Radiology Anatomy of the Spine and Upper Extremity · 2004. 10. 5. · Radiology Anatomy of the...

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Radiology Anatomy of the Spine and Upper Extremity Timothy J. Mosher, MD Department of Radiology Phone: 531-4566 Email: [email protected]

Transcript of Radiology Anatomy of the Spine and Upper Extremity · 2004. 10. 5. · Radiology Anatomy of the...

  • Radiology Anatomy of the Spine and Upper Extremity

    Timothy J. Mosher, MDDepartment of Radiology

    Phone: 531-4566Email: [email protected]

  • Learning Objective

    • Identify anatomic structures of the spine and upper extremities on standard radiographic and cross-sectional images

  • SPINE

  • Visual Human Sagittal View

    7 Cervical Vertebra

    12 Thoracic Vertebra

    5 Lumbar Vertebra

    5 Sacral Vertebra (fused)

    3 Coccygeal Vertebra (fused)

  • Lumbar Vertebral Body

    BODY

    PEDICLETRANSVERSE

    PROCESS

    LAMINA

    SPINOUS PROCESS

  • Lumbar Vertebral Body

    BODY

    PEDICLETRANSVERSE PROCESS (fractured)

    LAMINA

    SPINOUS PROCESS

  • SPINE FROM THE FRONT

    BODY

    TRANSVERSE PROCESS

  • SPECIMEN RADIOGRAPH L4

    BODY

    PEDICLES SPINOUS PROCESS

    TRANSVERSE PROCESSES

  • SPINE FROM THE BACK

    TRANSVERSE PROCESS

    LAMINA

    SPINOUS PROCESS

    INF ARTFACET

    SUP ARTFACET

  • SPECIMEN RADIOGRAPH L4

    Lamina and Facets

  • AP Lumbar Spine

  • AP Lumbar Spine

  • AP Lumbar Spine

    BODYPEDICLE

    TRANSVERSEPROCESS

    SPINOUSPROCESS

    LAMINA

  • Spine Viewed from Side

    BODY PEDICLE

    TRANSVERSE PROCESS

    LAMINA SPINOUS PROCESS

  • Spine Viewed from Side

    PARS INTRAARTICULARIS

    SUPERIOR FACET

    INFERIOR FACET

  • Lateral Lumbar Spine

  • Lateral Lumbar Spine

    BODY

    PEDICLE

    SPINOUS PROCESS

  • Lateral Lumbar Spine

    PARS

    INFERIOR FACET

    SUPERIOR FACET

  • CT Lumbar Spine Sagittal Reconstructions

  • Facet Joints Axial ViewInferior Facets

    Superior Facets

    Cervical Thoracic Lumbar

  • Facet Joints Sagittal Reconstructions

    Cervical Thoracic Lumbar

  • Intervertebral Disc Space

    NEURALFORAMEN

    INTERVERTEBRAL DISC

  • Nerve Roots

    BODY DISC PEDICLE

    INF FACETSUP FACET

    SPINOUSPROCESSNERVE ROOT

  • Intervertebral Disc

    Body

    BodyNucleus Pulposa

    Annulus Fibrosa

    Sagittal Section Lumbar Spine

  • MRI: Intervertebral DiscSpinal Cord

    (Cauda Equina)

    Intervertebral Disc•Nucleus Pulposa•Annulus Fibrosa

  • Cauda Equina

    MRI Myelogram

  • Neural Foramen

    Pedicle (L3)

    Pedicle (L4)

    L3/L4 Intervertebral Disc

    L3 Nerve Root

  • Neural Foramina Cervical Spine

    Viewed from bottom

    Vertebral Body

    Cervical Spinal Cord

    Nerve Roots

    Facet Joint

  • Spinal Ligaments

  • Spinal Ligament

    Anterior Longitudinal Spinal Ligament

    Posterior Longitudinal Spinal Ligament

  • Case Study: 17 year-old Male involved in a MVA

    Do you see a fracture?

    Fracture of C7 vertebral body

  • Case Study: 17 year-old Male involved in a MVA

    Bilateral Facet Dislocation at C6/7

    Right Left

    What other structures are likely to be injured?

