Pulse Radiology MRI > Week 11: Upper Extremities > Flashcards

Week 11: Upper Extremities Flashcards

(56 cards)

Study These Flashcards
1
Q

What are the 5 exams included in Upper Extremities of MRI?

A
  1. TMJs
  2. Shoulder
  3. Elbow
  4. Wrist
  5. Hand
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2
Q

MRI TMJ and Shoulder require the patient to be in what position?

A

Supine, head-first

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3
Q

An MRI TMJ requires the body to be off-set and perpendicular to the alignment light. True or False?

A

False; Mid-sagittal plane of the body should be perpendicular to the alignment light.

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4
Q

What is the landmark used during an MRI of the TMJs?

A

Maxilla

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5
Q

What coil should be selected by the tech during an MRI TMJs?

A

8 Channel Brain coil (or TMJ coil, though rarely available)

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6
Q

Which of the 5 exams of the Upper Extremities require the body to be supported while relaxed and with the legs uncrossed?

A

All of them

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7
Q

All 5 exams of the Upper Extremities require the same sequence options; what are they?

A
  1. Flow compensation ON
  2. No Phase Wrap ON
  3. Saturation bands used, depending on the phase direction
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8
Q

Of the 5 exams of the Upper Extremities, which has a unique set of protocols? What are the protocols?

A

MRI TMJs
1. 3 plane localizer
2. Sagittal-Oblique Open
3. Sagittal-Oblique Closed
4. Coronal-Oblique Open
5. Coronal-Oblique Closed

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9
Q

What does TMJs stand for, what is it, and where?

A

Tempo-mandibular Joints; The articulations of the jaw; Just anterior to the ears.

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10
Q

TMJs’ protocols are performed with the jaws opened and closed, why?

A

The mandibular condyles glide anteriorly and inferiorly while open, and resets back into the fossa while closed.

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11
Q

The 3 plane localizer performed during MRI TMJs views the bony skull layout to achieve what?

A

The localization of the TMJs’ obliqued positioning, both sagitally and coronally.

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12
Q

Which protocol of MRI TMJs views the joints in profile, with the mandibular condyles pushed posteriorly and superiorly into the mandibular fossa?

A

Sagittal-Oblique Closed

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13
Q

The Coronal-Oblique Open and Closed of MRI TMJs is used to show what?

A

Any medial or lateral shifting/tilting of the joints during both positions of the jaw, revealing the presence of arthritis.

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14
Q

How would the FoV and slice thickness be described in all protocols of MRI TMJs?

A

Small and Thin

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15
Q

How is the body positioned during an MRI Shoulder?

A

Off-set, with the affected shoulder in external rotation and perpendicular to the alignment light

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16
Q

What is the importance of keeping the shoulder externally rotated during MRI Shoulder?

A

Internal rotation will close the glenoid labrum and shorten the rotator cuff, causing suboptimal imaging of shoulder joint.

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17
Q

What landmark is used for positioning during an MRI Shoulder?

A

Coracoid process

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18
Q

What coil should be selected by the technologist during an MRI Shoulder?

A

3 or 8 Channel Shoulder coil

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19
Q

Besides MRI TMJs, what are the 5 basic protocols for the rest of the Upper Extremity exams?

A
  1. 3 plane localizer
  2. Coronal (IR, T2FS)
  3. Coronal (T1, T2, PD)
  4. Axial (T1, T2, PD)
  5. Sagittal (T1, T2, PD)
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20
Q

The coronal protocols of an MRI Shoulder are unique in that they are not true coronal; they are coronal oblique. Why?

A

In anatomical position, the shoulder joint is not on a straight plane; the joint lies on an oblique plane as the shoulder curves into the upper arm.

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21
Q

During both coronal-oblique protocols of an MRI Shoulder, what determines the degree of angulation when plotting from true coronal?

A

The plane is angled parallel to the supraspinatus tendon OR perpendicular to the glenohumeral joint

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22
Q

The MRI Shoulder coronal-oblique (IR, T2FT) protocol views fat-suppressed, long-axis cross sections of specific shoulder anatomy and pathology. This includes the ____________ attachment, superior and inferior ________ ________, and fluid within the joint ( _________ ).

A
  1. Supraspinatus
  2. Glenoid labrum
  3. Synovitis
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23
Q

What is better viewed on the coronal-oblique (T1, T2, PD) protocol vs. the coronal-oblique (IR, T2FS) of an MRI Shoulder?

Study These Flashcards
A

Cartilage within the glenohumeral joint

24
Q

In what protocol/plane is insufficient external rotation most evident within an MRI Shoulder exam?

