Shoulder Mri Scan in Delhi by Dr Shekhar Shrivastav

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Shoulder MRI Scan in Delhi,Shoulder MRI Scan,Shoulder MRI Delhi by Dr Shekhar Shrivastav - Dr. Shekhar Srivastav is an Orthopedic Surgeon attached to Sant Parmanand Hospital, Delhi with special interest in Knee & Shoulder surgery. After obtaining his M.S. Orthopedics degree he has undergone training in various centers in India and Abroad which has helped him in understanding the Orthopedics problems and their Management. He did his AO/ ASIF fellowship at University Hospital, Salzburg, Austria in 2006 and recieved training in Arthroscopy & Sports Medicine at TUM, Munich (Germany) & Rush Orthopedics Centre, Chicago( USA). He has an experience of more than fifteen years of diagnosing and treating Orthopedics & Trauma patients.

Details at http://www.delhiarthroscopy.com/

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Shoulder Mri Scan in Delhi by Dr Shekhar Shrivastav

  1. 1. MRI SHOULDER WHAT TO SEE DR SHEKHAR SRIVASTAV Sr. Consultant- Knee & Shoulder Arthroscopy Sant Parmanand Hospital delhiarthroscopy.com
  2. 2. Normal Anatomy delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  3. 3. Normal Shoulder MRI Coronal Oblique Sagital Oblique Axial Cuts delhiarthroscopy.com
  4. 4. Normal Coronal Oblique Parallel to plane of Supraspinatus • Supraspinatus • A-C Joint • Sub-acromial & Sub-Deltoid bursa delhiarthroscopy.com • Labrum- Sup & Inf • Biceps Tendon delhiarthroscopy.com
  5. 5. Normal Coronal Oblique • d delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  6. 6. Normal Coronal Oblique • Parallels the central tendon of supraspinatus delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  7. 7. Normal Sagittal Oblique Perpendicular to the plane of Supraspinatus • Medial to Lateral • Coraco-acromial arch • Rotator cuff • Shape of Acromion delhiarthroscopy.com delhiarthroscopy.com
  8. 8. Normal Sagittal Oblique • a delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  9. 9. Normal Axial Cuts delhiarthroscopy.com delhiarthroscopy.com
  10. 10. Normal Axial Cuts • Labrum- Ant & Post • Gleno-humeral ligament • Gleno-humeral cartilage • Biceps Tendon • Subscapularis & Teres delhiarthroscopy.com Minor delhiarthroscopy.com
  11. 11. Arthrogram Sequence • Distension of joints, crowded structures seen delhiarthroscopy.com separately Labrum, G-H ligaments, biceps anchors • Partial articular surface RC tears delhiarthroscopy.com • SLAP tears delhiarthroscopy.com
  12. 12. Pathological process Shoulder • Impingement • Rotator cuff pathology • Instability • Miscellaneous- Biceps, Infection, Adhesive Capulitis delhiarthroscopy.com
  13. 13. Osseous Acromial Outlet • A-C joint • Acromion • Humeral Head delhiarthroscopy.com delhiarthroscopy.com
  14. 14. Extrinsic Impingement • A-C osteophytes • Sub-acromial delhiarthroscopy.com Enthesophytes • Acromion Shape delhiarthroscopy.com delhiarthroscopy.com
  15. 15. Acromion Shape 3 types delhiarthroscopy.com Type1 delhiarthroscopy.com Type 2 delhiarthroscopy.com delhiarthroscopy.com Type 3
  16. 16. Rotator Cuff Pathology • Tendinosis • Partial thickness Cuff Tears • Full thickness Cuff Tears delhiarthroscopy.com
  17. 17. Tendinosis • Thickened tendon with degeneration delhiarthroscopy.com • Intrasubstance degeneration • Normal to intermediate SI changes delhiarthroscopy.com delhiarthroscopy.com
  18. 18. Partial Cuff Tears Three types • Articular side- FP, CZ delhiarthroscopy.com • Interstitial • Bursal side delhiarthroscopy.com delhiarthroscopy.com
  19. 19. Partial RC Tear • Intrasubstance tear • Bursal sided RC Tear delhiarthroscopy.com Bursal Tear delhiarthroscopy.com Intra-Substance Tear delhiarthroscopy.com
  20. 20. Full thickness RC tears • Tear extending from bursal to articular surface • Fluid in SA-SD bursa • Retraction of tendon • Muscle undergoes Atrophy Degeneration Fatty Infiltration delhiarthroscopy.com delhiarthroscopy.com
  21. 21. Full Thickness RC Tears • Tendons involved • Size of the tear- AP & ML plain delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  22. 22. Full Thickness RC Tears • Muscle Atrophy delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  23. 23. Instability Spectrum ranging from subtle instability to frank dislocation • Anterior Instability • Posterior Instability • SLAP tear delhiarthroscopy.com
  24. 24. Anterior Instability • Bankart Lesion • Bony Bankart delhiarthroscopy.com • Glenoid Erosion • Hill Sach s lesion delhiarthroscopy.com delhiarthroscopy.com
  25. 25. Anterior Instability • Bankart Lesion delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  26. 26. Anterior Instability • Bony Bankart delhiarthroscopy.com Bony Bankart Glenoid Erosion delhiarthroscopy.com Glenoid Erosion delhiarthroscopy.com
  27. 27. Anterior Instability • Hill Sach s LesionPostero-Sup aspect of Humeral Head delhiarthroscopy.com delhiarthroscopy.com
  28. 28. Anterior Instability • Hill Sach s Lesion delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  29. 29. Posterior Instability • Posterior Labral Lesion • Reverse Hill Sach s delhiarthroscopy.com delhiarthroscopy.com
  30. 30. SLAP Tear • Superior Labrum Antero-Posterior Tear • Avulsion Biceps Anchor delhiarthroscopy.com delhiarthroscopy.com
  31. 31. SLAP Tear • Normal Biceps Anchor delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  32. 32. SLAP Tear • Torn labral delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  33. 33. Biceps Pathology • Tendinosis • Rupture • Dislocation delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  34. 34. Miscellaneous Osteonecrosis delhiarthroscopy.com • Fractures Osteonecrosis delhiarthroscopy.com Infection Occult Fractures delhiarthroscopy.com delhiarthroscopy.com
  35. 35. • Shoulder is a complex joint with many normal variants • Proper clinical examination and probable clinical diagnosis • MRI very sensitive test for diagnosing shoulder problems • MRI findings should corroborate clinical findings delhiarthroscopy.com
  36. 36. j Thank Y ou delhiarthroscopy.com
  37. 37. Various lesions seen in Dislocation Shoulder ALSPA Perthes Lesion Chondral Defect Reverse Hillsachs & Post Labral tear delhiarthroscopy.com
  38. 38. Rotator Cuff • Supraspinatus • Infraspinatus • Teres minor • Subscapularis delhiarthroscopy.com
  39. 39. Partial Cuff Tears • Articular sided cuff tear delhiarthroscopy.com delhiarthroscopy.com delhiarthroscopy.com
  40. 40. Miscellaneous delhiarthroscopy.com Infection delhiarthroscopy.com Adhesive Capsulitis delhiarthroscopy.com

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