  • Case Study: 17 year-old Male involved in a MVA

    Spinal Cord InjuryAnterior Longitudinal Spinal Ligament

    Posterior Longitudinal Spinal Ligament

  • Upper ExtremityUpper Extremity

  • Radiographic AnatomyX-RAY BEAM

    FILM

  • LEFT SHOULDER (FRONT)CLAVICLEACROMIONCORACOIDGLENOIDSCAPULAHUMERUS

  • SHOULDER (BACK)CLAVICLEACROMIONSPINEGLENOID

    HUMERUSSCAPULA

  • AP Shoulder

    Humerus

    Clavicle Acromion

    Greater Tuberosity

    Glenoid

    Coracoid

  • LEFT SHOULDER AXILLARY VIEW

    X-RAYTUBE

    FILM

  • RIGHT SCAPULA FROM BELOW

    CORACOID

    ACROMION

    GLENOID

    SPINE

    BODY

  • LEFT SHOULDER (AXILLARY)

    Anterior Coracoid

    Clavicle

    Acromion

    Humerus

    Lesser Tuberosity

    Glenoid

  • Case Study: 52 year old male with shoulder pain

    Do you identify the cause of the shoulder pain?

  • MRI Anatomy of the Shoulder

  • MUSCLES FROM THE FRONT

    SUPRASPINATUS

    SUBSCAPULARIS

  • Rotator Cuff Muscles Sagittal View

    Anterior

    Subscapularis

    Supraspinatus

    Infraspinatus

    Teres Minor

  • Rotator Cuff: Subscapularis

    Sagittal View Coronal View

  • Rotator Cuff: Supraspinatus

    Sagittal View Coronal View

  • MUSCLES FROM THE BACK

    SUPRASPINATUS

    INFRASPINATUS

    TERES MINOR

  • Rotator Cuff: Infraspinatus

    Sagittal View Coronal View

  • Rotator Cuff: Teres Minor

    Sagittal View Coronal View

  • Anatomy Considerations in Rotator Cuff Tears

  • Impingement of the Rotator Cuff

    Anterior View

    Supraspinatus

    Subscapularis

    Coracoacromial Arch

    •Acromion

    •AC Joint

    •Coracoacromial liagment

    •Coracoid Process

  • MRI Anatomy of the Rotator Cuff

  • MRI Anatomy of the Rotator Cuff

  • Rotator Cuff Tear

    Contrast injected into glenohumeral joint

    Contrast leaking into subacromial bursa through tear in supraspinatus

  • ROTATOR CUFF TEAR

    10/30/03 10/30/031/30/04 1/30/04

  • The Elbow

  • LEFT ELBOW FROM FRONTHumerus

    Lateral Epicondyle

    Capitulum

    Radial HeadUlna

    Trochlea

    Medial Epicondyle

    LateralMedial

  • Elbow from the BackHumerus

    Lateral Epicondyle

    Olecranon fossa

    Radial HeadUlna

    Olecranon

    Medial Epicondyle

  • AP ELBOWHumerus

    Lateral Epicondyle

    Capitulum

    Radial HeadUlna

    Trochlea

    Medial Epicondyle

    LateralMedial

  • Medial View of ElbowHumerus

    UlnaOlecranon

    Radial Head

    Coronoid

    Medial Epicondyle

  • Medial View of ElbowHumerus

    UlnaOlecranon

    Radial Head

    Coronoid

    Medial Epicondyle

  • The Wrist

  • The Wrist Palmar ViewCarpal Bones (Proximal Row)

    Radius Ulna

    Scaphoid

    Lunate Triquetrum

    Pisiform

  • The Wrist Palmar ViewCarpal Bones (Proximal Row)

    Radius Ulna

    ScaphoidLunate

    Triquetrum

    Pisiform

  • The Wrist Palmar ViewCarpal Bones (Distal Row)

    Radius Ulna

    Trapezium

    Trapezoid HamateCapitate

  • The Wrist Palmar ViewCarpal Bones (Distal Row)

    Radius Ulna

    Trapezium

    Trapezoid Hamate

    Capitate

  • MR Anatomy of the Wrist

    Coronal Wrist

    Radius

    Lunate

    Capitate


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