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JOINT DISEASES


OSTEOARTHRITIS ●
ACHILES TENDON RUPTURE

RHEUMATOID ARTHRITIS ●
POSTERIOR TIBIAL TENDON
RUPTURE

DISH

TENDINOSIS

ANKYLOSING SPONDYLOSIS

ROTATOR CUFF INJURIES

GOUT

GLENOHUMERAL

CPPD
INSTABILITY

AVASCULAR NECROSIS OF ●
EPICONDYLITIS
HIP

BICEPS TENDON RUPTURE

ILIOPSOAS BURSITIS

CARPAL TUNNEL SYNDROME

MENISCAL TEARS

AVASCULAR NECROSIS OF

ACL INJURY
SCAPHOID
OSTEOARTHRITIS

RADIOLOGICAL FEATURES
● PRIMARY – IDIOPATHIC
● SECONDARY – MULTIPLE CAUSES
● JOINT SPACE NARROWING

● EROSIVE OR HYPERTROPHIC
● SUBCHONDRAL SCLEROSIS
VARIETY ● SUBCHONDRAL EROSION
● AFFECTS WEIGHT BEARING ● SUBCHONDRAL CYSTS AND
JOINTS
MICROFRACTURES
● CAUSES KNEE PAIN AND
RESTRICTON OF MOVEMENT AND
● OSTEOPHYTE FORMATION
JOINT DESTRUCTION, DISABILITY ● SUBLUXATION OF JOINTS
● CALCIFICATION OF
FIBROCARTILAGE AND
HYALINE CARTILAGE
XRAY KNEE OA

● JOINT SPACE
NARROWING
● SUB CHONDRAL
SCLEROSIS
RHEUMATOID ARTHRITIS ●
RADIOLOGICAL FEATURES
● INFLAMMATORY ARTHRITIS ● INITIALLY JOINT WIDENING
● . PANNUS FORMATION WITH BECAUSE OF SYNOVITIS ,
DESTRUCTION OF UNDERLYING EFFUSION AND THEN EROSION
CARTILAGE AND JOINT NARROWING
● AFFECTS SMALL JOINTS OF ● SOFT TISSUE SWELLING
HANDS AND FEET MORE THAN ● SUB CHONDRAL CYSTS PRESENT
WEIGHT BEARING JOINTS
● NO SUBCHONDRAL SCLEROSIS
● MARGINAL EROSIONS – DIFF
FROM OSTEOARTHRITIS WHICH ● OSTEOPOROSIS – PERIARTICULAR
HAS CENTRAL EROSIONS TO START WITH THEN DIFFUSE
AND THEN REGIONAL PRESENT
● SPINE – ONLY CERVICAL AND
RARELY LUMBAR SPINE ● JOINT SUBLUXATION AND
INVOLVEMENT SEEN DISLOCATION.
● PIP JT > DIP JT DIFFERENTIATES ● ARTHRITIS MUTILANS – FINAL
IT FROM BOTH OA AND STAGE OF JOINT DESTRUCTION
PSORIATIC OA
● CAN CAUSE SECONDARY OA
1.XRAY-RA
● RA –
● JOINT SPACE
NARROWING
● JOINT
DESTRUCTION
● OSTEOPOROSIS
● NO SCLEROSIS
2.XRAY - RA
● JOINT
NARROWING
● JOINT
DESTRUCTION
● SOFT TISSUE
SWELLING
DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

SPINE – R> L

COMMONLY AFFECTS
ELDERLY PATIENTS ●
ANTERIOR LONGITUDINAL
LIGAMENT OSSIFICATION

FLOW ING OSSIFICATION OF

SPURS DEVELOP FROM THE
LIGAMENTS OF THE SPINE IN
OSSIFIED LIGAMENTS WHICH
A SEGMENT INVOLVING 4 OR
MAY FUSE WITH THE ADJACENT
5 VERTEBRAE SPURS
CONTIGUOUSLY
● OSSIFICATION OF POSTERIOR

