Order “Pars Protocol” MRI
To identify the presence of pars (including pedicles) stress reaction or fracture, a specific MRI protocol needs to be performed. MRI accurately identifies bone oedema and cortical defects and avoids the need for ionising radiation associated with a CT scan. Ideally, the MRI scan should be performed in a radiology facility that is familiar with performing and reporting these sequences.
The request forms should include the following:
LINK TO PDF
LINK TO AFFILIATED RADIOLOGY PROVIDERS KNOWLEDGEABLE ON THE TOPIC
| MRI lumbar spine pars protocol Thin slice (1-2mm) sagittal T1 (VIBE/ THRIVE) Thin slice (1-2mm) fluid sensitive sequence (T2FS/ PDFS/ STIR) Please assign to sports medicine/ musculoskeletal reporting group. |
Diagnose and Classify
The pars (or pedicle) pathology is classified on MRI as follows:
Oedema
Present
- Signal intensity ratio is measured with a special imaging tool (if >1.5 this means it is a pathological stress reaction)
- Previous studies indicate that injuries with oedema present have a good chance of healing
Absent
- If a fracture is present without surrounding oedema, it is probably a ‘chronic defect’ and will probably not heal
Fracture
Absent
- Incomplete (unicortical) fracture
- Complete (bicortical) fracture
Both pars should be classified as bilateral pathology is common.
Enrol in Audit
The research group encourages clinicians to include all patients with pars pathology into the treatment audit. Please fill in the following form to include your patient and our research team will contact you with details.