Overview
In this course you learn tips and tricks, relevant anatomy and important pathology in MSK Radiology, that will increase your confidence and speed in MSK radiology.
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1
Module One - The Journey
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1. 1 The road that lays ahead
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1.1 Action items
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1.2 Why is MSK difficult
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1.3 How to improve
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1.4 Your Resources
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1.5 How to live Q&A sessions
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2
Module Two - Shoulder
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2.1 Shoulder Approach
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2.2 Shoulder Anatomy
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Exercise: Identify this structures
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Anatomy Assessment (MRI)
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2.3.1 Pathology - SLAP or not?
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2.3.2 Pathology - Labral tears vs Variants
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2.3.3 Pathology - Tendinosis
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2.3.4 Pathology - Rotator Cuff Tears
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Action items - Cases to report
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Case 1 - Contusion 6 weeks ago, persistent pain, limited motion. Rotator cuff tear?
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Case 1 - Submit your report
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Case 1 - Solution (Video and Report)
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Case 2 - limited abduction and anteversion after near fall from scaffold tower
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Case 2 - Submit your report
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Case 2 - Solution (Video and Report)
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Case 3 - 2x subluxation during nightly epilepsy with paralysis for a few days. pain in external rotation and exercising.
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Case 3 - Submit your report
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Case 3 - Solution (Video and Report)
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Case 4 - Pain for years, probably osteoarthritis. Query: bursitis? frozen shoulder?
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Case 4 - Submit your report
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Case 4 - Solution (Video and Report)
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Case 5 - Shoulder pain for 2 years, clinically scapular dyskinesia, no trauma
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Case 5 - Submit your report
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Case 5 - Solution (Video and Report)
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3
Module Three - Hip
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3.1 Hip Approach
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3.2 Hip Anatomy
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Exercise: Identify these structures
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Anatomy Assessment (MRI)
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3.3.1 Pathology Overview
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3.3.2 Pathology Lablar Tear or Not
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3.3.3 Pathology Abductor Tendons
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3.3.4 Pathology Bursitis
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Action items - Cases to report
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Case 1 - Femoroacetabular Impingement
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Case 1 - Submit your report
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Case 1 - Solution (Video and Report)
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Case 2 - FAI, after arthroscopic adhesiolysis and cam surgery and suture of dehiscent joint capsule
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Case 2 - Submit your report
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Case 2 - Solution (Video and Report)
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Case 3 - Suspected FAI. Labrum? Cartilage? cam?
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Case 3 - Submit your report
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Case 3 - Solution (Video and Report)
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Case 4 - 2x arthroscopy (cam + labral surgery, acetalar trimming), limited ROM, still pain, query: labrum (more info above in action item section)
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Case 4 - Submit your report
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Case 4 - Solution (Video and Report)
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Case 5 - Bilateral Hip pain. Radiograph (external) shows osteolysis of sacrum. Pathology?
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Case 5 - external Radiograph (you need to manually window it)
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Case 5 - Submit your report
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Case 5 - Solution (Video and Report)
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Bonus: Keynote Lecture - Hip MRI in young and old people
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4
Module Four - Knee
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1 approach knee
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2.1 Anatomy overview
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2.1.0 harris lines
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2.1.1 Patellar measurements and TTTG
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2.1.2 Adductor tubercle
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2.1.3 Prepatellar quadriceps continuation
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2.1.4 Posteromedial Corner Anatomy
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2.1.5 Posterolateral corner anatomy MRI
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2.1.6 ALL and AIML and their relationship to segond fractures
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2.1.7 Medial synovial PCL fold
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2.1.8 Knee Plicae Anatomy
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2.1.9 Meniscus variants
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2.1.10 Oblique menisco-meniscal ligament
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2.1.11 Accessory popliteus muscle
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3.1 Pathology Meniscus posterior horn lesions
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3.2 Ramp lesion anatomy and pathology
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3.3 ACL tear, meniscopopliteal fascile injury post arthroscopy
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3.4 Gap sign ACL partial tear
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3.5 Black line sign cartilage fissures
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3.6 Superolateral Hoffa impingement
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3.7 Runner's knee
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3.8 Prepatellar edema relevant or not
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3.9 SIFK not SONK
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3.10 MRI after ACL-Reconstruction
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Case 1 - Knee distortion during football. Persistent medial pain
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Case 1 - Submit your Report
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Case 1 - Solution (Video and Report)
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Case 2 - Knee distorsion. ACL? Meniscus?
