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Wrist, hand, foot, ankle

It's all the same.

PAIN

S Vijayanathan GSTT NHS FT

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• Thank you to you the audience, the organisers for having me and

• Prof F, Prof O'D, Mr. S, Mr.J, Prof. P, Dr. G, Dr. M, Dr. G, Dr. G, Dr. D & Ms. A, Mr. S- the tip of a deep iceberg.

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A hybrid modality deserves a truly hybrid reporting style

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.

In musculoskeletal imaging to talk about function you must intimately

understand structure

As always start with the whole body

• The axial

• The appendicular

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Check the statics and the blood pool

• You know what to do

Check the previous imaging

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I do not believe you can effectively use a modality unless you understand the other modalities used to image a

pathology along side it.

Digression

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The CT

• Joint space

• Alignment

• Bone density

• Soft tissue

Components to comment on

• Bone- alignment, density, joint space

• Tendon insertion and relations

• Ligament attachment and relations

• Neurovascular bundles

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Tracer uptake

Concise Interpretation

• I like bullet points

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Peripheral Appendage- upper limb

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Peripheral Appendage- lower

limb

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Ankle ligamentsAnkle ligaments

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Disorders of anatomy

• Impingements- anterior , posterior , hard and soft

• Coalitions

• Discontinuity - fractures

• Not everything is degeneration

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Some things MRI and Spect/ct get wrong- when in doubt go back to the

history and examination.

But there are some things– only SPECT/CT will get right!

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Thank youFurther reading:

Musculoskeletal MRI- Dussault and Helms