PRESERVATION OF DISC LONGITUDINAL LIGAMENT CAN
HEIGHT TO DIFFERENTIATE CAUSE SPINAL STENOSIS
FROM DEGENERATIVE ●
CAN OCCUR AS ISOLATED
PROCESS
CONDITION

NO JOINT FUSION AS IN AS ● RADIOGRAPHIC PICTURE

NOT AN ARTHRITIC ●
BRIDGING OSTEOPHYTES
CONDITION BUT A REACTION
AFFECTING MULTIPLE
TO STRESS
LEVELS OUT OF PROPOTION

ASYMPTOMATIC OR C/F OF TO THE DEGREE OF
BACKPAIN ,STIFFNESS , DEGENRATIVE CHANGE
TENDINOSIS
1.XRAY DISH
● BRIDGING
OSTEOPHYTES
AFFECTING
MULTIPLE LEVELS
OUT OF
PROPOTION TO
THE DEGREE OF
DEGENRATIVE
CHANGE
2.XRAY - DISH
● BRIDGING
OSTEOPHYTES
AFFECTING
MULTIPLE LEVELS
OUT OF
PROPOTION TO
THE DEGREE OF
DEGENRATIVE
CHANGE
ANKYLOSING SPONDYLITIS
● ANKYLOSIS – JOINT FUSION
● SPONDYLITIS – INFLAMMATION OF
● SPINAL INVOLVEMENT PRECEEDS SI JOINT
INVOLVING STRUCTURES IN THE SPINE. INVOLVEMENT AND CONSISTS OF EARLY
EROSION AND SCLEROSIS OF ANTERIOR
● PROGRESSIVE , CHRONIC CONDITION CORNERS OF VERTEBRAL BODIES LEADING
TO SQUARING OF VERTEBRAL
● AFFECTS YOUNG ADULTS 25-35YRS BODIES ,SYNDESMOPHYTE FORMATION,
LONGITUDINAL LIGAMENT MINERALIZATION
● AFFECTS SACROILIAC JOINTS,SPINAL AND ANKYLOIS OF APOPHYSEAL JOINTS
APOPHYSEAL JOINTS, ANNULUS FIBROSIS
AND THE DEEP LAYERS OF THE ANTERIOR ● ON MATURATION SYNDESMOPHYTES
LONGITUDINAL LIGAMENT PRODUCES BAMBOO SPINE APPEARANCE
● M:F = 10: 1 ● SI JT :EARLY UNILATERAL , THEN
CLASSICALLY B/L SYMMETRICAL
● BONY ANKYLOSIS – EARLY AND RAPID -
HALLMARK OF THE DISEASE ● INTIAL FINDING: LOSS OF JOINT MARGIN
DEFINITION
● RADIOLOGICAL FEATURES
● LATER: JOINT WIDENING ,IRREGULARITY,
● PRINCIPLE SITES OF INVOLVEMENT : EROSION ON THE ILIAC SIDE LEADING TO
LOWER 2/3 SI JOINT,HIPS, KNEES,ANKLES, SCLEROSIS AND ULTIMATELY ANKYLOSIS
SHOULDERS, COSTOVERTEBRAL JOINT,
MANUBRIOSTERNAL JOINT,SYMPHYSIS ● LIGAMENT INVOLEMENT RESULTS IN
PUBIS. INDISTINCTNESS OF CORTICES OF BOTH
BONES DUE TO 'WHISKERING OF BONE' ON
● SMALL JOINTS NOT INVOLVED EITHER SIDE LEADING TO ANKYLOSIS.
● SPINE:STARTS IN TL REGION AND
PROGRESSES UPWARDS
1.XRAY - AS
● SQUARING OF
VERTEBRAE
● SYNDESMOPHYTE
S
2.XRAY -AS
● SI JOINT SPACE
NARROWING
● SCLEROSIS
● FUSION -
ANKYLOSIS
3.XRAY - AS
● SI JOINT
SCLEROSIS
GOUT ●
RADIOLOGICAL FEATURES DEVELOP
ONLY IN CHRONIC TOPHACEOUS GOUT.