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Case 2 - Submit your report
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Case 2 - Solution (Video and Report)
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Case 3 - Medial knee pain. Varus osteoarthritis.
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Case 3 - Submit your report
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Case 3 - Solution (Video and Report)
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Case 4 - Suspicion of LCL lesion DD meniscus. Ligament? Mensicus?
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Case 4 - Submit your report
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Case 4 - Solution (Video and Report)
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Case 5 - New trauma after ACL (semi-T , 3x) repair 10 months ago, query: re-tear? heard a pop
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Case 5 - Submit your report
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Case 5 - Solution (Video and Report)
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5
Module Five - Ankle and Foot
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1 approach ankle
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2 Anatomy
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2.1.0 Anatomy - deltoid ligament
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2.1.1 Anatomy - spring ligament anatomy
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2.1.2 Anatomy - lateral ankle ligaments
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2.1.3 Anatomy - syndemosis ankle
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2.1.4 Anatomy - lisfranc and bifurcate ligament anatomy
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2.1.5 Anatomy - accessory muscles in the ankle joint
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2.1.6 Anatomy - peroneus brevis variant insertion
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2.1.7 Anatomy - great toe
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2.1.8 Anatomy - distal phalanx great toe exostosis
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3.1.0 Pathology - anterior ankle impingement syndrome
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3.1.1 Pathology - anterolateral impingement
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3.1.2 Pathology - fluid around posterior tibial tendon
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3.1.3 Pathology - fascial sleeve of the medial malleolus
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3.1.4 Pathology - fascial sleeve avulsion example
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3.1.5 Pathology - syndesmosis injury and double bundle ATFL
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3.1.6 Pathology - peroneal tendon injury
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3.1.7 Pathology - superior peroneal retinaculum anatomy and injury
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3.1.8 Pathology - retrocalcaneal bursitis
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3.2.1 Pathology -Morton neuroma part 1
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3.2.2 Pathology - Morton neuroma part 2
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3.2.3 Pathology - osteomyelitis
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3.2.4 Pathology - diabetic denervation edema
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3.2.5 Pathology - plantar plate tear
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3.2.6 Pathology - CRPS foot
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3.2.7 Pathology - unknown case approach
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Bonus - Keynote Lecture Spring ligament MRI
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Case 1 - Ankle distorsion 1 month ago, persistent pain on weight-bearing. Bone bruise? Rupture ATFL?
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Case 1 - Submit your report
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Case 1 - Solution (Video and Report)
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Case 2 - Recurring ankle supinations, new trauma during football, clinically not assesable due to swelling and pain. Pathology? Lateral ligament injury?
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Case 2 - Submit your report
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Case 2 - Solution (Video and Report)
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Case 3 - Plantar foot pain, no trauma. Pathology?
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Case 3 - Submit your report
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Case 3 - Solution (Video and Report)
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Case 4 - Persistent forefoot pain and hammer toes
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Case 4 - Submit your report
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Case 4 - Solution (Video and Report)
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Case 5 - naviculocuneiforme osteoarthritis DD osteonecrosis os naviculare. Degree of OA? exclusion of osteonecrosis?