Study These Flashcards
A

The axial (T1, T2, PD)

25
The MRI Shoulder Axial (T1, T2, PD) protocol is used to view short-axis cross sections of the: 1. anterior and posterior ______ ______ 2. ____ attachments 3. Position of the ____ within the ______.
1. Glenoid labrum 2. Rotator cuff 3. Humeral head; Glenoid fossa
26
Similar to the coronal protocols of an MRI Shoulder, the sagittal (T1, T2, PD) is also slightly angled from true sagittal. What determines the angulation?
Plane is angled perpendicular to the supraspinatus tendon OR parallel to the glenohumeral joint
27
The MRI Shoulder sagittal (T1, T2, PD) protocol views long-axis, in-profile cross sections of 2 tendons, 2 muscles, and a possible abnormality. What are they?
1. Supraspinatus tendon 2. Infraspinatus tendon 3. Subscapularis muscle 4. Teres minor muscle 5. Possible dislocations
28
What are 4 common clinical concerns for an MRI Shoulder (which is most common)?
1. Rotator cuff tear (most common) 2. Labral tear 3. Adhesive capsulitis/Frozen shoulder 4. Dislocations
29
What 4 muscles make up the "Rotator cuff"?
1. Supraspinatus 2. Infraspinatus 3. Subscapularis 4. Teres minor
30
Where do tendons most often tear?
At insertion or attachment (not the origin)
31
What are the 2 ways to position a patient for Upper Extremity MRI exams (excluding Shoulder and TMJs)?
1. Supine, feet first 2. Prone, head first ("Superman" position)
32
How should the body be positioned during an MRI Elbow for each patient orientation?
1. off-set, with the affected elbow in external rotation and perpendicular to alignment light 2. off-set, with affected arm above head
33
What landmark is during MRI Elbow exams?
Olecranon process
34
The coil used during MRI Elbow exams depends on the patient position - which coil would you use for each?
1. Supine: 32 channel elbow coil 2. Superman: 8 channel knee coil
35
Which protocol of an MRI Elbow identifies fractures and edema patterns, views ulnar and radial collateral ligaments, and evaluates articulations of radio-humeral and ulno-humeral joints?
Coronal (IR, T2FT)
36
The axial (T1, T2, PD) protocol of an MRI Elbow exam views short-axis cross sections of the ____ and ____ muscles, the ____ nerve, and the medial/lateral ____ ________ attachments.
1. Bicep 2. Triceps 3. Ulnar 4. Collateral ligament
37
During a sagittal (T1, T2, PD) MRI of the elbow, the radial head and collateral ligaments are viewed in long-axis profile. True or False?
False; The Sagittal views the olecranon process and bursa, Bicep and triceps tendon insertions, and anterior/posterior fat pads.
38
What are 4 clinical concerns for an MRI Elbow? Which is the most common?
1. Ulnar Collateral ligament tear (most common) 2. Lateral epicondylitis (tennis elbow) 3. Pigmented villonodular synovitis (PVNS) 4. Radial head fractures
39
Ulnar Collateral Ligament tears are common in which sport player?
Baseball pitchers
40
"Tommy John Surgery" is performed to reconstruct what anatomical structure?
The medial/ulnar collateral ligament
41
Bicep tears usually occur at the muscle's insertion point at what bone marking?
the radial tuberosity
42
What type of motion frequently results in bicep tears?
pulling
43
What are the 2 acceptable body positions during an MRI Wrist, depending on the patient's orientation?
1. Supine: off-set, with the affected wrist supinated and perpendicular to the alignment light 2. Superman: off-set, with affected arm above head
44
What landmark is used during an MRI Wrist exam?
Mid-carpal region
45
The coil used during MRI Wrist exams depends on the patient position - which coil would you use for each?
1. Supine: 8 channel wrist coil 2. Superman: 8 channel knee coil
46
As with most of the exams of Upper Extremities, MRI Wrist includes a coronal (IR, T2FS) and coronal (T1, T2, PD). What do they view?
1. fractures and edema patterns 2. Triangular Fibrocartilage Complex (TFCC) 3. Ulnar and Radial Collateral ligaments 4. Carpal bones
47
Which protocol of an MRI Wrist exam views short-axis cross sectionals of the Median nerve, Flexor/extensor tendons, retinaculum, and Ulnar nerve?
Axial (T1, T2, PD)
48
The Sagittal (T1, T2, PD) protocol of an MRI Wrist exam view in-profile, long-axis cross sectionals of what?
1. Carpal bone articulations 2. flexor tendons
49
What are the 2 most common clinical concerns for an MRI Wrist?
1. Triangular Fibrocartilage Complex (TFCC) 2. Carpal Tunnel Syndrome
50
How do patient's with suspected TFCC tears normally present?
With distal ulnar pain after a fall on out-stretched hand
51
What condition of the wrist is characterized by finger numbness, caused by compression of the retinaculum and impingement of median nerves?
Carpal tunnel syndrome
52
What are the 2 acceptable body positions during an MRI Hand, depending on the patient's orientation?
1. Supine: off-set, with affected hand perpendicular to alignment light 2. Superman: off-set, with arm and hand above head
53
The MCP joints are used as a landmark for which exam of MRIs of Upper Extremities?
MRI Hand
54
What kind of coil is used for MRI Hand?
a small, general purpose hand coil
55
The Coronal (IR, T2FS) protocol of an MRI Hand uses fat-suppression to better identify fractures and edema patterns. True or False?
True
56
What anatomical structures are evaluated during an MRI Hand?
1. Metacarpals 2. Flexor digitorum tendons 3. Interosseous muscles 4. Collateral ligaments 5. Interphalangeal joints
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