76-Dr Ahmed Esawy imaging oral board MRI shoulder joint part 1
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Transcript of 76-Dr Ahmed Esawy imaging oral board MRI shoulder joint part 1
الرحمن الله بسمالرحيم
RADIOLOGY CHANNELIMAGING ORAL BOARDMRI SHOULDER JIONT
Biceps Tendon/Anchor
Osseous Structures
Arthritis
Neural Impingement
RADIOLOGICAL ANATOMY OF MRI SHOULDER JIONT
Causes of painful shoulderThe shoulder joint can be affected by various
pathological disorders
Causes of painful shoulderThe shoulder joint can be affected by various
pathological disorders
ROTATOR CUFF TENDINO PATHY
ROTATOR CUFF TENDINOPATHY
Partial, undersurface tear of the rotator cuff. US image shows mixed echogenicity of the undersurface of the cuff (straight arrows) that reflects torn cuff fibers and adjacent fluid. The bursal fibers are intact (curved arrows).
Staging, Grading or Classification Criteria
Partial-thickness tear of the rotator cuff. Oblique coronal T2-weighted MR image shows an undersurface tear with a
discrete flap (arrows) that was verified at surgery .
Partial rotator-cuff tear, indirect MR arthrography, oblique-coronal plane. Intravenous contrast media injection, 10-
15min motion and fat suppression shows, thinned, irregular-shaped supraspinatus tendon, concordant with
partial tearing .
ROTATOR CUFF PARTIAL THICKNESS TEAR
Large, full-thickness tear of the rotator cuff. Coronal (longitudinal) US image shows a large cuff defect filled with fluid and debris (straight arrows). Also apparent are the medially retracted edge of supraspinatus tendon (curved arrow), near apposition of deltoid muscle (D) to the humeral head, and loss of outer convexity.
Massive full-thickness tear of the rotator cuff. (A) US image demonstrates a massive rotator cuff tear, the gap filled with hypoechoic fluid (straight arrows). The underlying hyaline cartilage is exposed (naked cartilage sign) (curved arrows). (B) US image shows apposition of the deltoid muscle (D) to the underlying humeral head (solid arrows). An osseous excrescence appears at the articular
margin (open arrow).
ROTATOR CUFF FULL THICKNESS TEAR
ROTATOR INTERVAL TEARS
ROTATOR INTERVAL TEARS
Normal Anatomy of Rotator Interval Capsule
SGHL
MRI of Lesions of Rotator Interval Capsule in Presence of Supraspinatus Tendon Tears
Conclusion
MICROINSTABILITY, SHOULDER
ROTATOR CUFF POST-OPERATIVE REPAIROperative (open or arthroscopic) repair or
debridement of the RTC tendons
Calcifying tendinitis, oblique-coronal plane. Calcific deposits lead to focal signal void within the thickened, irregular tendon.
ROTATOR CUFF CALClFlC TENDONlTIS
PARSONAGE-TURNER SYNDROME
SUBSCAPULARlS RUPTURE
PECTORALIS MAJOR TEAR