INBORN ERROR OF PURINE
METABOLISM WHICH CAUSES

EROSIONS + SOFT TISSUE SWELLINGS
HYPERURICEMIA , DEPOSITION OF ARE THE HALLMARK OF THE DISEASE.
MONOSODIUM URATE CRYSTALS IN ●
JOINT NARROWING
JOINTS AND SOFT TISSUES
RESULRING IN RECURRENT ● PERIARTICULAR , MARGINAL OR
EPISODES OF ACUTE ARTHRITIS SUBCHONDRAL EROSION WHICH ARE
CYST LIKE WITH A THIN SCLEROTIC RIM

AUTOSOMAL DOMINANT CONDITION

THESE ARE LOCATED REMOTE FROM

AGE – THIRD DECADE OF LIFE THE ARTICULAR SURFACE AND HELPS
● 4 STAGES IN DISEASE TO DIFFERENTIATE FROM RA WHERE
PROGRESSION.1.ASYMPTOMATIC THEY OCCUR ON BARE AREAS OF THE
HYPERURICEMIA 2.ACUTE GOUTY BONE.
ARTHRITIS 3.INTERCRITICAL GOUT ● HAND – SEVERE DEFORMITY WITH
4.CHRONIC TOPHACEOUS GOUT TELESCOPING SEEN DURING

ACUTE ARTHRITIS – MOST COMMON TREATMENT
EARLY MANIFESTATION ●
WRIST – MCP JT MC INVOLVED

TYPICALLY AFFECTING THE 1ST MTP● FOOT – MTP JT OF 1ST TOE
JT. INVOLVEMENT IS HALLMARK LOCATION

CHRONIC TOPHECEOUS GOUT – ●
HALLUX VALGUS IS A COMMON
SOFT TISSUE LUMPS OCCUR ACCOMPANIMENT
CONTAINING MSU DEPOSITS.
2.XRAY - GOUT
● SOFT TISSUE
SWELLING
● MTP,PIP JT
DESTRUCTION
PSEUDOGOUT(CPPD)

CPPD – CALCIUM PYROPHOSPHATE ●
UNIFORM CARTILAGE THINNING,
DIHYDRATE DEPOSITION DISEASE . MULTIPLE SUBCHONDRAL CYSTS AND
OSTEOPHYTES

DEPOSITION OF CPPD IN JOINTS,
BURSAE AND TENDON SHEATHS ●
LARGE PERI ARTICULAR CALCIFIC
DEPOSITS CAN CAUSE PRESSURE

IF THE CONDITION IS SYMPTOMATIC
EROSIONS-
IT IS CALLED PSEUDO GOUT.
TOPHACEOUSPSEUDOGOUT

ASYMPTOMATIC IN WHICH CASE THE ● GIANT CYSTS, STRUCTURAL
ONLY RADIOLOGICAL FEATURE IS
COLLAPSE AND FRAGMENTATION ARE
CHONDROCALCINOSIS.
RECOGNIZED FEATURES.
● ACUTE ATTACKS : SEEN ONLY ON ●
CROWN DENSE SYNDROME – CTGOUT
MRI /CT NOT ON RADIOGRAPHS.
AT THE AT.AX. JOINT CAUSES CORD
● CHRONIC ARTHROPATHY : AFFECTS COMPRESSION
PATELLOFEMORAL ARICULATION ● CS SPINE – INTERVETEBRAL DISC
MOST COMMONLY
CALCIFICATION , JOINT SPACE

