Radiology Anatomy of the Spine and Upper Extremity

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Radiology Anatomy of the Spine and Upper Extremity

• Timothy J. Mosher, MD
• Department of Radiology
• Phone [phone]
• Email tmosher_at_psu.edu

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Learning Objective

• Identify anatomic structures of the spine and
  upper extremities on standard radiographic and
  cross-sectional images

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SPINE
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Visual Human Sagittal View
7 Cervical Vertebra
12 Thoracic Vertebra
5 Lumbar Vertebra
5 Sacral Vertebra (fused)
3 Coccygeal Vertebra (fused)
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Lumbar Vertebral Body
BODY
PEDICLE
TRANSVERSE PROCESS
SPINOUS PROCESS
LAMINA
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Lumbar Vertebral Body
BODY
PEDICLE
TRANSVERSE PROCESS (fractured)
SPINOUS PROCESS
LAMINA
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SPINE FROM THE FRONT
BODY
TRANSVERSE PROCESS
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SPECIMEN RADIOGRAPH L4
BODY
PEDICLES
SPINOUS PROCESS
TRANSVERSE PROCESSES
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SPINE FROM THE BACK
SUP ART FACET
TRANSVERSE PROCESS
LAMINA
INF ART FACET
SPINOUS PROCESS
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SPECIMEN RADIOGRAPH L4
Lamina and Facets
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AP Lumbar Spine
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AP Lumbar Spine
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AP Lumbar Spine
BODY
PEDICLE
LAMINA
SPINOUS PROCESS
TRANSVERSE PROCESS
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Spine Viewed from Side
BODY
PEDICLE
TRANSVERSE PROCESS
LAMINA
SPINOUS PROCESS
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Spine Viewed from Side
PARS INTRAARTICULARIS
SUPERIOR FACET
INFERIOR FACET
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Lateral Lumbar Spine
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Lateral Lumbar Spine
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Lateral Lumbar Spine
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CT Lumbar Spine Sagittal Reconstructions
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Facet Joints Axial View
Cervical
Thoracic
Lumbar
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Facet Joints Sagittal Reconstructions
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Intervertebral Disc Space
NEURAL FORAMEN
INTERVERTEBRAL DISC
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Nerve Roots
INF FACET
SUP FACET
BODY
DISC
PEDICLE
SPINOUS PROCESS
NERVE ROOT
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Intervertebral Disc
Body
Body
Sagittal Section Lumbar Spine
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MRI Intervertebral Disc
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Cauda Equina
MRI Myelogram
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Neural Foramen
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Neural Foramina Cervical Spine
Viewed from bottom
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Spinal Ligaments
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Spinal Ligament
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Case Study 17 year-old Male involved in a MVA
Do you see a fracture?
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Case Study 17 year-old Male involved in a MVA
Right
Left
Bilateral Facet Dislocation at C6/7
What other structures are likely to be injured?
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Case Study 17 year-old Male involved in a MVA
Spinal Cord Injury Anterior Longitudinal Spinal
Ligament Posterior Longitudinal Spinal Ligament
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Upper Extremity
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Radiographic Anatomy
X-RAY BEAM
FILM
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LEFT SHOULDER (FRONT)

• CLAVICLE
• ACROMION
• CORACOID
• GLENOID
• SCAPULA
• HUMERUS

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SHOULDER (BACK)

• CLAVICLE
• ACROMION
• SPINE
• GLENOID
• HUMERUS

SCAPULA
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AP Shoulder
Humerus
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LEFT SHOULDER AXILLARY VIEW
FILM
X-RAY TUBE
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RIGHT SCAPULA FROM BELOW
CORACOID
GLENOID
SPINE
BODY
ACROMION
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LEFT SHOULDER (AXILLARY)
Anterior
Humerus
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Case Study 52 year old male with shoulder pain
Do you identify the cause of the shoulder pain?
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MRI Anatomy of the Shoulder
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MUSCLES FROM THE FRONT
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Rotator Cuff Muscles Sagittal View
Anterior
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Rotator Cuff Subscapularis
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Rotator Cuff Supraspinatus
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MUSCLES FROM THE BACK
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Rotator Cuff Infraspinatus
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Rotator Cuff Teres Minor
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Anatomy Considerations in Rotator Cuff Tears
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Impingement of the Rotator Cuff
Anterior View
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MRI Anatomy of the Rotator Cuff
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MRI Anatomy of the Rotator Cuff
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Rotator Cuff Tear
Contrast leaking into subacromial bursa through
tear in supraspinatus
Contrast injected into glenohumeral joint
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ROTATOR CUFF TEAR
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The Elbow
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LEFT ELBOW FROM FRONT
Humerus
Lateral
Medial
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Elbow from the Back
Humerus
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AP ELBOW
Humerus
Lateral
Medial
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Medial View of Elbow
Humerus
Ulna
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Medial View of Elbow
Humerus
Ulna
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The Wrist
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The Wrist Palmar ViewCarpal Bones (Proximal Row)
Radius
Ulna
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The Wrist Palmar ViewCarpal Bones (Proximal Row)
Radius
Ulna
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The Wrist Palmar ViewCarpal Bones (Distal Row)
Radius
Ulna
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The Wrist Palmar ViewCarpal Bones (Distal Row)
Radius
Ulna
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MR Anatomy of the Wrist
Coronal Wrist
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