MRI of Shoulder Flashcards

1
Q

rotator cuff is composed of the tendons of four muscles that converge on the greater and lesser tuberosities of the humerus, namely:

A

supraspinatus, infraspinatus, subscapularis, teres minor

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2
Q

of the rotator cuff muscles, this most commonly causes clinically significant problems and is the one that is most commonly surgically treated

A

supraspinatus

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3
Q

lies just superior to the scapula and inferior to the AC joint and acromion. it inserts into the greater tuberosity of the humerus

A

supraspinatus

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4
Q

2 to 3 centimeters proximal to the insertion of supraspinatus is a section of the tendon called the

A

“critical zone”

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5
Q

critical zone is reported to have ____ and is therfore less likely to heal following trauma

A

decreased vascularity

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6
Q

critical zone of the supraspinatus tendon is a common location for

A

rotator cuff tears

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7
Q

a fibricartilaginous ring that surounds the periphery of the bony glenoid of the scapula

A

glenoid labrum

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8
Q

serves as an attachment site for the capsule and broadens the base of the glenohumeral joint to allow increased stability

A

glenoid labrum

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9
Q

tears and detachment of the glenoid labrum most commonly occur from and result in

A

dislocations or instability of the humerus

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10
Q

one of the most common procedurs for shoulder pain whereby the coracoacromial ligament was cut, the anterolateral portion of the acromion was removed, and AC joint osteophytes were resected

A

Coracoacromial arch decompression

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11
Q

most likely source of most rotator cuff problems

A

intrinsic degeneration

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12
Q

treating intrinsic degeneration requires

A

debriding the abnormal tissue and repairing the cuff

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13
Q

rotator cuff is best seen on what view

A

oblique coronal images that are aligned parallel to the supraspinatus muscle and on oblique sagittal images

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14
Q

primary sequence for imaging the rotator cuff

A

FSE T2W oblique coronal sequence with slice thickness no greater than 5mm and 3 mm

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15
Q

MR arthrogram is typically performed by injecting how many cc of saline or gadolinium

A

10 to 15 cc

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16
Q

useful landmark for noting the anterior portion of supraspinatus tendon is the ____, with the anterior most fibers of the supraspinatus found immediately posterolateral to the groove

A

biccipital groove

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17
Q

normal supraspinatus tendon is said to be of what signal

A

uniformly low in signal on all pulse sequences

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18
Q

if the signal in the tendon gets brighter on the T2W, it is abnormal and represents

A

tendinosis or tendinopathy or a partial thickness tear

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19
Q

vast majority of partial tears occur on what side

A

articular side

20
Q

partial tear that occurs at the insetion of the fibers of the cuff onto the greater tuberosity

A

rim-rent-tear

21
Q

bone impaction on the posterosuperior aspect of the humeral head and can be seen in patients with anterior instability of the glenohumeral joint. this is called

A

Hill-Sachs lesion

22
Q

A Hill-Sachs lesion almost always indicated that the anteroinferior labrum will be torn or detached, which is called

A

Bankart lesion

23
Q

normal labrum appears as

A

triangular shaped low signal structure on axial image

24
Q

what is larger, anterior or posterior labrum

A

anterior

25
Q

superior labrum is evaluated in what view

A

oblique coronal views

26
Q

if joint fluid extends between the bony glenoid and the base of the labrum, a _____ is present

A

detached labrum

27
Q

often seen in throwing athletes secondary to the pull of long head of biceps that insert on the superior labrum

A

superior labral tears, called superior labrum anterior to posterior lesions (SLAP)

28
Q

normal variant: an opening beneath the anterosuperior labrum and the bony glenoid that mimics a detachment

A

sublabral foramen

29
Q

normal variant: consists of an absent anterosuperior labrum in association with a thickened “cord-like” middle glenohumeral ligament

A

Buford complex

30
Q

seen only on the anterior part of the superior labrum and should be thin and smooth and extends medially

A

sublabral recess

31
Q

SLAP tear in comparison to sublabral reces

A

more irregular and extends superiorly and laterally

32
Q

runs in the bicipital groove between the greater and lesser tuberosities and insters onto the superior labrum

A

long head of biceps tendon

33
Q

suprascapular nerve is made up of branches from the

A

C4, C5 and C6 roots of the brachial plexus

34
Q

nerve that runs superior to the scapula, from anterior to posterior, just medial to the coracoid process

A

suprascapular nerve

35
Q

suprascapular nerve innervates the

A

supraspinatus and infraspinatus

36
Q

this syndrome is most commonly seen in males who are athletic, particularly weight lifters and in this population is almost always associated with a tear of the superior and/or posterior labrum and the subsequent formation of a paralabral ganglion in the spinoglenoid notch

A

suprascpular nerve entrapment

37
Q

if infraspinatus is smaller than the other muscles and/or has fatty infiltration, _________ is the likely diagnosis

A

suprascapular nerve entrapment secondary to a ganglion in the spinoglenoid notch

38
Q

if teres minor has fatty atrophy, what is the diagnosis

A

quadrilateral space syndrome

39
Q

most commonly occurs from fibrous bands or scar tissue in the quadrilateral space impinging on the axillary nerve

A

quadrilateral space syndrome

40
Q

space that lies between the teres minor superiorly, teres major inferiorly, long head of triceps medially and diaphysis of the humerus laterally

A

quadrilateral space

41
Q

what nerve traverses the quadrilateral space and innervates the teres minor and deltoid muscles

A

axillary nerve

42
Q

what muscle is never involved in quadrilateral space syndrome

A

deltoid muscle

43
Q

image sequence that are useful for identifying muscle edema

A

oblique sagittal fat-supressed T2 weighted images

44
Q

in about 1% of cases, neurogenic edema is found in muscle groups that correspond to a particular nerve distribution. this is characteristic for

A

Parsonage-turner syndrome

45
Q

Parsonage-turner syndrome may be associated with

A

prior vaccinations, viral illness or general anesthesia

46
Q

Parsonage-turner syndrome can affect what nerves

A

axillary or suprascapular nerve or both