RADIOCARPAL,CARPOMETACARPAL NARROWING AND
AND ELBOW COMMONLY INVOLVED ●
SI JT – OSTEOARTHRITIC CHANGES

CHONDROCALCINOSIS FREQUENTLY ● SYMPHYSIS PUBIS – THIN VERTICAL
BUT NOT INVARIABLY PRESENT
LINEAR CALCIFICATION SEEN

ARTHROPATHY : B/L SYMETRICAL
DISTRIBUTION
AVASCULAR NECROSIS OF HIP
● HIP IS THE MC AFFECTED PART
IN AVN
● STAGE 2: XRAY-FEMORAL HEAD
● CAUSE : ELDERLY – TRAUMATIC SPHERICAL. DIFFUSE
ESPECIALLY SUBTROCHANTERIC OSTEOPOROSIS AND SUBSEQUENT
FRACTURE. YOUNG – NON SCLEROSIS. MRI -'DOUBLE
TRAUMATIC EG: LEG CALVE LINE'.
PERTHES
● STAGE 3:XRAY -LATERAL VIEW-
● INVESTIGATION OF CHOICE :MRI FEMORAL HEAD LOSES SPHERICAL
– MORE SENSITIVE THAN CT OR SHAPE. MRI- LOW SIGNAL LINE
SCINTI. IN ALL SEQUENCES PARALLEL TO
SUBARTICULAR CORTEX
● STAGING AND MRI
INDICATING SUBCHONDRAL
FEATURES:STAGE 0 : FRACTURE.THIS PRECES HEAD
ASYMPTOMATIC ,DIAGNOSED WHEN COLLAPSE.JOINT SPACE
C/L SYMPTOMATIC HIP IS MAINTAINED.
AFFECTED.MRI -MARROW EDEMA
● STAGE 4: COLLAPSE,
● STAGE 1: XRAY:FEMORAL HEAD DESTRUCTION OF CARTILAGE AND
SPHERICAL .MINOR JOINT SPACE NARROWING.
OSTEOPOROSIS ,TRABECULAE
NORMAL.MRI – 'DOUBLE LINE'
DEMARCATION BETWEEN NORMAL
AND ABNORMAL BONE.
1.XRAY- GOUT

● 1ST MTP
JT
AFFECTED
ILIOPSOAS BURSITIS N SUFE
● ILIOPSOAS BURSITIS

COMMONEST BURSA AROUND ●
SLIPPED UPPER FEMORAL
THE HIP TO GIVE A SOFT TISUE EPIPHYSES
MASS

OCCURS IN ADOLECENTS AND

COMMUNICATES W ITH THE JOINT
YOUNG CHILDREN
IN 15% OF INDIVIDUALS.

SLIP IS USUALLY POSTERIOR

LIES BETW EEN THE ILIOPSOAS
MUSCLE AND HIP CAPSULE AND ●
XRAY – FROG LATERAL SHOWS
LATERAL TO FEMORAL VESSELS THE SLIP

BECOMES ENLARGED IN OA AND ●
MRI SHOWS SECONDARY
RA PROCESSES , OTHERW ISE AVASCULAR NECROSIS OF
REMAINES A COLLAPSED FEMORAL HEAD AT
STRUCTURE PRESYMPTOMATIC STAGE

C/F : PAIN , SW ELLING AND
NEUROPATHY DUE TO
COMPRESSION OF ADJACENT
FEMORAL NERVES
MENISCAL TEARS

MRI MODALITY OF CHOICE , ●
BUCKET HANDLE TEAR
ARTHROGRAPHY ALSO USED . ●
IN CASES OF VERTICAL TEARS

T1,T2 AND PROTON DENSITY ●
THE FREE OF TEAR MAY
SHOW TEARS
DISLODGE INTO JOINT SPACE.

NORMAL MENISCI IS BOW TIE ●
THIS MAY BREAK OFF ON BOTH
SHAPED ON SAGITTAL VIEW
SIDES AND BECOME A
OF MRI WITH LOW SIGNAL
FRAGMENT
INTENSITY

THIS FRAGMENT USUALLY

TEARS APPEAR AS HIGH
GETS LODGED IN THE INTER-
SIGNAL WITH IN THE
CONDYLAR NOTCH.
MENISCUS BECAUSE OF
IMBIBED SYNOVIAL FLUID ●
MEDIAL MENISCUS MORE
COMMONLY INVOLVED

DEGENERATIVE TEARS
APPEAR AS HIGH SIGNAL ON ● C/F - LOCKED KNEE OR
HORIZONTAL LESIONS INABILITY TO EXTEND KNEE
MAY OCCUR.

