensans ilii, transient osteopenia of the hip, and sports-related injuries. Muscle and skeletal injuries associated with childbirth including pubic and sacral diastasis can be evaluated more completely providing information, which may lead to improved management. Pelvic MSK infections can be diagnosed earlier with the use of MSK MRI preventing complications. Ultrasound can be used for evaluation of superficial MSK structures and for detection of round ligament varicosities and occult hernias during pregnancy. Advances in MRI with MR neurography and in high-resolution ultrasound increase the value imaging can provide in the diagnosis and management of neuropathy in those patients with atypical or severe presentations.