Musculoskeletal Radiology

MRI

Bone Scan

• Cortical Bone Radiography – Simple anatomy

# of long bone
CT Scan – Complex
# of axial skeleton
• Cancellous bone/ Bone marrow
- MRI Localized disease
- Bone scan non localised disease
• Bone mineral density – DEXA
• Soft tissue: MRI
• Ligament
• Tendon

Named fractures 1:30

1. Montaggia Fracture
• Ulnar fracture
• Displacement of proximal radio - ulnar joint

1
2. Galezzi
• Fracture of radius
• Distal radio-ulnar joint disrupted

3. Colle’s Fracture
• Fracture at distal end of radius

2
 “Dinner fork deformity”

4. March fracture
• Subtle fracture at the shaft of meta tarsel (2nd or 3rd)

a
b

c g

d
i

a ® Bullet shape vertebrae ® Achondroplasia

b ® Cord fish/ fish mouth ® Severe osteoporosis

3
 c ® H shape vertebrae ® Sickle cell anemia

d ® Sandwich appearance ® Rugger jersey spine ® Renal osteodystrophy/

Osteopetrosis

e ® Courdray appearance ® Vertebral Hemangioma

f ® Vertebra Plana ®

• Esonophilic
Granuloma
? • Myeloma/
Metastasis
• Lymphoma
g ® Picture frame vertebrae ® Paget’s disease
• Trauma

h ® Ivory vertebrae ® Paget’s Disease ®

• Lymphoma
• Infection of TB
• Myeloma/ Metastasis
• Paget’s disease

4
 i ® Bamboo spine ® Ankylosing Spondylitis

bone tumor 03:30

Epiphysis

Metaphysis

Diaphysis

• Fallen fragment sign

• Well defined lytic lesion Simple Bone Cyst
• On metaphysis
Lesion

Lytic lesion (black) Sclerotic (white)

Growth plate

Fused Unfused

GCT Chondroblastoma (Codman’s Tumor)

SBC – Non expansile, Fallen fragment sign

ABC - Expansile
5
GIANT CELL TUMOR

• Soap bubble appearance

• Epiphyseal lytic lesion
• Growth plate fused
• Tibia

• Expansile lytic lesion

• Distal end of radius
• After the fusion of growth plate

OSTEOSARCOMA

Sunburst pattern ® sign of aggressive periosteal reaction

Metaphysis Diaphysis

Osteosarcoma Ewing’s Sarcoma

6
MRI 05:27

Lumbosacral Spine MRI

Intervertebral disc

N does not cross vertebral margin

PIVD: Prolapsed Intervertebral Disc

T2 – Fat image

a – Patella
a b
b – Femur

c – Tibia
*
*- Anterior cruciate ligament
c

7
ACL Injury:

• Instability in stepping down

• question mark sign/ buckling of PCL

• Bucket handle tear of M.M fragment seen in anterior to the PCL

Double PCL sign – Bucket handle tear of medial meniscus