This course provides a variety of cases of –

• MRI imaging of internal derangement of shoulder joint
• Recurrent shoulder instability .
• Glenoid bone loss and on track-off track lesions.
• Rotator cuff pathologies and classification
• Internal impingement and other common shoulder pathologies.

After completing this course, the participants will be better able to:

• Understand common clinical scenarios and imaging appearances of shoulder joint pathologies.  
• Document imaging details relevant to management.

So we in our practice do 5 sequences

One is only fat supressed sequence, that is pad fat sat or stir sequence, which we do in coronal plane and rest all are PD weighted images as you can seen there are two axial which we obtained, one axial is a thin axial which helps us to evaluate the labrum better so that we can see small labral pathologies even.

So there are two axial then two pd other are coronal and sagittal pd weighted images.

So we all aware sequences are using.

So let me start how we plan a scan.

So while planning a scan which we take into account, first of all we take an axial images obtained.

You need to figure out, where your supraspinatus tendon is. So this is your supraspinatus tendon going, so your coronal images are planned along the supraspinatus tendon.

So can u see in this image, this is your supraspinatus tendon and along this we plan coronal images

These are basically oblique and simultaneously perpendicular to it would be a sagittal. So this is your oblique sagittal images. This is how you need to plan your shoulder scan.

Then another important thing, while you are placing the patient. So what position should you place the patient in. So the patient should be placed is by hand by the side. So it can be either in neutral position or an external rotated position. You all can see my hand. So your hand once it become straight like this, it can be in the neutral position or an external rotated position and internal rotated position will distort all the anatomy related to this subscapularis and the anterior structure because once this internally rotated this bicipital groove will come somewhere and this stricture will not be seen pretty well, so u keep the hand in neutral positionor an external rotated position.

So these are two most important things to be kept in mind

1. How you should position the patient and
2. What all sequences you obtained and how you obtain those sequence

Some people also prefer doing pd fat sat axial images

So basically in our practice we are used to pd without fact suppression images and they are very comfortable for us so in ur intitial practice u can start with pd fat sat and then can go on with pd weighted images. It’s perfectly normal but try and   see the strcucture on both and then eventually realise that pd without fat suppression will give better idea of structure.

So now let's start with anatomy. So now once you start. so how do you approach a scan. While you are approaching scan, you always start with a PD suppressed sequence. What all you look in a PD-fat suppressed sequence as you all can answer that pd fat suppressed is look for anything because all the fat is suppressed so anything other will shine out. So that you can see all the bone marrow pattern and bursae or joints effusion. So these are the key things you are looking on PD fat suppressed sequence. So let’s just start seeing the seeing the sequence so how you start and where you start. So first of all you need to figure out your coracoid process. So when you see your corocoid process you know that this is the anterior most section of the scan and as u knee on going posterior you will start seeing the shoulder joint. So the first thing is also find out where is your coracoid process is that is the anterior most section and from here you should start seeing the scan. While seeing this area it is important to look you should keep in mind about you can see marrow edema in this coracoid process. So if there is marrow edema, it is so because of having any fracture or direct injury or may be associated with instability case.