MRI CLAVICAL

MRI Clavicle is a specialized imaging technique that provides a detailed evaluation of the clavicle (collarbone) and its surrounding soft tissues, joints, and neurovascular structures. It is particularly useful when X-rays or CT scans do not adequately reveal soft tissue injuries or subtle bone pathologies. The clavicle acts as a strut between the sternum and the scapula, contributing to shoulder stability and upper limb mobility. Given its role in shoulder girdle function, injuries and pathologies involving the clavicle can significantly impair arm movement and cause pain. MRI provides multiplanar, high-resolution images without radiation, making it ideal for comprehensive evaluation.

Purpose of MRI Clavicle

1. Trauma assessment

• Detects fractures, bone bruises, and occult injuries not visible on X-rays.
• Evaluates associated soft tissue injuries following shoulder or chest trauma.

2. Joint evaluation

• Assesses the sternoclavicular and acromioclavicular joints for arthritis, dislocation, or ligament tears.

3. Soft tissue lesion detection

• Identifies muscle tears, tendon injuries, and ligament disruptions in the region.

4. Tumor evaluation

• Detects primary or metastatic bone tumors involving the clavicle.

5. Infection and inflammation

• Diagnoses osteomyelitis, septic arthritis, and inflammatory joint diseases.

6. Chronic pain investigation

• Determines causes of persistent clavicle pain when other imaging is inconclusive.

7. Post-surgical follow-up

• Monitors healing after clavicle fracture fixation or joint reconstruction.

Anatomy of the Clavicle and Related Structures

• The clavicle is an S-shaped bone connecting the sternum (manubrium) to the scapula (acromion process).
• Medial end forms the sternoclavicular joint with the sternum.
• Lateral end forms the acromioclavicular joint with the scapula.
• Surrounding muscles include pectoralis major, deltoid, trapezius, subclavius, and sternocleidomastoid.
• Ligaments include the costoclavicular, sternoclavicular, and acromioclavicular ligaments.
• The subclavian vessels and brachial plexus run close to the clavicle, making vascular and nerve assessment important in trauma.

Procedure for MRI Clavicle

Before the scan

• The patient’s medical history is reviewed, including details of trauma, surgeries, or chronic pain.
• Metallic objects, jewelry, and clothing with metal fasteners are removed.
• Patients with pacemakers or other incompatible implants are evaluated for MRI safety.
• Contrast injection may be planned for tumor, infection, or postoperative evaluation.

During the scan

• The patient lies supine with the arm positioned comfortably to minimize motion.
• A surface coil or dedicated shoulder coil is used to improve image quality.
• Sequences include coronal, sagittal, and axial planes to visualize the clavicle and adjacent joints.
• Imaging extends to the surrounding muscles, vessels, and lymph nodes if necessary.
• The scan usually takes 25–40 minutes.

After the scan

• Patients can resume normal activity unless sedated.
• The radiologist reviews the images and prepares a detailed report.

MRI Sequences for Clavicle Evaluation

T1-weighted sequences

• Provide detailed anatomy and bone marrow evaluation.

T2-weighted sequences

• Highlight fluid, edema, and soft tissue changes.

STIR or fat-suppressed sequences

• Enhance detection of bone marrow edema, inflammation, and soft tissue lesions.

Gradient echo sequences

• Useful for detecting small hemorrhages or cartilage abnormalities.

Post-contrast T1-weighted images

• Employed to evaluate tumors, infections, or postoperative enhancement patterns.

Common Conditions Detected

Fractures

• Complete, incomplete, or stress fractures.
• Detection of fracture lines not visible on X-ray.

Bone bruises

• Microtrabecular injuries following trauma.

Joint dislocations

• Sternoclavicular or acromioclavicular joint displacement.

Ligament tears

• Acromioclavicular, coracoclavicular, and sternoclavicular ligament injuries.

Osteoarthritis

• Degeneration of sternoclavicular or acromioclavicular joints with osteophyte formation.

Inflammatory arthritis

• Rheumatoid arthritis affecting joints with erosions and synovitis.

Osteomyelitis

• Bone marrow infection with associated soft tissue swelling.

Bone tumors

• Primary tumors such as osteosarcoma, Ewing sarcoma, or metastases from breast, lung, or thyroid cancers.

Soft tissue masses

• Lipomas, sarcomas, or lymphadenopathy near the clavicle.

Advantages of MRI Clavicle

• Superior visualization of soft tissues, bone marrow, and cartilage compared to X-rays and CT.
• No exposure to ionizing radiation.
• Multiplanar imaging capability for comprehensive assessment.
• Ability to detect subtle bone and soft tissue abnormalities early.

Limitations

• More expensive and less available than X-rays or CT scans.
• Contraindicated in patients with certain metallic implants.
• Sensitive to motion artifacts, requiring patient cooperation.
• Less optimal for detecting fine cortical bone details compared to CT.

When This Scan is Preferred

• Persistent clavicle pain after normal X-rays.
• Suspected occult fracture or bone bruise.
• Evaluation of tumor or infection in the clavicle.
• Preoperative planning for clavicle reconstruction.
• Postoperative assessment of hardware position and healing.

Patient Preparation Tips

• Wear comfortable, metal-free clothing.
• Inform the radiology team about implants, injuries, or surgeries.
• Follow fasting instructions if contrast will be administered.
• Keep still during the scan to ensure image clarity.

Conclusion

MRI Clavicle is an advanced imaging tool that offers detailed evaluation of the clavicle bone, associated joints, ligaments, muscles, and surrounding neurovascular structures. It is particularly valuable for detecting soft tissue injuries, bone marrow abnormalities, and subtle fractures not seen on conventional imaging. The scan is critical for accurate diagnosis, treatment planning, and follow-up in trauma, degenerative conditions, infections, tumors, and chronic pain involving the clavicle. By combining high-resolution, multiplanar images without radiation exposure, MRI Clavicle plays an essential role in musculoskeletal and sports medicine diagnostics.