Knee MRI, with its high soft tissue contrast is one of the main imaging tools to depict knee joint pathology. MRI allows accurate imaging of intra-articular structures such as ligaments, cartilage, menisci, bone marrow, synovium, and adjacent soft tissue.
Knee exams require a dedicated extremity coil, providing a homogenous imaging volume and high SNR to ensure best signal coverage. A complete knee MR examination includes for example sagittal and coronal T1 weighted, and proton density weighted pulse sequences +/- fat saturation, or STIR sequences. For high spatial resolution, maximal 4 mm thick slices with at least an in plane resolution of 0.75 mm and small gap are recommended. To depict the anterior cruciate ligament clearly, the sagittal plane has to be rotated 10 - 20° externally (parallel to the medial border of the femoral condyle). Retropatellar cartilage can bee seen for example in axial T2 weighted gradient echo sequences with Fatsat. However, the choice of the pulse sequences is depended of the diagnostic question, the used scanner, and preference of the operator.
Diagnostic quality in knee imaging is possible with field strengths ranging from 0.2 to 3T. With low field strengths more signal averages must be measured, resulting in increased scan times to provide equivalent quality as high field strengths.
More diagnostic information of meniscal tears and chondral defects can be obtained by direct magnetic resonance arthrography, which is done by introducing a dilute solution of gadolinium in saline (1:1000) into the joint capsule. The knee is then scanned in all three planes using T1W sequences with fat suppression. For indirect arthrography, the contrast is given i.v. and similar scans are started 20 min. after injection and exercise of the knee.
Frequent indications of MRI scans in musculoskeletal knee diseases are:
e.g., meniscal degeneration and tears, ligament injuries, osteochondral fractures, osteochondritis dissecans, avascular bone necrosis and rheumatoid arthritis.

See also Imaging of the Extremities and STIR.

Advantages of low field imaging are the small-sized 5 Gauss fringe field and therefore the less static magnetic field exposure for the surrounding area, as well as less contraindications causing lower risks for the MRI safety by implemented metal and magnetic devices and equipment.
Low field systems are sometimes for restricted use, e.g. dedicated extremity scanner or open MRI devices. Open MRI devices equipped with permanent magnets are well-suited for MR guided interventions because these machines combine the lower magnetic fields of this type of magnets and the better patient access of open MRI scanner.
In some cases, the contrast of different tissues is better at lower field strength, depending on their T1 or T2 relaxation times. The disadvantage of the lower signal to noise ratio are a poor resolution and a longer scan time for a good image quality.

See also Claustrophobia, Contraindications and MRI Safety.

See also the related poll result: 'In 2010 your scanner will probably work with a field strength of'

Lung imaging is furthermore a challenge in MRI because of the predominance of air within the lungs and associated susceptibility issues as well as low signal to noise of the inflated lung parenchyma. Cardiac and respiratory triggered or breath hold sequences allow diagnostic imaging, however a comparable image quality with computed tomography is still difficult to achieve.
Assumptions for lung MRI:
The current trends in MRI are the use of new imaging technologies and increasingly powerful magnetic fields. Among these technologies are parallel imaging techniques as well as ventilation agents like hyperpolarized helium for the use as an inert inhalational contrast agent to study lung ventilation properties. With hyperpolarized gases clear images of the lungs can be obtained without using a large magnetic field (see also back projection imaging). Single shot sequences (e.g. TSE or Half Fourier Acquisition Single Shot Turbo Spin Echo HASTE) used in lung MR imaging benefits from parallel imaging techniques due to reduced relaxation time effects during the echo train and therefore reduced image blurring as well as reduced motion artifacts.
In the future, more effective contrast agents may provide an alternative solution to the need for high field MRI. Dynamic contrast enhanced MRI perfusion has demonstrated a potential in the diagnosis of pulmonary embolism or to characterize lung cancer and mediastinal tumors. 3D contrast enhanced magnetic resonance angiography of the thoracic vessel.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'

