1. Shoulder Buford Complex
The buford complex occurs in approximately 1.5% and is characterized by absence of the anterior upper pelvis lip and cord-like thickening of the ligaments in the oblioflubuse. The thickened mid-plenum ligament attaches directly to the shoulder blade.
In the presence of the Buford complex, the thickened ligament in the middle of the glenobial brachial is shown on the MRI axis image of the upper half of the joint cavity, which is close to the edge of the joint plenum, and the corresponding area of the puria lip is absent, similar to a puel lip tear.
Shoulder Buford Complex: Partial lipid pressure T1WI axis of the upper joint cavity MR Articulation video (A) shows a thickened mid-pirium ligament (arrow) close to the edge of the joint pelvis, with absence of the pyelometrium (arrow). Video of muscle-pressurized TWI sagittal MR joints with subjects (B) showing cord-like thickening of the median pyelmoblast ligament (arrow)
Buford complexes can be diagnosed by MR imaging, MR arthrography, or arthroscopy to assess shoulder stability.
If the Buford complex is misdiagnosed as a puncular tear and surgically attached to the neck of the joint pyelonecline cartilage, rotation and lifting of the humerus will cause severe pain and limited movement.
differential diagnosis:
Buford complexes are easily confused with the sublipal foramen or pathological purcupine tears.
Identification of thickened median obosophrenic ligaments in MRI oblique sagittal images helps avoid misdiagnosing the Buford complex as a purylolabial tear.
If no signs of abnormalities are seen in the adjacent upper and lower pelvis lips, a Buford complex needs to be suspected.
2. Parsonage-Turner syndrome and tetralateral foramen syndrome
The earliest neuromuscular changes in patients with Parsonage-Turner syndrome were high signals of diffuse water-sensitive SEQUENCEs of MRI, such as STIR sequences or T2-weighted sequences; The signal is normal on the T1-weighted image.
After a few weeks, in the subacute to chronic phase, neuromuscular atrophy is manifested by muscle volume reduction and increased T1WI signaling due to fat infiltration.
Parsonage-Turner syndrome: MRI T1WI coronary image (A) shows fat infiltration and atrophy of deltoid muscle (coarse arrow), inferior orthopedic muscle (fine arrow), and small round muscle (arrow). MRI TIW1 sagittal image (B) of the same patient shows fat infiltration and atrophy of the superior orthopinatus muscle (coarse arrow), inferior orkas muscle (fine arrow), and small round muscle (arrow).
MrI signs of fortess syndrome include small round muscle atrophy and, less commonly, deltoid muscle atrophy due to chronic compression due to muscle volume reduction and fat infiltration.
To diagnose Parsonage-Turner syndrome, signs of MRI must be combined with the patient's clinical history. MRI images of fortetraform syndrome usually have no structural abnormalities in the tetralateral foramen region, but show signs of secondary neuromyopathy.
Parsonage-Turner syndrome is a rare, self-limiting disease characterized by sudden onset of non-traumatic shoulder pain with progressive upper extremity band muscle atrophy.
The clinical feature of foramen syndrome is blunt pain on the anterior medial side of the shoulder joint, which worsens with anterior flexion, abduction, and external rotation of the upper arm.
These include abnormalities of the shoulder joint itself, such as rotator cuff tears, impact syndrome, and labial tears.
MRI is recommended for patients with shoulder pain and shoulder weakness, as it is sensitive to abnormal signals of loss of nerve damage in the upper extremities.
3. Abrassion osteopathy
The acromioles are an extra piece of bone with a 7% to 15% chance of occurring in normal populations. The acromioles are produced by the failure of the ossified center of the acromal blade and the main bone to melt during the development of the scapula. The acromiolate is easily displayed on plain x-rays of the shoulder axillary position, but difficult on anteroposterior and posterior x-rays.
The acromion ossicles are ideally displayed on MRI axis images, connected to the base of the shoulder by a movable joint or cartilage, and should not be misdiagnosed as a fracture.
