RSNA 2013 

Abstract Archives of the RSNA, 2013


RC404A

MR Checklist Approach

Refresher/Informatics

Presented on December 3, 2013
Presented as part of RC404: Current Imaging of the Shoulder: Rotator Cuff and Glenohumeral Joint Instability including Normal Variants, Pitfalls, Controversies, and Postoperative Challenges

Participants

David Wayne Stoller MD, Presenter: Nothing to Disclose

LEARNING OBJECTIVES

1) Develop a shoulder checklist method including interpretation techniques for the rotator cuff and interval, biceps labral complex, inferior glenohumeral ligament complex, and capsular structures including the anterior band. 2) Identify glenoid wear patterns in multidirectional instability, microinstability, anterior and posterior instability.

ABSTRACT

The shoulder checklist represents a way of approaching shoulder MRIs consistently by emphasizing key structures that should be reviewed in specific planes. In the coronal plane, the AC joint should be evaluated for arthrosis; the rotator cuff should be evaluated first anteriorly and then posteriorly so that far anterior cuff tears or isolated infraspinatus tears posteriorly are not missed. The biceps labral complex is where the superior labrum and the intrarticular biceps are adherent. The superior labrum is evaluated for intralabral tear or detachment from the biceps. The IGLLC is evaluated for tear or hyperintensity and thickening. The articular cartilage of the humeral head is inspected for congruity. In the axial plane, the anterior inferior labrum is established on the inferior axial images with no fluid between the fibral cartilage and the articular cartilage of the glenoid. The anterior band of the IGL is usually identified at or above the equator. There is no fluid between the posterior labrum and the articular cartilage of the glenoid. The subscapularis tendon is evaluated along its entire insertion from inferior to superior. The extraarticular biceps is evaluated for medial subluxation. In the sagittal plane, the rotator cuff is evaluated to differentiate contributing tendons of the supraspinatus and the infraspinatus and to assess the size of the rotator cuff in the anterior to posterior plane. The biceps pulley at the mid rotator cuff interval is evaluated. The glenoid fossa is inspected for sclerosis or osteophytic ridging.  

Cite This Abstract

Stoller, D, MR Checklist Approach.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/12020091.html