肩袖影像学概论.pdfVIP

Gregory Cvetanovich, MS3 Gillian Lieberman, MD May 2011 A Compendium of Rotator Cuff Imaging Gregory Cvetanovich, Harvard Medical School Yr 3 Gillian Lieberman, MD Gregory Cvetanovich, MS3 Gillian Lieberman, MD Overview • Patient presentation • Rotator cuff – Anatomy – Function – Pathology • Menu of radiologic tests • Normal rotator cuff anatomy on MRI • MRI examples of rotator cuff tears 2 Gregory Cvetanovich, MS3 Gillian Lieberman, MD Patient Presentation • 53 year-old woman presents to rheumatology clinic for routine follow-up six months after diagnosis of likely seronegative rheumatoid arthritis – Since beginning treatment with MTX, her bilateral joint pain and stiffness resolved with the exception of right shoulder pain – She has experienced right shoulder pain intermittently for a number of years, worsening with overhead activity and improving with rest and NSAIDs – In recent months, the right shoulder pain has worsened and become more frequent, sometimes awakening her at night. • Physical Exam: R shoulder exam significant for pain and weakness with limited ROM presumed secondary to pain – Clinic note does not document other details of shoulder physical exam, such as impingement signs or detailed rotator cuff exam 3 Gregory Cvetanovich, MS3 Gillian Lieberman, MD Shoulder Anatomy • The shoulder has the greatest range of