Pearls from Stoller Macau April 2011 - 9. Elbow

1. Anatomical Variants
• pseudo defect of trochlea
• transverse trochlea ridge
• pseudo defect of capitellum (post on coronal)
2. Valgus injury (throwing) - tension medial side, compression lateral side
3. "T sign" - partial tear anterior bundle MCL distally
4. Medial Anatomy - PT, FCR, FDS
5. Lateral Anatomy - ECRB (most common tendon involved), EDC, ECU
6. Lateral - 3 ligaments - LCL, LUCL (attaches to supinator crest of ulna distally), annular ligament
7. Biceps tear - if partial need to state wether under or over 50%
8. Lacertus fibrosis - medial to biceps on axial; prevents proximal "slingshot" of torn biceps 
9. Anconeus epitochlearis

Pearls from Stoller Macau April 2011 - 7. Muscle

1. Direct Injury - contusion, laceration, haematoma
2. Indirect injury- strain or tear
3. Myositis Ossificans - peripheral calcification - do a CT
4. DOMS

Pearls from Stoller Macau April 2011 - 4. Ankle

1. NB: anterior process talus; lateral process calcaneus (snowboarders)
2. Subtalar joint - anterior, middle, posterior facets
3. Lateral gutter -- a 3D space between AITFL/PITFL and ATFL/PTFL
4. Posterior ankle ligaments - Transverse Tib-Fib Lig, PITFL, Tibial Slip, PTFL
5. Anterolateral impingement (soft tissue related to antero-lat gutter) vs Ant. impingement (bony)
6. Soft Tissue Impingement
• Anterolateral (ATFL and  AITFL related to partial or completer tear)
• Syndesmotic
• Posterior (PTFL -- myxoid)
7. Spring (Calcaneonavicular ligament)
• Lateral/Intermediate/Superomedial
• Axial - int. and lat.; slice up - superomedial
• Coronal - next to TP
8. POP Syndrome
• # or displacement of Os peroneum
• Ass. Peroneus Longus Tear
9. Tarsal Tunnel Syndrome
• Post. Tibial N. compression
10. 4 Plantar Muscles -  (Med) Ab. Hallucis, Fl. Dig. Brevis, Quadratus Plantae, Ab. Digiti Minimi
11. Subtalar ligaments
• subtalar interosseus - medial (coronal)
• cervical - lateral and anterior (coronal and sag)
• intermediate root extensor retinaculum - post. to cervical (sag)
12. OLT Stages
13. Tennis Leg - ruptured crura; fascia

Pearls from Stoller Macau April 2011 - 3. Knee

1. Trochlear groove - assess on sag.
2. Meniscofemoral and meniscotibial (coronary) recesses.
3. Horizontal tear - must extend to apex (sag).
4. Flap tear - one type that looks horizontal but extends short of apex creating small inferior leaf.
5. Flap tear -- vertical configuration, but inner 1/3 (sag).
6. Vertical/longitudinal tear - outer 1/3 (sag).
7.  Menisco-capsular separation -- two scenarios
• ACL with tear of periph of post. horn lat. meniscus (fluid betw. capsule and periph. of post. horn).
• MCL tear with meniscotibial lig. tear.
8.  Posterolat. corner -- review on sag and axial.
9. SONK -- almost all cases are probably insufficiency fractures
10. CMP - MRI adaptation of Outerbridge classification; describe rather than classify; ICRS classification.
11. MPFL - slice above proximal origin of MCL, tears at femur
12. Patella tendinosis - best on GRE.

Pearls from Stoller Macau April 2011 - 2.Shoulder

1. Anterior band of IGHL can have high attachment -- 3rd structure on axial (in addition to labrum and MGHL).
2. Sublabral foramen (antero-superior); sublabral sulcus (superior)
3. Hill-Sachs - position - where articular cartilage in NOT; at level of footprint on axial (1st two slices).
4. MGHL - "squiggly" on Sag.
5. Patterns of glenoid sclerosis.
6. Anteroinferior labrum -- assess 1st -- spectrum of injury
• Perthes -  labral tear, minimal displacement, intact periosteum
• ALPSA - labral tear and medial displacement of IGLLC, medially stripped but intact periosteum (NB POLPSA)
• GLAD - labral tear (partial), no detachment, chondral defect, intact periosteum
• Bankart - avulsion of IGLLC (anterior and medial), disruption of scapula perisoteum
7.  SGHL/CHL -- "Biceps pulley" -- look on Sag
8. HAGL -- anterior band IGHL tear (+BHAGL) aot RHAGL or PHAGL -- post. band
9. GAGL
10. "Wave Sign" -- massive RC tear  - repairable acute tear without scarring

Pearls from Stoller Macau April 2011 - 1.Technique

1. Zoom in to see detail.
2. Every series should contain a plain T1.
3. GRE/T2* -- for shoulders and knee at least -- useful for chondrocalcinosis, PVNS, blood
4. Hip -- should include sag
5. Hip - one large FOV series
6. Ankle -- NB ant. process of calcaneus and lateral process of talus