Magnetic Resonance Imaging of Osteo-Articular System at the Douala General Hospital

Objectives: Osteoarticular pathology has benefited greatly from MRI. This modality was only recently introduced in our country and its implantation is still rare. The objective of this study was to evaluate the practice of MRI of osteoarticular system in Douala General Hospital. Method: It was a cross-sectional descriptive study during a five-month period from May to September 2017 involving all patients referred to the Imaging Department of the Douala General Hospital for osteoarticular MRI. All the patients were scanned using an open-sided mid-field MRI APERTO LUCENT (0.4 T) using axial, sagittal and coronal slices in T1-weighted, T2-weighted proton density. T1 gadolinium or water-fat saturation (WFS) slices were obtained after injection of a contrast agent (Dotarem). Collected data were analyzed using SPSS v20 and Microsoft Excel 2010 softwares. Results: 34 patients were enrolled in this study; osteoarticular MRI accounted for 12% of the activity behind MRI of the spine (40.4%) and the brain (42.5%). The mean age of patients was 37.6 ± 13.1 years with extremes between 6 and 61 years. There was male predominance with a sex ratio of 1.83. Trauma (44.2%) and pain (42.1%) were the most common indications. MRI of the lower limb (85.3%) and more particularly of the knee (68.9%) was more frequently performed than that of the upper limb (14.7%). Orthopedic surgeons (38.2%) and rheumatologists (26.5%) were the main referral physician. 73.5% of request’s forms did not conform to the eight compliance criteria according to the recommendations of French National Agency for Accreditation and Health Evaluation. Most of the examinations (94.1%) were performed without the injection of contrast agent (Dotarem). 97% of MRI was pathological. Traumatic pathologies (39.4%) were most frequent and concerned the knee (27.3%) and the ankle/feet (12.1%), followed by the degenerative pathologies (21.2%) which concerned the knee (18.2%) and hip joints (3%), inflammatory pathologies (12.1%) reaching the shoulder (9.1%) and wrist/hand (3%) while tumoral pathologies (6%) were reaching the knee (3%) and the leg (3%). Conclusion: The MRI of the osteoarticular system is quite common, ranking third after the MRI of the spine and the brain. This study showed that MRI has a significative impact on diagnosis of osteoarticular diseases whit a concordance of 97% with clinic.