Axial position (A), coronal position (B), and sagittal position (C) of MRI showing unfused acromial ossification center (arrow) on moderately weighted imaging
The acromion is usually formed by the fusion of multiple ossification centers, and the completion time is usually around 25 years. Agrarian ossicles are found on plain X-ray in clinically symptomatic patients and should be further investigated for rotator cuff lesions. Acromial ossicles may be associated with rotator cuff impact.
The acroplopathic bonelet may be confused with a fracture of the distal acromion.
Rotator cuff impact is susceptible to the presence of acromial ossicles, and routine acromial MRI can detect the presence of a shoulder ossicle.
4. Internal shoulder impact:
Posterior superior opal lip lesions of the shoulder joint are accompanied by a series of abnormalities such as internal tears in the upper or lower muscle tendons of the shoulder joints and subarticular cyst changes in the posterior humeral head, which can determine the diagnosis of internal impact of the shoulder joint.
Internal impact of the shoulder joint: lipid pressure T WI MR arthrogram (A) of shoulder abduction and external rotation shows a partial tear (arrow) on the side of the tendon joint of the superior supramanthal muscle. Lipid pressure T1WI axial MR arthroplasty (B) of the same patient shows blunting of the posterior pelvis lip and scar tissue formation (arrow). Lipid pressure T2WI coronary MR arthrocotomy video (C) showing bone marrow edema (arrow) at the back of the humerus head
Lipid pressure T1WI axis MR arthrocomatomy showing cyst changes in the posterior humerus (arrow)
Internal shoulder impact, also known as posterior-upper impact, occurs in throwers who need to be extremely abducted and externally rotated shoulder joints. The impact of the rotator cuff with the posterior upper pelvis lip is the cause of pain in the back of the shoulder of the thrower. Patients with posterior upper shoulder pain are associated with instability in the anterior part of the shoulder joint.
Mri imaging of the upper cyst usually occurs in the exposed area of the upper part of the posterior humerus, behind the large nodule of the humerus.
Posterior cystic changes with alterations in the rotator cuff and posterior upper pelvis lip can diagnose an internal shoulder impact. Occasionally, cystic lesions communicating with the joint are found in the bone behind the large nodule of the humerus.
5. Hill-Sachs injury with lateral flattening of the humerus head
Anterior pentarium dislocation of the oblioflaval joint involves an impact on the anterior pupal margin of the humerus, resulting in a compression fracture of this area of the humerus, known as Hill-Sachs injury.
Hill-Sachs injury: Intracyclone sheet (A) of the upper humerus shows Hill-Sachs injury (arrow). Lipid pressure T2wI axial MR arthrocotomy (B) of the same patient shows Hill-Sachs injury (arrow) above the beak level
The proximal humerus includes the humerus head, large nodules, small nodules, and anatomical and surgical neck of the humerus. The humerus is rounded and its posterior lateral part is slightly flattened.
Anatomical features of the proximal posterior lateral side of the humerus may resemble Hill-Sachs injuries.
Posterolateral flattening of the humerus head: MRI T1WI axial tablets show a normal anatomical depression (arrow) on the posterolateral side of the proximal humerus below the level of the beak process
One way to distinguish normal anatomical changes from Hill-Sachs injuries is when Hill-Sachs injuries occur above or above the beak level.
differential diagnosis:
The humeral neck is below the beak level in the MRI axial image, so it should not be confused with Hill-Sachs injury.
Sometimes a grooved defect on the humerus head and a Hill-Sachs injury may be confused with a fracture of the humerus large nodule.
6. Red bone marrow and intramedullary tumors near the humeral backbone
In adults, red bone marrow remains in the axial bone, and red bone marrow is also present in the metaphyseal end of the femur and humerus proximal to the humerus. Red bone marrow may be observed in the proximal bone marrow region of the humerus in normal adults. Red bone marrow on MRI T2WI, lipid pressure T2WI, or STIR sequence images do not show a pronounced hyperinflection and are not accompanied by destruction of adjacent cortex or soft tissue mass formation.