TRAUMATIC TEARS APPEAR AS
VERTICAL HIGH SIGNAL
LESIONS
MRI – NORMAL MENISCI
● NORMAL “BOW TIE”
APPEARANCE OF
THE MENISCUS
MRI – DEGENERATED TEARS
● ARROW
INDICATING FULL
THICKNESS TEAR
OF MEDIAL
MENISCUS
● HIGH INTENSITY
SIGNAL SPANNING
THE FULL
THICKNESS OF
MENISCUS
ANTERIOR CRUCIATE LIGAMENT TEARS
● DOES NOT EXIST IN ISOLATION ● PARTIAL OR INCOMPLETE
DISRUPTIONS MAY BE ASSOCIATED
● ASSO WITH MENISCL TEARS IN 68% OF WITH ATTENUATION OF SOME
ACUTE INJURIES AND 91% OF FASCICLES WHICH MAY APPEAR
CHRONIC INJURIES INDISTINCT DUE TO ADJACENT
OEDEMA AND HEMORRHAGE.
● COLLATERAL LIGAMENT INJURY
COMMON ACCOMPANYING FINDING ● SECONDARY SIGNS INCLUDE A
BUNCHING UP OF THE POSTERIOR
● C/F – PAINFUL KNEES + ACUTE
CRUCIATE LIGAMENT , ANTERIOR
HEMARTHROSIS
TRANSLATION OF FEMUR ON TIBIAL
● NORMAL ACL IS REPRESENTED AS CONDYLES AND A WAVY PATELLAR
ONE OR MORE BANDS OF LOW LIGAMENT, ALTHOUGH THESE ARE
SIGNAL INTENSITY AND SEPARATE NOT SPECIFIC.
FIBRE BUNDLES CAN BE ● ABSENCE OF ACL IN BOTH SAGITTAL
DISTINGUISHED NEAR THE POINT OF
AND CORONAL PLANE IS DIAGNOSTIC
ATTACHMENT DUE TO INTERPOSITION
OF FAT BETWEEN THEM ● SEGOND FRACTURE -
POSTEROLATERAL TIBIAL FRACTURE
● COMPLETE TEAR – DISCONTINUITY IN
AND FRATURE OF LATERAL FEMORAL
LOW SIGNAL BAND IS PRESENT
CONDYLE ARE RELATIVELY SPECIFIC
FOR ACUTE COMPLETE ACL TEARS
T2W MRI -ACUTE ACLTEAR
● Acute tear of the
ACL manifest as
focal interruption of
the ligament. T2-
weighted image
shows focal
hyperintense edema
and/or fluid
involving the
proximal ACL
ACHILLES TENDON RUPTURE
● LARGEST AND STRONGEST TENDON ●
MRI FINDINGS OF
IN THE HUMAN BODY TENDINOSIS:DIFFUSE SWELLING OR
● FORMED BY COMMON INSERTION OF THICKENING WITH INCREASED SIGNAL
SOLEUS, PLANTARIS AND ON T2 AND STIR.
GASTROCNEMIUS ● SAGITTAL IMAGES WILL DEMONSTRATE
● INJURIES COMMONLY SEEN IN INCRESED CONVEXITY ANTERIORLY
MIIDDLE AGED MEN AND OEDEMA WITH KAGER'S FAT
TRIANGLE OR RETROCALCANEAL
● COMONLY ASSOCIATED WITH BURSA.
SPORTING ACTIVITIES ● PARTIAL TEAR : LINEAR FOCAL REGIONS
● PREDISPOSING FACTORS : OF INCREASED SIGNAL
DEGENERATION DUE TO DIABETES
MELLITUS , GOUT , RHEUMATOID
● COMPLETE TEAR : INCREASED SIGNAL
ARTHRITIS AND OTHER CONNECTIVE ON T2 BETWEEN ENDS OF THE TORN
TISSUE DISORERS LIGAMENT.

