Hip/shoulder

Which of the following is true about avascular necrosis of the hip:

-On T1W images, necrotic focus with in the femoral head appears hypointense. -On T2W images, there is hyperintense bone marrow edema. -Ischemic area remains hypointense on T2W images. All of the above

Which of the following statements is correct regarding SLAP tears:

-Take place at superior portion of the glenoid labrum -Extends anterior-to-posterior in direction -Maybe mistaken with sublabral recess All of the above

what are the two roles for the corachohumeral ligament?

-strengthens the superior portion of the joint -restrains external rotation

what are the three glenohumeral ligaments?

1. superior (SGHL) 2. middle (MGHL) 3. inferior(IGHL)

Which of the following questions is correct regarding the following image?

A is marking the anterior acetabulum labrum B is marking the posterior acetabulum labrum D is marking the teres ligament E is marking the femoral head All of the above statements are correct

The following are T1W and T2W fat saturated images of bilateral hip in a patient with history of avascular necrosis (AVN). Which of the following statements is correct regarding these images?

AVN is limited to the femoral head of the left hip joint.

Identify the structured labeled as A in the following image.

Acetabulum labrum

Which statement is incorrect regarding the full thickness tears of the rotator cuff:

Acute tears are associated with atrophy of the muscle belly

Identify the structure marked with letter A in the following image

Anterior acetabulum labrum

Which of the following images demonstrate a normal labrum?

Axial PD fat saturated

Which structure normally inserts in the humeral head region identified with red arrow in this image?

Biceps tendon

The following is an axial STIR image of a patient's hips. Which of the following statements is correct regarding this image?

Blue arrow is marking the bladder

The following is an MR arthrogram of the right hip. What type of sequence was used to capture this image?

Coronal T1W fat saturated sequence

The largest and strongest muscle of shoulder is the?

Deltoid muscle (located outside of the joint)

High signal intensity seen in the femoral neck region demonstrate a normal signal intensity of the bone marrow in this joint. Ax T2W Fat Sat Cor PD Fat Sat

False

In the following image the label C is marking the lesser trochanter of the femur bone.

False

The following images demonstrate AVN in the left hip only. Cor STIR

False

The following is a normal X-ray of bilateral hip. There is no abnormality seen in either hip joints.

False

The glenohumeral joint is stabilized by the glenohumeral ligaments :SGHL, MGHL, IGHL.

False

The labrum of the shoulder is the site of attachment of the long head of the biceps tendon inferiorly and the glenohumeral ligaments, which provide stability to the joint.

False

There are two bursae associated with the shoulder joint: subarcomial bursa and infraacromial bursa.

False

The following is a coronal T2W fatsaturated image of a shoulder in a patient after a fall. There is a tear in the inferoposterial labrum.

False Labral tear is seen in the superior labrum.

The following is a T1W axial image of a hip. Which structure is marked by letter A in this image?

Femoral head

What is the most likely diagnosis based on these images:

Fracture of left femoral neck with out displacment

The following is a coronal STIR image of a patient who suffered a fall. He is complaining of shoulder pain and is unable to life his arm up. What is the correct diagnosis based on this image?

Full thickness tear of supraspinatus tendon

Which structures are marked by red arrows in the following axial gradient echo image of the shoulder?

Glenoid labrum

The following images are of a patient with femoral neck fracture. Based on these images what is correct classification of this femoral neck fracture?

Intracapsular fracture

The following is a T1W axial image of a hip. Which structure is marked by letter B in this image?

Labrum

The following is an image of MR arthrogram of a right hip. Which structure is marked by a red circle in this image?

Labrum

The following is an axial image of a shoulder. Which of the following statements is correct regarding this image?

Letter C is marking the posterior labrum

The following is an image of MR arthrogram of a right hip. Which structure is marked by a red arrow in this image?

Ligementum teres insertion site

The following is a coronal T1W image of bilateral hip in a 12 year old female. Which structure is marked by the red arrow?

Location of normal growth plates in both femurs

Which nerve (or nerves) pass near the hip joints anteriorly?

Obturator nerve Femoral nerve

Which structures is marked by letter A in the following axial image of a shoulder?