Red bone marrow: MRI T1WI coronary image (A) shows a mild reduction in epiphyseal (arrow) and epiphyseal (arrow) signal limitations. Lipid pressure T2WI coronary MRI images (B) of the same patient show that epiphyseal (arrow) and epiphyseal (arrow) signals are not completely suppressed
Red bone marrow is usually symmetrically distributed bilaterally, with different MRI characteristics for aggressive lesions, with signal reduction on T1WI.
Leukemia infiltrates: MRI T1WI coronary image (A) shows a distinctly low-signal area (arrow) at the epiphyseal end. Lipid pressure T2WI coronary MRI image (B) of the same patient showing distinct high-signal areas (arrows)
Signals on the T2WI vary depending on the histological type of lesion, cell type, water content, and whether there is fibrosis, necrosis, bleeding, or inflammatory response.
These include bone marrow reversal, bone marrow infiltration or replacement, bone marrow depletion, and bone marrow edema.
7. MR arthrography of shoulder arthrodiseration and external rotation: anterior pyelometril tear
When MRI arthrogram is performed, partial tears of the rotator cuff and some types of glial tears are diagnosed in the shoulder abduction and external rotation (ABER) positions, which are more sensitive than traditional positions.
Lipid pressure TW images of shoulder abduction, external rotation (ABER) POSITION MR shoulder arthrotomy show tears of the anterior inferior pyelometrium (arrow) and superior muscle muscle (arrow).
Shoulder abduction, external rotation (ABER) position MR shoulder arthrogram lipid pressure TW image showing partial tear (arrow) on the side of the superior myopinal tendon joint
Lipid pressureTM images of shoulder abduction, external rotation (ABER) MR shoulder arthroidography showing anterior inferior pyelometrial tear (arrow) and partial tear on the side of the tendon joint of the superior supraspinatus muscle (arrow)
ABER-bit MRI arthrography, the most sensitive sign of anterior lower labial tear is the entry of contrast media into the fissure between the glial lip and the joint pelvis.
Incomplete anterior puryl lip tear is defined as a tear that does not involve the deep fibers of the suborbial ligament and the periosteum of the anterior shoulder blade, and the contrast medium fills the fissure at the base of the anterior glial lip, travels very short, and terminates at the edge of the scapula pelvis bone.
Bankart injury on ABER-bit MR arthrography images is characterized by contrast media-filled fissures at the base of the anterior pelvis lip that are wider and deeper than incomplete anterior pelvis tears, and occasionally contrast media around the edges of the scapular pyelonecosa bone.
8. Avulsive fracture of the humerus large nodule
Plain x-rays show unsegrated or isolated bone pieces and bone cortex defects at the site of the large nodule of the humerus.
Avulsive fractures of the large humerus nodule: anteroposterior (A), Grashey (anterior and posterior oblique) (B) and axillary x-ray plain (C) showing avulsive fractures (arrows) of the large nodules of the humerus Note the appearance of small nodules (arrows) on plain axillary X-rays
The great humerus nodule is the attachment of the superior, inferior, and small round muscles. Simple macronodular fractures are uncommon. Clinical examination makes it difficult to distinguish between a simple large humerus nodule avulsive fracture and a rotator cuff tear. But because the treatment measures are different, the difference between the two is very important. Fractures of the large nodule of the humerus without displacement often occur in conjunction with surgical neck fractures of the humerus and anterior dislocation of the shoulder joint.
Sometimes a grooved defect in the humerus head or a Hill-Sachs lesion is mistaken for a fracture of the large humerus nodule.
On plain X-rays, a large nodule avulsive fracture of the humerus may not be apparent, and patients with suspected rotator cuff tears generally require AN MRI scan, and sometimes such patients may occasionally show bone marrow edema in the area of the large humerus nodule, suggesting a diagnosis of an occult avulsive fracture.
9. Posterior shoulder dislocation
When the humerus head is protruding backwards, it is simultaneously relocated to the lateral side of the posterior pelvis margin, so that the shoulder space widens when orthostatic projection occurs.