● ACHILLES TENDINOSIS PRESENTS


● USG PREFERRED MODALITY WHENEVER
CLINICALLY WITH SWELLING OF THE AVAILABLE
TENDON ,MOST PRONOUNCED
APPROXIMATELY 5 CM PROXIMAL TO
INSERTION BUT PATIENT MAY
PRESENT WITH AN ACUTELY
RUPTURED TENDON.
ANKLE SPRAIN

COMMON INJURIES ● E ARLIER ARTHROGRAPHY W AS


NOT ROUTINELY EVALUATED THE ONLY MODALITY OF
W ITH INJURIES INVESTIGATION

USUALLY LATERAL LIGAMENTS ●
NOW ULTRASOUND AND MRI ARE
INVOLVED PREFERRED.

LATERAL LIGAMENTS INCLUDE
ANTERIOR AND POSTERIOR
TALOFIBULAR LIGAMENTS AND
CALCANEOFIBULAR LIGAMENTS

GRADE 1 SPRAIN – STRETCHING
AND TEARING OF ANTERIOR
TALO FIBULAR BUNDLE

GRADE 2 SPRAIN – TEARING OF
ANTERIOR TALOFIBULAR AND
STRETCHING OF CALCANEO
FIBULAR

GRADE 3 SPRAIN – DISRUPTION
OF ALL THREE LIGAMENTS
ROTATOR CUFF INJURIES

MRI FINDINGS :PARTIAL THICKNESS

MUSCLES OF THE ROTATOR CUFF TEARS : NOT VISIBLE EARLY . THEN
INCLUDES 1.SUPRASPINATUS BECOME VISIBLE WHEN TEAR
2.INFRASPINATUS ENLARGES
3.SUBSCAPULARIS AND 4.TERES ● FULL THICKNESS TEARS ; VISIBLE AS
MINOR INCREASED SIGNAL ON PROTON
DENSITY AND T1 AND T2 SEQUENCES

TYPES OF ROTATOR CUFF AND WHICH CROSSES THE FULL
INJURIES ON ARTHROGRAPHY THICKNESS OF THE ROTATOR CUFF
ARE TYPE 1: DEGENERATION AND TENDON.
TENDINOSIS W ITHIN TENDON BUT ●
SECONDARY SIGNS OF FULL
NOT VISIBLE ON THE SURFACE THICKNESS TEARS INCLUDES FLUID IN
THE SUBACROMIAN AND SUBDELTOID

TYPE 2: PARTIAL THICKNESS BURSA AND SUBACROMIAN
ROTATOT CUFF TEARS ARE SUBDELTOID PERIBURSAL FAT AND
PRESENT ; THESE MAY BE FATTY ATROPHY OF ROTATOR CUFF
INTRASUBSTANCE OR MAY OPEN MUSCLES
ON TO SUPERIOR AND INFERIOR ● MRI GIVES INFO ABOUT THE CAUSE
SURFACES. OF THE IMPINGEMENT OR TEAR SUCH
AS SOFT TISSUE SWELLINGS , SPURS

