Upper Extremity Flashcards
what do you base your off-sets off?
anatomic location of area of interest from isocenter (@120-125 L or R)
common shoulder indications
- pain
- rotator cuff tears
- frozen shoulder
- mass, lump or bump
- impingement
when an exam is ‘labrum’ related, what does that mean?
it includes arthrogram
magic angle artifact
55 degree oriented to B0
occur on short TE sequences
which sequence has high resolution and SNR for evaluating the gleno-humeral articular cartilage?
axial PD
arthrogram?
intra-articular use of gado & saline injection
performed under fluoro
what should you include in all humerus scans?
radial tuberosity
ABER
Abduction - External Rotation Position
T1 sequence permits optimal visualization of the ant. inf. labral lig. complex (attaches to labrum)
humerus common indications
mass
lesion
muscle tear
deformity
elbow common indications
ulnar nerve compression
mass lesions
muscle tear
elbow protocol
angle slices 20 degree
anterior parallel to collateral ligaments
what is the pathology ?
scaphoid-lunate ligament tear
what is this pathology ?
TFCC tear
what is the position for wrist exam?
supine
elbow and wrist facing up
*use pads to bring wrist close to isocenter
shoulder anatomy
axial
shoulder anatomy
sagittal
biceps anatomy
axial
elbow anatomy
axial
how do you plan coronals for supraspinatus tendon?
parallel to supraspinatus
how do you plan sagittals for supraspinatus tendon?
perpendicular to supraspinatus
what causes vessel artifact ?
active blood flow while scanning
elbow protocols angle?
20 degree
ant parallel to collateral ligaments
bicep tendon protocols angle?
90 degree above head
feet first, supine
wrist indications?
ganglion cyst
wrist pain
carpal tunnel
triangular cartilage (TFCC tear)
Kienbock’s disease
shoulder patient position
- supine
- external rotation/ thumb up
where is the center FOV of shoulder scan?
middle of the glenohum joint
protocol for coronal (routine shoulder)
parallel to supraspinatus
protocol for sagittal (routine shoulder)
perpendicular to supraspinatus
protocol for axial (routine shoulder)
cover mid AC joint through humeral head
what sequence follows an arthrogram?
Fat Sat Suppressed sequences
what is the pt injected with in a shoulder arthrogram?
lidocaine and .2 ml Gado
what diagnosis does an arthrogram used for?
- rotator cuff tears
- glenoid labral disruption
- chondral defect
pt position for humerus scan
immobilization straps and pads
arm in external rotation / neutral thumb up
ELBOW: what are valuable to demo joint structures in any plane?
volume acquisitions
ELBOW [technical issues]
what is used to provide good contrast between boney margins of the joint and synovial fluid?
coherent GRE
ELBOW [technical issues]
what is necessary to distinguish fat from pathology?
pre-sats
ELBOW [technical issues]
what is used to maintain high resolution in acceptable scan times?
FSE
ELBOW [technical issues]
what is close to periphery of bore extra shimming might be needed to max SNR?
FOV
ELBOW [technical issues]
what is needed to demo the elbow joint?
high resolution imaging
ELBOW [artifact problems]
pt motion (in swimmer/superman position)
pulsation (humeral/ radial vessels: pre-sats placed S and I to the FOV
protocol for routine elbow
angle slices 20 degree
ant parallel to collateral ligaments
ELBOW [FABS position]
perpendicular to the radial shaft
