Sunday, April 17, 2011

Pearls from Stoller Macau April 2011 - 3. Knee

  1. Trochlear groove - assess on sag.
  2. Meniscofemoral and meniscotibial (coronary) recesses.
  3. Horizontal tear - must extend to apex (sag).
  4. Flap tear - one type that looks horizontal but extends short of apex creating small inferior leaf.
  5. Flap tear -- vertical configuration, but inner 1/3 (sag).
  6. Vertical/longitudinal tear - outer 1/3 (sag).
  7.  Menisco-capsular separation -- two scenarios
    • ACL with tear of periph of post. horn lat. meniscus (fluid betw. capsule and periph. of post. horn).
    • MCL tear with meniscotibial lig. tear.
  8.  Posterolat. corner -- review on sag and axial.
  9. SONK -- almost all cases are probably insufficiency fractures
  10. CMP - MRI adaptation of Outerbridge classification; describe rather than classify; ICRS classification.
  11. MPFL - slice above proximal origin of MCL, tears at femur
  12. Patella tendinosis - best on GRE.

Pearls from Stoller Macau April 2011 - 2.Shoulder

  1. Anterior band of IGHL can have high attachment -- 3rd structure on axial (in addition to labrum and MGHL).
  2. Sublabral foramen (antero-superior); sublabral sulcus (superior)
  3. Hill-Sachs - position - where articular cartilage in NOT; at level of footprint on axial (1st two slices).
  4. MGHL - "squiggly" on Sag.
  5. Patterns of glenoid sclerosis.
  6. Anteroinferior labrum -- assess 1st -- spectrum of injury
    • Perthes -  labral tear, minimal displacement, intact periosteum
    • ALPSA - labral tear and medial displacement of IGLLC, medially stripped but intact periosteum (NB POLPSA)
    • GLAD - labral tear (partial), no detachment, chondral defect, intact periosteum
    • Bankart - avulsion of IGLLC (anterior and medial), disruption of scapula perisoteum
  7.  SGHL/CHL -- "Biceps pulley" -- look on Sag
  8. HAGL -- anterior band IGHL tear (+BHAGL) aot RHAGL or PHAGL -- post. band
  9. GAGL
  10. "Wave Sign" -- massive RC tear  - repairable acute tear without scarring

Pearls from Stoller Macau April 2011 - 1.Technique

  1. Zoom in to see detail.
  2. Every series should contain a plain T1.
  3. GRE/T2* -- for shoulders and knee at least -- useful for chondrocalcinosis, PVNS, blood
  4. Hip -- should include sag
  5. Hip - one large FOV series
  6. Ankle -- NB ant. process of calcaneus and lateral process of talus