The MRI device is located within a specially shielded room (Faraday cage) to avoid outside interference, caused by the use of radio waves very close in frequency to those of ordinary FM radio stations.
The MRI procedure can easily be performed through clothing and bones, but attention must be paid to ferromagnetic items, because they will be attracted from the magnetic field. A hospital gown is appropriate, or the patient should wear clothing without metal fasteners and remove any metallic objects like hairpins, jewelry, eyeglasses, clocks, hearing aids, any removable dental work, lighters, coins etc., not only for MRI safety reasons. Metal in or around the scanned area can also cause errors in the reconstructed images (artifacts). Because the strong magnetic field can displace, or disrupt metallic objects, people with an implanted active device like a cardiac pacemaker cannot be scanned under normal circumstances and should not enter the MRI area.
The MRI machine can look like a short tunnel or has an open MRI design and the magnet does not completely surround the patient. Usually the patient lies on a comfortable motorized table, which slides into the scanner, depending on the MRI device, patients may be also able to sit up. If a contrast agent is to be administered, intravenous access will be placed. A technologist will operate the MRI machine and observe the patient during the examination from an adjacent room. Several sets of images are usually required, each taking some minutes. A typical MRI scan includes three to nine imaging sequences and may take up to one hour. Improved MRI devices with powerful magnets, newer software, and advanced sequences may complete the process in less time and better image quality.
Before and after the most MRI procedures no special preparation, diet, reduced activity, and extra medication is necessary. The magnetic field and radio waves are not felt and no pain is to expect.
Movement can blur MRI images and cause certain artifacts. A possible problem is the claustrophobia that some patients experience from being inside a tunnel-like scanner. If someone is very anxious or has difficulty to lie still, a sedative agent may be given. Earplugs and/or headphones are usually given to the patient to reduce the loud acoustic noise, which the machine produces during normal operation. A technologist observes the patient during the test. Some MRI scanners are equipped with televisions and music to help the examination time pass.
MRI is not a cheap examination, however cost effective by eliminating the need for invasive radiographic procedures, biopsies, and exploratory surgery. MRI scans can also save money while minimizing patient risk and discomfort. For example, MRI can reduce the need for X-ray angiography and myelography, and can eliminate unnecessary diagnostic procedures that miss occult disease.

See also Magnetic Resonance Imaging MRI, Medical Imaging, Cervical Spine MRI, Claustrophobia, MRI Risks and Pregnancy.
For Ultrasound Imaging (USI) see Ultrasound Imaging Procedures at Medical-Ultrasound-Imaging.com.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'

The subacute risks and side effects of magnetic and RF fields (for patients and staff) have been intensively examined for a long time, but there have been no long-term studies following persons who have been exposed to the static magnetic fields used in MRI. However, no permanent hazardous effects of a static magnetic field exposure upon human beings have yet been demonstrated.
Temporary possible side effects of high magnetic and RF fields:
The results of some animal and cellular studies suggest the possibility that electromagnetic fields may act as co-carcinogens or tumor promoters, but the data are inconclusive. Up to 45 tesla, no important effects on enzyme systems have been observed. Neither changes in enzyme kinetics, nor orientation changes in macromolecules have been conclusively demonstrated.
There are some publications associating an increase in the incidence of leukemia with the location of buildings close to high-current power lines with extremely low-frequency (ELF) electromagnetic radiation of 50-60 Hz, and industrial exposure to electric and magnetic fields but a transposition of such effects to MRI or MRS seems unlikely.
Under consideration of the MRI safety guidelines, real dangers or risks of an exposure with common MRI field strengths up to 3 tesla as well as the RF exposure during the MRI scan, are not to be expected.

For more MRI safety information see also Nerve Conductivity, Contraindications, Pregnancy and Specific Absorption Rate.

See also the related poll result: 'In 2010 your scanner will probably work with a field strength of'