Supraspinatus tendon

Identify the structure labeled as A in the following image.

Synovial fluid in the joint

Which of the following muscles does not contribute to the "rotator cuff" group:

Teres major

The following is a coronal STIR image of a shoulder. Which of the following statements regarding the structure marked by a red arrow in this image is correct?

The arrow is pointing to supraspinatus muscle. The signal intensity in this muscle is abnormal

What is the site of attachment of the long head of the biceps tendon superiorly and the glenohumeral ligaments, which provide stability to the joint.

The labrum

A normal rotator cuff tendon is uniformly low signal on all sequences.

True

A rotator cuff tendon which appears somewhat grey on T1W and black on T2W images is normal. The change in T1W signal intensity maybe related to the magic angle artefact.

True

ABER position in shoulder MR imaging is used to assess the anterior labrum and partial undersurface tears of the rotator cuff.

True

Avascular necrosis is described as a vascular insult to the blood supply of the femoral head.

True

Bankart lesions are seen in the antero-inferior portion of labrum; it may involve superior labrum and the biceps anchor.

True

Bone marrow edema and hemorrhage associated with acute fracture of the femoral neck of in the hip appears as high signal on STIR and low signal on T1W images.

True

Chronic inflammation of the supraspinatus tendon results in edema of the tendon, narrowing of the subacromial space and eventual abrasion of the tendon.

True

Chronic pancreatitis and chronic steroid intake are some of the causes for avascular necrosis of the hip.

True

Fat atrophy of the rotator cuff muscles indicates a nerve entrapment syndrome.

True

Fractures of the femoral neck maybe intracapsular or intertrochanteric.

True

Hip MR arthrography is typically used to assess the labrum in this joint.

True

In a fracture of femoral head, fracture line appears as low signal intensity on both T1W and STIR sequences.

True

Intracapsular fracture of the femoral neck have a high incidence of AVN.

True

Intracapsular fracture of the neck of the femur may appear as low signal fracture line with adjacent high T2 signal in the femoral neck region.

True

On T2W images, avascular necrosis demonstrates hyperintense signal in the bone due to bone marrow edema

True

Paralabral cyst containing proteinaceous material may appear as high signal on T1W images.

True

Some of the associated finding in a shoulder labral tear may include: bony edema in the glenoid and joint effusion.

True

Subscapularis of rotator cuff inserts onto the lesser tuberosity of humerus; supraspinatus, infraspinatus and teres minor insert onto the greater tuberosity of the humerus.

True

T1W fat saturated sequences are used for assessing a joint during MR arthrography procedure.

True

Tendinosis of the rotator cuff appears as intermediate signal on T1W and normal signal on T2W images.

True

The following image demonstrates a fracture of right femoral neck and displacement of the right femoral head.

True

The following is an axial T2W fat saturated image of a patient's bilateral hip who suffered a fall. Irregular shaped and hetergenous, hyperintense signal of the left femoral neck indicate a possible fracture in the left hip.

True

The rotator cuff inserts along the humeral head.

True

The site of the paralabral cyst corresponds to the site of the labral tear in the shoulder joint.

True

The subacromial bursa is located between the capsule and the deltoid. It does not communicate with the shoulder joint.

True

The superior glenohumeral ligament (SGHL) runs

anteriorly in front of the long head of the biceps tendon between the 12 and 1o'clock positions into the lesser tuberosity

coracohumeral ligament lies

anterosuperiorly

The glenohumeral joint has two sets of ligaments

coracohumeral ligament and glenohumeral ligaments

Where does the main movement take place?

glenohumeral joint (ball-and-socket) synovial joint

The inferior glenohumeral ligament (IGHL)

is the most constant. It arises from the inferior portion of the labrum and has two parts: an anterior band that is thicker and a posterior band that tends to be thinner. -Both bands insert into the surgical neck of the humerus.

The middle glenohumeral ligament (MGHL)

is the most viable in position and thickness. It runs from the anteriorsuperior portion of the glenoid rim to blend with the scapularis tendon. It may be absent.

Which of the following statements is correct regarding the following image?

label A is marking gluteus minimus