Posterior shoulder dislocation: grooved lines (arrows) shown on anteroposterior and posterior (A) of the shoulder x-ray, suggesting an embedding fracture. MRT1WI axis image (B) of the same patient showing anterolateral anti-Hill- Sachs fracture of the bone after post-humeral dislocation (arrow)
In posterior shoulder dislocation, two parallel cortical lines are visible on the anterolateral side of the humerus.
One of them is the bony articular surface of the humerus head, and the other is the groove embedded edge of the fracture. Anti-Hill-Sachs fractures are fractures with anterior medial embedding of the humerus secondary to posterior humerus dislocation.
Post-shoulder dislocation: patients with CT scan of the shoulder that shows retro-humeral dislocation, anterolateral anti-Hill-Sachs fracture (arrow) of the humerus
Antiseous Bankart fractures are fractures of the posterior inferior joint of the joint secondary to posterior poopar dislocation.
The number one problem with posterior shoulder dislocation is making a diagnosis, with a missed diagnosis rate of more than 50% in first-time patients
In the case of snow in the shoulder cavity or lymphedema of the upper extremities, the widening of the shoulder space on the x-ray orthostatic film is easily confused with the posterior shoulder dislocation.
10. Shoulder pseudo-subluxation:
The humeral head moves down in a subluxative state.
Shoulder pseudo-subluxation: A. Anteroposterior and anterior position of the shoulder joint X. Plain x-ray showing downward subluxation of the humerus head; B. Flat x-ray of the anteroposterior position of the shoulder joint shows downward subluxation of the humerus head. Note fractures (arrows) of the proximal humerus
It is important to identify the downward subluxation of the humerus, i.e. shoulder sagging. Lower subluxation of the shoulder joint with fracture is a relatively mild injury. May be due to some iatrogenic intervention process.
When the diagnosis is in doubt, a plain x-ray of the upper arm suspension elevation or a re-plain x-ray after suction of the joint cavity may be helpful.
11. Pseudocyst of the humerus:
Sparse areas of trabecular trabecularity located on the proximal lateral side of the humerus are evident on x-rays of young people. In older people due to the reduction of trabeculabras proximal humerus, the sparse area of the trabecular is less pronounced.
Pseudocyst of the humerus head: A. anterior and posterior X.ray of the shoulder joint shows that the sparse area (arrow) of a trabecular bone is located in the lateral part of the proximal end of the humerus; B. Anteroposterior X-ray of the shoulder joint shows that the sparse area of a trabeculabra is located in the lateral proximal part of the humerus
Although myeloma, giant cell tumor, chondroblastoma, and metastatic lesions can occur in the humerus head and resemble pseudocysts, these pathological processes can be differentiated from pseudocysts by, for example, cortical destruction, the presence of periosteal bone, a wider range of invasions, and unclear boundaries.
When it is not possible to determine whether the X-ray area is a true lesion or a pseudocyst, MRI is valuable in differentiating and can show whether it is normal bone marrow or tumor tissue.
12. Supraspital pelvis tears from anterior to posterior with the lower foramen/crypt of the oblibra
Superior labral anteroposterior (SLAP) injury usually refers to a tear in the upper pellometrium centered on the tendon attachment of the biceps long cepharicus.
SLAP Tear: Lipid Pressure T1WI Coronary MR Arthroplasty shows a tear in the upper pyelum labia and contrast media entering the pyelum lip (arrow)
The lower foramen of the oblial lip is located in front of the tendon attachment of the biceps, including the anterior pyelecta.
Lower foramen of the oblipals: Lipid pressure T1WI coronary position MR arthrotomy video (A) showing absence of the anterior upper puel lip (arrow). Lipid pressure T1WI axis MR arthroplasty of the same subject (B) shows the separation of the anterior upper pyelomega lip from the joint pyelometrin cartilage (arrow). Lipid pressure T1WI sagittal position MR arthroplasty video (C) of the same subject showing absence of anterior upper pelvis lip (arrow)
The sublipal crypt is a fissure located between the ligament complex of the capsule and the upper part of the articular cartilage.
