Upper Extremity

Question 1

what do you base your off-sets off?

Answer 1

anatomic location of area of interest from isocenter (@120-125 L or R)

Question 2

common shoulder indications

Answer 2

• pain
• rotator cuff tears
• frozen shoulder
• mass, lump or bump
• impingement

Question 3

when an exam is ‘labrum’ related, what does that mean?

Answer 3

it includes arthrogram

Question 4

magic angle artifact

Answer 4

55 degree oriented to B0

occur on short TE sequences

Question 5

which sequence has high resolution and SNR for evaluating the gleno-humeral articular cartilage?

Answer 5

axial PD

Question 6

arthrogram?

Answer 6

intra-articular use of gado & saline injection

performed under fluoro

Question 7

what should you include in all humerus scans?

Answer 7

radial tuberosity

Question 8

ABER

Answer 8

Abduction - External Rotation Position

T1 sequence permits optimal visualization of the ant. inf. labral lig. complex (attaches to labrum)

Question 9

humerus common indications

Answer 9

mass
lesion
muscle tear
deformity

Question 10

elbow common indications

Answer 10

ulnar nerve compression
mass lesions
muscle tear

Question 11

elbow protocol

Answer 11

angle slices 20 degree

anterior parallel to collateral ligaments

Question 12

what is the pathology ?

Answer 12

scaphoid-lunate ligament tear

Question 13

what is this pathology ?

Answer 13

TFCC tear

Question 14

what is the position for wrist exam?

Answer 14

supine
elbow and wrist facing up

*use pads to bring wrist close to isocenter

Question 15

shoulder anatomy

Answer 15

axial

Question 16

shoulder anatomy

Answer 16

sagittal

Question 17

biceps anatomy

Answer 17

axial

Question 18

elbow anatomy

Answer 18

axial

Question 19

how do you plan coronals for supraspinatus tendon?

Answer 19

parallel to supraspinatus

Question 20

how do you plan sagittals for supraspinatus tendon?

Answer 20

perpendicular to supraspinatus

Question 21

what causes vessel artifact ?

Answer 21

active blood flow while scanning

Question 22

elbow protocols angle?

Answer 22

20 degree

ant parallel to collateral ligaments

Question 23

bicep tendon protocols angle?

Answer 23

90 degree above head

feet first, supine

Question 24

wrist indications?

Answer 24

ganglion cyst
wrist pain
carpal tunnel
triangular cartilage (TFCC tear)
Kienbock’s disease

Question 25

shoulder patient position

Answer 25

* supine * external rotation/ thumb up

Question 26

where is the center FOV of shoulder scan?

Answer 26

middle of the glenohum joint

Question 27

protocol for coronal (routine shoulder)

Answer 27

parallel to supraspinatus

Question 28

protocol for sagittal (routine shoulder)

Answer 28

perpendicular to supraspinatus

Question 29

protocol for axial (routine shoulder)

Answer 29

cover mid AC joint through humeral head

Question 30

what sequence follows an arthrogram?

Answer 30

Fat Sat Suppressed sequences

Question 31

what is the pt injected with in a shoulder arthrogram?

Answer 31

lidocaine and .2 ml Gado

Question 32

what diagnosis does an arthrogram used for?

Answer 32

* rotator cuff tears * glenoid labral disruption * chondral defect

Question 33

pt position for humerus scan

Answer 33

immobilization straps and pads arm in external rotation / neutral thumb up

Question 34

ELBOW: what are valuable to demo joint structures in any plane?

Answer 34

volume acquisitions

Question 35

ELBOW [technical issues] what is used to provide good contrast between boney margins of the joint and synovial fluid?

Answer 35

coherent GRE

Question 36

ELBOW [technical issues] what is necessary to distinguish fat from pathology?

Answer 36

pre-sats

Question 37

ELBOW [technical issues] what is used to maintain high resolution in acceptable scan times?

Answer 37

FSE

Question 38

ELBOW [technical issues] what is close to periphery of bore extra shimming might be needed to max SNR?

Answer 38

FOV

Question 39

ELBOW [technical issues] what is needed to demo the elbow joint?

Answer 39

high resolution imaging

Question 40

ELBOW [artifact problems]

Answer 40

pt motion (in swimmer/superman position) pulsation (humeral/ radial vessels: pre-sats placed S and I to the FOV

Question 41

protocol for routine elbow

Answer 41

angle slices 20 degree ant parallel to collateral ligaments

Question 42

ELBOW [FABS position]

Answer 42

perpendicular to the radial shaft