MUSCLESKELETAL RADIOLOGY

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MUSCLESKELETAL RADIOLOGY
Michael Maristany, MD Prepared by Carlos R.
Giménez, MD, FACP Professor of Radiology
Former Director MRI Body Division and MSK Section
LOUISIANA STATE UNIVERSITY MEDICAL CENTER School
of Medicine in New Orleans
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DIAGNOSIS TREATMENT
CLINICAL HISTORY
DIAGNOSIS BONE LESION
PATHOLOGY
RADIOLOGY
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Diagnostic modalities
Diagnostic modalities
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DIAGNOSTIC IMAGING
PLAIN RADIOGRAPH NUCLEAR MEDICINE CT MRI ANGIOGRAP
HY BIOPSY
SKELETAL
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Diagnostic algorithm

• Radiographs
• of the symtomatic area
• gtgtgt diagnosis

no
MRI for assessing bone soft tissue Component
Yesgtgtgtstop
CT for assessing matrix Composition
Nuclear medicine for Assessing asymptomatic Multip
licity or activity
MRI/CT CHARACTERIZATION
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CONVENTIONAL Rx

• IT REMAINS AS THE MOST RELIABLE IN THE
• HISTOLOGIC NATURE OF A SPECIFIC LESION
• DETECTION
• LOCALIZATION
• CHARACTERIZATION

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Tid bits

• It is always a good idea to start with a
  radiograph of the area in question.
• Proceed with MRI if you are concern with
  ligaments or
• soft tissue problems, occult fracture or
  characterization
• A CT if you are more concern with bony problems
• Sometimes you need both.

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Case 1

• 28 yo male complains of arm pain

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Hx unable to lift arm. Shoulder X-Ray (-)
SUPRASPINATUS
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RUPTURE ACL PARTIAL PCL
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RETINACULUMRUPTURE
ACL RUPTURE
MCL RUPTURE
PCL
Fx
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Ligament injuries

• CT is more optimal than MRI
• True or False

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• For the evaluation of Disc disease, ligamentous
  or spinal cord injury in trauma MRI is preferred
• For the evaluation of vertebral fractures in
  spine trauma CT is preferred.
• Point Both are use in evaluation of the spine in
  trauma.!

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UNILATERAL FACET LOCK
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BILATERAL FACET LOCK
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Fx POSTERIOR ARCH AXIS - ANTERIOR SUBLUXATION AXIS
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• Indirect Signs of Thoracic
• Spine Injury
• Paravertebral hematoma
• Mediastinal widening
• Pleural fluid (hemothorax)
• Sternal fracture
• Rib fractures costovertebral
• dislocations
• The double spinous process sign

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BURST FRACTURE
C 8005
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Medullary compression by disc degeneration
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Extruded disc
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5
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L 5 - S 1 HERNIA