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Case 5 - Submit your report
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Case 5 - Solution (Video and Report)
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posterior ankle impingement
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6
Module Six - Wrist
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1 Approach Wrist
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1.1 Technical & Protocol considerations
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2 Anatomy
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2.1. Anatomy of the distal ulnar nerve
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3.1 Pathology - Bone
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3.2. Pathology - Soft Tissue
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3.3. Case 1
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3.3. Case 2
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3.3. Case 3
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3.3. Case 4
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3.3. Case 5
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3.3. Case 6
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3.3. Case 7
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3.3. Case 8
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3.3. Case 9
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3.3. Case 10
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3.3. Case 11
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3.3. Case 12
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3.3. Case 13
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3.3. Case 14
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3.3. Case 15
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3.4. Ulnar nerve pathology - Case 1
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3.4. Ulnar nerve pathology - Case 2
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3.4. Ulnar nerve pathology - Case 3
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3.4. Ulnar nerve pathology - Case 4
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Case 1A - Right wrist contusion some days ago. Pressure pain at the SL ligament. Question: SL ligament lesion? (part 1)
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Case 1B - Right wrist contusion some days ago. Pressure pain at the SL ligament. Question: SL ligament lesion? (part 2)
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Case 1 - Submit your report
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Case 1 - Solution (video and report)
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Case 2 - fall 9 months ago, persistent dorsal wrist pain, pain above dorsal distal radius, SL and CMC III. lesion?
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Case 2 - Submit your report
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Case 2 - Solution (video and report)
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Case 3 - Distorsion of wrist some months ago, persistent pain
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Case 3 - Submit your report
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Case 3 - Solution (video and report)
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Case 4 - Pain in the metacarpophalangeal joint of the thumb over the wrist to the forearm with swelling on the left side. Pathology?
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Case 4 - Submit your report
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Case 4 - Solution (video and report)
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Case 5 - Chronic wrist pain on the left side, since distal radius fracture 8 years ago, pain with active and passive movement over the distal radius mainly dorsal, limited mobility.
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Case 5 - Submit your report
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Case 5 - Solution (video and report)
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7
Module Seven - Elbow
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1. Approach
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2.0 Anatomy
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2.2. anatomy radial collateral ligaments
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2.1 distal biceps tendon
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2.3 bicipitoradial bursa
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Case 1 - Extensor deficit and pain in left elbow/wrist after unusual heavy activity
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Case 1 - Submit your report
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Case 1 - Solution (Video and Report)
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Case 2 - Pain distal upper arm, retracted biceps muscle, distal biceps tendon tear. Query: amount of retraction?
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Case 2 - Submit your report
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Case 2 - Solution (Video and Report)
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Case 3 - sudden pain while lifting a heavy box today. clinically partial tear triceps brachii muscle at myotendinous junction. Query: partial tear?
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Case 3 - Submit your report
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Case 3 - Solution (Video and Report)
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Case 4 - Fall 10 days ago on the left elbow. stiffness and extension not possible.
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Case 4 - Submit your report
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Case 4 - Solution (Video and Report)
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Case 5 - therapy-resistant lateral epicondylitis for some months.
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Case 5 - Submit your report
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Case 5 - Solution (Video and Report)
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Module Eight - Sacroiliac joint (SpA)
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1.0 Approach SIJ
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2.0 Anatomy SIJ
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3.0 Pathology - Sacroiliitis or not
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3.1 Pathology - Spine SpA
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Case 1 - HLA B 27 positive. Elevated CRP. Radiological suspicion of SIJ arthritis. History of additional disc hernia possible.
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Case 1 - Submit your report
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Case 1 - Solution (Video and Report)
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Case 2 - Pain in the right SI-joint. SIJ arthritis?
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Case 2 - Submit your report
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Case 2 - Solution (Video and Report)
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Case 3 - Increasingly restrictive right SIJ pain. Arthritis?
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Case 3 - Submit your report
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Case 3 - Solution (Video and Report)
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Case 4 - Suspicion of bilateral left accentuated sacroiliitis in early stage. Query: Edema, Enhancement, Erosions?
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Case 4 - Submit your report
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Case 4 - Solution (Video and Report)
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Case 5 - The patient has recurrent left gonarthritis and an inflammatory-like back pain with mild left SIJ sclerosis. HLA-B27 and anti-CCP are positive. Regarding clarification of the differential diagnosis, MRI with Gd+ required.
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Case 5 - Submit your report
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Case 5 - Solution (Video and report)
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9
Module Nine - Reporting Week
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1 How to speed things up
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2 How to continue learning
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3 Learn by teaching
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Course Evaluation
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10
Module Ten - Miscellaneous
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The MSK puzzle
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Tumors
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Exam (TBD)
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