Shoulder Flashcards
1
Q
AP external rotation
A
- places greater tuberosity in picture GH space averages 5 mm 5 mm effusion or dislocation
2
Q
AP internal rotation
A
- places lessor tuberosity in picture musculocutaneous attachments could be screened for avulsions or bone destruction
3
Q
Axillary view
A
- helps determine the exact relationship of humeral head to glenoid fossa in evaluating GH jt dislocation
- cocacoid also well defined views through arm pit
4
Q
anterior oblique view
A
- scap view is used to assess fracrure or dislocations of prox humerus and scap advantage: pts arm in neutral
5
Q
MRI indications
A
- RTC pathology
- long head of the biceps pathology
- glenoid labrum pathology
- impingement syndromes
- loose bodies
- neoplasms or infections of bone, soft tissue, or joint
6
Q
MRI orthogonal planes
A
- axial-* top to bottom (long head of biceps, subscap muscle and tendon, labrum, capsule and GH ligaments, GH jt)
- oblique coronal*- frontal (supraspinatus endon bursa, ac jt, acromion, subacromial/subdeltoid bursa, labrum, and GH jt)
- oblique sagittal*- L and R (rotator intervals, coracoacromial ligament, ac jt, bone marrow)
7
Q
MR arthorogram
A
- MOST specific test for labral tears
- Good for diagnosing RTC tears
8
Q
Indications for CT of shoulder
A
- severe trauma alignment and displacement of fracture fragments
- loose bodies in GH jt
- used for soft tissue eval if MRI contraindicated
- same orthogonal planes as MRI
9
Q
MSUS indications of shoulder
A
- define tears, tendinosis, and/or calcification of RC muscles
- eval subacromial/subdeltoid bursa
- eval biceps tendon
- assess ac jt laxity
- differentiate effusion
- guide needle aspiration of the joint
10
Q
Fractures of the proximal humerus
A
- Neutral AP and scapular Y lateral is sufficient for eval
- Complex fractures may require a CT
11
Q
Fractures of the clavicle
A
- An AP view as well as a 45 deg caudal tilt sufficient
- Distal third fractures may require a weighted and unweighted CT of the AC joint
12
Q
Fractures of the scapula
A
- Rare injury.
- Direct blow or violent trauma
- AP, axillary, and scapular Y lateral view for most scap fractures
- CT might be needed to assess glenoid
13
Q
GH dislocations
A
- AP, axillary, and scapular Y lateral views to determine exact relationship of humeral head to glenoid fossa
- CT to check for loose bodies, impact ion fractures, and avulsions
- MRI to assess injury to RC, capsule, and labrum
14
Q
AC joint separation
A
- Bilateral AP views of the AC joints, with and without weights to assess ligament injury
15
Q
Rotator cuff tears
A
- Arthrography is recommended only if the patient cannot have an MRI or US expertise not available available
16
Q
Glenoid Labrum tears
A
- MR arthrography is the most appropriate procedure to assess suspected instability and labral tears
- Contrast gives a better visualization of the labrum, capsular structures, and underside of the Rotator cuff
- US is great to view biceps tendon abnormalities assoc with labral tears
17
Q
Impingement syndrome
A
- MRI or diagnostic US can identify various assoc soft tissue pathologies- bursitis, tendinitis, and tears of RC and labrum
18
Q
Routine radiograph eval of the shoulder
A
- AP view with arm ER
- AP view with arm IR
19
Q
Routine radiograph eval of the AC joint
A
- Bilateral AP with and without weights
20
Q
Routine radiograph eval of the scapula
A
AP Lateral
21
Q
Advanced imaging with CT and MRI
A
- Planes: axial, oblique sagittal, and oblique coronal
- CT-ABCs
- MRI- ABCDs.
- T1 to define anatomy and T2 to highlight pathology
22
Q
Trauma imaging
A
- AP with arm in neutral, axillary view of the GH jt, and ant oblique (scapular Y lateral view)
- MRI recommended for acute and subacute shoulder pain if initial radiographs normal and if RC pathology, instability, or labral tears suspected