TYPE 3: FULL THICKNESS ETC.
ROTATOR CUFF TEAR W ITH
COMMUNICATION BETW EEN
● SUBSCAPULARIS AND TERES MINOR
TEARS OCCUR MOSTLY AS PART OF
SUBACROMIAN AND SUBDELTOID GLOBAL CUFF TEARS AND NOT IN
BURSA AND SHOULDER JOINT. ISOLATION.
1.MRI – NORMAL ROTATOR
CUFF
● NORMAL SIGNAL
OF ROTATOR
CUFF
2.MRI – FULL THICKNESS
TEARS
● MRI SHOWS
INCREASED
SIGNAL ON
PROTON DENSITY
AND T1 AND T2
SEQUENCES AND
WHICH CROSSES
THE FULL
THICKNESS OF
THE ROTATOR
CUFF TENDON.
3.MRI – PARTIAL THICKNESS
RC INJURY
● PARTIAL
THICKNESS
TEARS : NOT
VISIBLE EARLY .
THEN BECOME
VISIBLE WHEN
TEAR ENLARGES
GLENOHUMERAL INSTABILITY
● MRI AXIAL SEQUENCES
● BONY CONTOUR OF GH JT IS ● T1W SEQ – CHANGES IN SUB-
INTRINSICALLY UNSTABLE AND
CHONDRAL BONE.
THEREFORE THE STABILITY DEPENDS
UPON THE MUSCULAR , TENDINOUS ● T2W SEQ – EVALUATING
AND CAPSULAR STRUCTURES THAT CARTILAGENOUS LABRUM
ARE RELATED TO THE JOINT .
● HILLSACK'S LESION – FEMORAL HEAD

COMMONEST INSTABILITY – ANTERIOR WITH POSTEROLATERAL COMPRESSION
INSTABILITY FRACTURE. SEEN IN SINGLE OR
RECURRENT SHOULDER DISLOCATIONS
● ASSOCIATED WITH INJURIES TO
LABRUM AND INFERIOR ● POSTERIOR INSTABILITY – DUE TO
GLENOHUMERAL LIGAMENT AND POSTERIOR BAND OF THE INFERIOR
LABRUM GLENOHUMERAL LIGAMENT
● INVESTIGATION OF CHOICE: MR OR CT ● REVERSE HILLSACK'S LESION –
ARTHROGRAPHY COMPRESSION FRACTURE OF THE
ANTERIOR ASPECT OF THE HUMERAL
● COMMON FINDINGS : AVULSION OF HEAD
ANTERIOR LABRUM WITH OR WITHOUT
FRACTURE INVOLING THE
UNDERLYING INFERIOR GLENOID RIM –
BANKARD LESION
HILL SACHS LESION

● FRACTURE OF
THE POSTERO
SUPERIOR PART
OF THE FEMORAL
HEADN – SHOW
BY ARROWS
FROZEN SHOULDER

● C/F : PAIN ASSOCIATED WITH SEVERELY RESTRICTED SHOULDER


JOINT MOVEMENT
● NORMALLY A CLINICAL DIAGNOSIS
● ARTHROGRAPHY : CONTRACTION OF JOINT CAPSULE WITH
IRREGULARITIES OF CAPSULE INSERTION
● REDUCTION IN JOINT VOLUME AND EARLY LYMPHATIC FILLING
EPICONDYLITIS

COMMON OVERUSE SYNDROME ●
PROGRESSION TO TEAR
INDICATED BY VISIBLE DEFECT

TENNIS ELBOW – TEARING OF W ITHIN THE TENDON ,FILLED
EXTENSOR TENDON ATTACHED W ITH FLUID
TO LATERAL EPICONDYLE

ACUTE INJURIES ASSOCIATED

GOLFER'S ELBOW – TEARING W ITH HEMORRAGE AND
OF FLEXOR TENDON HEMATOMA
ATTACHED TO MEDIAL
EPICONDYLE ●
LIGAMENTOUS TEAR – W ORSE
PROGNOSIS

