MR of the sternoclavicular joints
Radiography in general is the most commonly used method in the evaluation of the sternoclavicular joints. However, this technique is often limited by joint obliquity or overlapping structures. Thus, although radiography is generally optimal for first-line evaluation, further treatment with computed tomography (CT) or magnetic resonance imaging
(MR) is often required for a more complete evaluation of the UC joints.
CT is ideal for diagnosing clavicle fractures with or without joint involvement, joint misalignment or
subtle bony changes. MR, however, is far superior in terms of the accuracy of assessing both intra-articular and extra-articular soft tissue, such as surrounding soft tissue. MR also allows accurate assessment of both bony and soft tissue stability of the joint structure.
Indications for MR imaging of the sternoclavicular joints
MR of the sternoclavicular joint is recommended for such ailments/diseases as:
- patients with SAPHO syndrome (disseminated osteomyelitis involving the axial or peripheral skeleton)
- erosions with associated calcification within the ligament of the joint between the handle and shaft of the sternum and the sternoclavicular joint
- periosteal ossification of the clavicle
- sternoclavicular arthritis
- injuries
- diagnosis of degenerative changes
- Upper limb dysfunction (pain, limited mobility, inability to move)
- infectious osteoarthritis
- Benign or malignant bone tumors
- histiocytosis;
- RA
- dislocations of the sternoclavicular joints
Contraindications for MR imaging of the sternoclavicular joints
MRI of the sternoclavicular joints cannot be performed in patients with permanently placed objects in the body, such as:
- neurostimulator,
- pacemaker,
- insulin pump,
- cochlear implant,
- OLD TYPE implants, endoprostheses, stabilizers, plates and orthopedic screws, which are made of ferromagnetic materials. Current implants are used that can be in the strong electromagnetic field found in MR.
- Shotgun shells, bullet fragments, metal filings in the eye.
Other relative contraindications to MRI are: first trimester of pregnancy.
Preparation for the study.
- You should bring with you the results of all imaging studies that have been performed to date.
- If you are taking medication, you should take it at a consistent time.
- As a precaution, it’s best not to bring anything into the MR lab that contains metal, so in a magnetic field it could pose a danger to both the patient and the equipment and staff in the room – as well as to the reliability of the test results.
- MR of the sternoclavicular joints does not require the removal of clothing. However, the outfit should be comfortable – making it easier to maintain immobility – and free of metal parts, such as zippers, buttons, buckles, underwire and bra hooks, and even sequins and metallic prints.
- It is a good idea to appear for the examination some time in advance, so that you can calmly fill out a questionnaire about your condition and possibly consent to the administration of contrast. The person performing the MRI must also have time to review the medical records of the condition with which the patient is presenting for the MRI.
Course of study.
Our facility has a state-of-the-art Siemens Magnetom Sola MR.
Its software can digitally reduce motion artifacts, so the examination has much higher quality. Nevertheless, the patient should lie still. Various supports, sponges or rollers (stabilizers) are often used for this purpose. MRI of the sternoclavicular joints is completely painless.