MRI SHOULDER WHAT TO SEE
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1 MRI SHOULDER WHAT TO SEE DR SHEKHAR SRIVASTAV Sr. Consultant- Knee & Shoulder Arthroscopy Sant Parmanand Hospital
2 Normal Anatomy
3 Normal Shoulder MRI Coronal Oblique Sagital Oblique Axial Cuts
4 Normal Coronal Oblique Parallel to plane of Supraspinatus Supraspinatus A-C Joint Sub-acromial & Sub-Deltoid bursa Labrum- Sup & Inf Biceps Tendon
5 Normal Coronal Oblique d
6 Normal Coronal Oblique Parallels the central tendon of supraspinatus
7 Normal Sagittal Oblique Perpendicular to the plane of Supraspinatus Medial to Lateral Coraco-acromial arch Rotator cuff Shape of Acromion
8 Normal Sagittal Oblique a
9 Normal Axial Cuts
10 Normal Axial Cuts Labrum- Ant & Post Gleno-humeral ligament Gleno-humeral cartilage Biceps Tendon Subscapularis & Teres Minor
11 Arthrogram Sequence Distension of joints, crowded structures seen separately Labrum, G-H ligaments, biceps anchors Partial articular surface RC tears SLAP tears
12 Pathological process Shoulder Impingement Rotator cuff pathology Instability Miscellaneous- Biceps, Infection, Adhesive Capulitis
13 Osseous Acromial Outlet A-C joint Acromion Humeral Head
14 Extrinsic Impingement A-C osteophytes Sub-acromial Enthesophytes Acromion Shape
15 Acromion Shape 3 types Type1 Type 2 Type 3
16 Rotator Cuff Pathology Tendinosis Partial thickness Cuff Tears Full thickness Cuff Tears
17 Tendinosis Thickened tendon with degeneration Intrasubstance degeneration Normal to intermediate SI changes
18 Partial Cuff Tears Three types Articular side- FP, CZ Interstitial Bursal side
19 Partial RC Tear Intrasubstance tear Bursal sided RC Tear Bursal Tear Intra-Substance Tear
20 Full thickness RC tears Tear extending from bursal to articular surface Fluid in SA-SD bursa Retraction of tendon Muscle undergoes Atrophy Degeneration Fatty Infiltration
21 Full Thickness RC Tears Tendons involved Size of the tear- AP & ML plain
22 Full Thickness RC Tears Muscle Atrophy
23 Instability Spectrum ranging from subtle instability to frank dislocation Anterior Instability Posterior Instability SLAP tear
24 Anterior Instability Bankart Lesion Bony Bankart Glenoid Erosion Hill Sach s lesion
25 Anterior Instability Bankart Lesion
26 Anterior Instability Bony Bankart Glenoid Erosion Bony Bankart Glenoid Erosion
27 Anterior Instability Hill Sach s Lesion- Postero-Sup aspect of Humeral Head
28 Anterior Instability Hill Sach s Lesion
29 Posterior Instability Posterior Labral Lesion Reverse Hill Sach s
30 SLAP Tear Superior Labrum Antero-Posterior Tear Avulsion Biceps Anchor
31 SLAP Tear Normal Biceps Anchor
32 SLAP Tear Torn labral
33 Biceps Pathology Tendinosis Rupture Dislocation
34 Miscellaneous Osteonecrosis Fractures Osteonecrosis Occult Fractures Infection
35 Shoulder is a complex joint with many normal variants Proper clinical examination and probable clinical diagnosis MRI very sensitive test for diagnosing shoulder problems MRI findings should corroborate clinical findings
36 j Thank You
37 Various lesions seen in Dislocation Shoulder ALSPA Perthes Lesion Chondral Defect Reverse Hillsachs & Post Labral tear
38 Rotator Cuff Supraspinatus Infraspinatus Teres minor Subscapularis
39 Partial Cuff Tears Articular sided cuff tear
40 Miscellaneous Infection Adhesive Capsulitis
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