CAUSE – CHRONIC REPETITIVE
TRAUMA

USG FINDINGS – SW ELLING OF
TENDONS , GENERALIZED

PLAIN RADIOGRAPH NORMAL REDUCED ECHOGENICITY AND
AND DIAGNOSIS IS CLINICAL FOCAL HYPOECHOIC AREAS which
CORRESPOND TO TEAR
● MR – EARLY STAGES –
INFLAMMATORY CHANGES
WITHIN THE TENDINOUS
ATTACHMENT- CORONAL T2
BICEPS TENDON RUPTURE
● COMMONEST SITE OF ● ACUTE INJURIES
DISTAL TEAR IS THE WITH INFLAMMATION
BICIPITAL CAN BE DETECTED
TUBEROSITY ON THE WITH FLAIR AND FAT
RADIUS SUPRESSED T2
● PROXIMAL TENDON WEIGHTED IMAGES
WILL RETRACT INTO ● AXIAL SLICES SHD
THE UPPER ARM INCLUDE THE DISTAL
● DIAGNOSED WITH INSERTION TO THE
MRI AND USG RADIUS
● DEGREE OF
RETRACTION CAN BE
ESTIMATED
CARPAL TUNNEL SYNDROME

CAUSE: COMPRESSION OF ●
MRI -DETECT THE CAUSE
STRUCTURES WITHIN THE
CARPAL TUNNEL WITH
● MEDIAN NERVE CHANGES –
COMPRESSION OF MEDIAN SEGMENTAL SWELLING,
NERVE DUE TO FLATTENING, PALMAR
BOWING ,INCREASED

TENOSYNOVITIS OF FLEXOR SIGNAL INTENSITY ON T2
TENDONS
WEIGHTED IMAGES

FRACTURE OF DISTAL RADIUS ● MRI : POST OP SHOWS

CARPOMETACARPO FIBROSIS AROUND
DISLOCATION RETINACULUM WHICH MAY

INFLAMMATORY PROCESS BE RESPONSIBLE FOR
INCLUDING RA , GOUT OR CONTINUING SYMPTOMS
SOFT TISSUE TUMOR

AGE /SEX : 30-60 YRS –
WOMEN MORE COMMON

DIAGNOSIS IS BY
ELECTROPHYSIOLOGICAL
TEST
AVASCULAR NECROSIS OF SCAPHOID

● POST TRAUMATIC, SECONDARY TO FRACTURE OF


PROXIMAL POLE OR WAIST OF SCAPHOID
● PLAIN RADIOGRAPHS :SCLEROSIS , RESORPTION AND
COLLAPSE
● MRI – SHOWS CHANGES IN AN EARLIER STAGE WHEN
PLAIN RADIOGRAPHS NORMAL
● T2W IMAGE & STIR – HIGH SIGNAL DUE TO POST
TRAUMA MARROW EDEMA ON BOTH SIDES OF
FRACTURE LINE
● AVASCULAR POLE SHOWS LOW SIGNAL ON T1 AND
INTERMEDIATE TO LOW SIGNAL ON T2W IMAGES
DEVELOPMENTAL
DISORDERS
ACHONDROPLASIA

PRENATAL
USG :INTRAUTERINE
DIAGNOSIS

RADIOLOGICAL FEATURES

SKULL – LARGE
● NARROW FORAMEN MAGNUM

SHORT SKULL BASE

IVD : SHORT , FLAT WITH
RELATIVELY LARGE IV DISC

CONGENITALLY NARROW
SPINAL CANAL
● PELVIS : ILIAC WINGS ARE
SQUARE , NARROW SCIATIC
NOTCH AND FLAT
ACETABULAR ROOF
2.X-RAY :PELVIS – SQUARED ILIAC
BONES, NARROW SCIATIC NOTCH
AND FLAT ACETABULAR ROOF ●
TUBULAR BONES :SHORT ,
THICK, CUPPING , FRAYING
OF METAPHYSES,

FIBULAR OVERGROW TH IS
PRESENT

HAND: BROAD

METACARPALS AND
PHALANGES: SHORT AND
TRIDENT CONFIGURATION

RIBS ARE SHORT W ITH
CUPPED ANTERIOR ENDS

THORACOLUMBAR GIBBUS IN
INFANCY
3.XRAY - ACP

● TRIDENT
FINGERS
4.XRAY – ACP
● TUBULAR BONES
ARE SHORT ,
BROAD
● WIDENING OF
METAPHYSIS
SEEN

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