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MUSCLESKELETAL RADIOLOGY

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. DIAGNOSIS & TREATMENT. CLINICAL HISTORY.

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MUSCLESKELETAL RADIOLOGY

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  1. MUSCLESKELETAL RADIOLOGY Michael Maristany, MD Preparedby 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

  2. DIAGNOSIS & TREATMENT CLINICAL HISTORY DIAGNOSIS BONE LESION PATHOLOGY RADIOLOGY

  3. Diagnostic modalities Diagnostic modalities

  4. DIAGNOSTIC IMAGING PLAIN RADIOGRAPH NUCLEAR MEDICINE CT MRI ANGIOGRAPHY BIOPSY SKELETAL

  5. Diagnostic algorithm • Radiographs • of the symtomatic area • >>> diagnosis no MRI for assessing bone & soft tissue Component Yes>>>stop CT for assessing matrix Composition Nuclear medicine for Assessing asymptomatic Multiplicity or activity MRI/CT CHARACTERIZATION

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

  7. 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.

  8. Case 1 • 28 yo male complains of arm pain

  9. Hx: unable to lift arm. Shoulder X-Ray (-) SUPRASPINATUS

  10. RUPTURE ACL PARTIAL PCL

  11. RETINACULUMRUPTURE MCL RUPTURE ACL RUPTURE PCL Fx

  12. Ligament injuries • CT is more optimal than MRI • True or False

  13. 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.!

  14. UNILATERAL FACET LOCK

  15. BILATERAL FACET LOCK

  16. Fx POSTERIOR ARCH AXIS - ANTERIOR SUBLUXATION AXIS

  17. Indirect Signs of Thoracic • Spine Injury • Paravertebral hematoma • Mediastinal widening • Pleural fluid (hemothorax) • Sternal fracture • Rib fractures & costovertebral dislocations • The double spinous process sign

  18. BURST FRACTURE C # 8005

  19. Medullary compression by disc degeneration

  20. Extruded disc 2 5

  21. L 5 - S 1 HERNIA

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