Order Reference Sheet (For Physicians)

MSK Order Form
Magnetic Resonance Imaging (MRI) Procedure Screening Form

MRI

Inventory

  • Main campus: MR1 1.5T Siemens Sola,  MR2 1.5T Phillips Ingenia, MR3 3T Siemens Vida, MR4 1.5T Siemens Aera, MR5 3T Siemens Skyra, MR6 3T Phillips Ingenuity, MR8 3T Siemens Skyra, MR20 1.5T Siemens Aera, PW4 MR 1.5T Phillips Ingenia
  • Katy/West Campus: MR1 1.5T Phillips Achieva,  MR2 3T Siemens Vida
  • Woodlands: 1 MRI 3T Siemens Vida, 1 MRI 1.5T Siemens Sola

Imaging Numbers

  • MRI knee (R and L without contrast): sports trauma RT- IMG2099  LT- IMG2098
  • MRI ankle (R and L without contrast): sports trauma  RT- IMG2101  LT- IMG2100             
  • MRI pelvis: sports trauma  IMG289
  • MRI hip 3T high resolution non-arthrographic RT- IMG2097, LT IMG2096
    • Notes: our institutional preference is for all arthrographic hip MRI’s to be performed with intra-articular contrast)
  • MRI lower extremity rotation profile (to assess for acetabular, femoral, and tibial version) IMG2506
  • MRI upper and lower extremity infection (R and L) UPPER RT- IMG2616, UPPER LT- IMG2521,  LOWER RT- IMG2522,  LOWER LT- IMG2614
    • Notes: If the child is from 3-8 years old, all will be screened to determine if they are a candidate for our limited non-sedate infection protocol

Procedures

  • MRI shoulder arthrograms (provide fluoro+MR IMG) FL- IMG2244  MRI- RT IMG872, LT- IMG871
  • MRI hip arthrogram (provide fluoro+MR IMG) FL- IMG2244   MRI- RT IMG1755, LT- IMG1754
  • MRI combo limited modifier JIA pre-injection followed by steroid injection (Please email mskradiology@texaschildrens.org for specific instructions on how to order.)
  • Ganglion cyst fenestrations IMG2658
  • Small joint injections (fingers, toes) IMG2242
  • Medium joint injections (elbow, wrist, ankle) IMG2243
  • Large joint injections (shoulder, hip, knee) IMG2244
  • Tendon sheath injections IMG2056
  • CP hip steroid injections IMG2244
    • Notes: 1. Please indicate if you wish to add steroids or Ropivicaine to the arthrographic procedure in the comments section. The arthrographic procedure as well as the diagnostic/therapeutic steroid/Ropivicaine procedure can be performed during the same procedure
    • 2. For emergent arthrocentesis to rule out infection, please call (IR-Main campus at 832-824-6333, IR-West Campus at 832-227-2621 or 832-227-4577, IR Woodlands at 936-267-5062)
  • Platelet Rich Plasma injections IMG2703

MSK US top 5

  • Ganglion cyst wrist  RT- IMG2530,  LT- IMG2424
  • Glenohumeral dysplasia RT- IMG2428,  LT- IMG2527 
  • DDH with manipulation IMG1682,  w/o manipulation IMG553
  • Hip for effusion IMG2558
  • Shoulder  RT- IMG2428,  LT- IMG2527 

MSK CT top 5

Inventory

  • Main Campus: 1 Siemens Somatom 96 detector duel energy CT, 1 Toshiba Aquilion 320 detector CT, 1 Toshiba Aquilion 160 detector CT, 1 Siemens 320 detector
  • Katy/West Campus: 1 Toshiba Aquilion 320 detector CT
  • Woodlands: 1 Toshiba Aquillion 160 detector CT

Imaging Numbers

  • CT knee non-contrast (R & L) RT- IMG2637  LT- IMG2636
  • CT ankle non-contrast (R & L) RT- IMG2441  LT- IMG2440
  • CT dynamic knee (for patellofemoral dysplasia (3 separate CT acquisitions at 40, 20, and 0 degrees of knee flexion. Both knees are always included with a dynamic exam)
  • CT version (to evaluate lower extremity rotation profile only when there are contraindications for MRI lower extremity rotation profile)
    • Acetabular RT- IMG2443, LT- IMG2442
    • Femoral RT- IMG2443, LT- IMG2442
    • Tibial  RT- IMG2443, LT- IMG2442
  • CT 3D post processing- IMG2017

MSK 3D printing