Sublial crypt: lip pressure T1WI coronary POSITION MR arthroplasty showing linear fissures (arrows) between the upper pellometrium and the joint pelvis
Clinical diagnosis of SLAP injury is difficult. The most common clinical symptom is nonspecific shoulder pain, particularly when the arms are lifted or crossed. Other symptoms include crackling, clicking, strangulation, weakness, stiffness, and instability.
The sublipal foramen and sublibelis of the obliar crypt resemble SLAP injuries. The lower foramen of the obliparum slopes inwards and inwards to the posterior joints, attaching to the lower part of the anterior plyopause. The margins of the crypt under the oblial lip are smooth and usually less than 2 mm wide.
Usually the sublipal crypt does not extend to the back of the biceps tendon. In addition, the interface of articular cartilage is also easily misdiagnosed as SLAP injury on MRI oblique coronal sites. In general, SLAP injuries travel sideways, while the articular cartilage interface is parallel to the cortex of the joint pelvis.
13. Normal variation of SLAP tear and biceps tendon pylo-lip complex
Diagnosis of SLAP injury depends on abnormalities in signaling and morphology of the upper pelometrium lip. Specific signs of MRI diagnosing SLAP injury include elevated glial lip signaling, extending or not extending to the biceps tendon pyllium lip attachment, and tearing of the upper plyolar lip.
SLAP: Lipid Pressure T1WI Coronary POSITION MR Arthroplasty Showing Tear of the Upper Pelvis Lip (Arrow)
Pseudo-SLAP is actually a small fissure between the upper labial lip and the beginning of the biceps tendon. Oblique coronal images on MRI show small fissures of variable depth filled with contrast medium.
Pseudo-SLAP: Lipid pressure T1WI coronary MR arthrotomy showing a small fissure between the upper pellometrium and the beginning of the biceps tendon (arrow)
The deep fissure between the upper gymbal lip of the shoulder joint and the attachment of the biceps tendon may resemble a SLAP injury. Elevated glyphal lip signals are not uncommon and may be related to the phenomenon of magic horns or degeneration of the plierals. The partial volumetric effect of the obosobial ligament is also one of the causes of this illusion.
14. Purylabial tear and transitional area between the pubic lip and the joint pyelometrionic cartilage
Diagnosis of a pupural tear relies on morphological changes such as deletion, wear, separation, displacement, or deformation. The presence of joint fluid or contrast media in the labial lip is also a sign of a tearing of the glyphal lip.
Punulos labial tear: lipid pressure T1WI axis MR arthrotomy showing contrast media extending to the pyelometrium (arrow)
Glean lip tears sometimes present as high signals that are all sequentially limited or diffuse to the joint surface, but this sign is less reliable in diagnosing a glenulum tear.
In standard MRI images of short TE sequences, there is a high signal between the labial and joint pyelomendone, the transitional area of the two tissue structures, but these areas are not filled with contrast agent on mr arthrograph images.
Between the glial lip and the joint glenocosmic cortex is the articular cartilage, particularly in the upper part of the shoulder joint, where the pirium lip is prone to tearing in the area of the MRI axial image.
Normal interface: Medium-weighted axial MRI slides show the area (arrow) between the fibrochondral cartilage of the glial lip and the transparent softness of the joint pyelum, which is easily misdiagnosed as a puncture tear
15. Kim injuries
On MR arthrography images, Kim's injury shows incomplete avulsion or flattening of the posterior lower pelvis lip, and the luteal lip is tilted backwards in the cartilage junction area, but the positional relationship between the joint pelometrionic cartilage and the puel lip remains normal.
Kim injury: A. Lipid pressure T1WI axial position MR arthroplasty shows flattening of the lower pelvis lip after the video (arrow); B. Fat pressure T1WI axis POSITION MR Arthroplasty shows incomplete tearing of the posterior lower pellometrid and increased posterior tilt of the pyelometrix (arrow)
When direct violence from the posterior and lower part of the shoulder joint acts on the posterior lower labia, it first causes tearing of the deep fibers of the oblial lip. The initial tear does not affect the surface of the pyelometrial cartilage junction and can result in missed diagnoses if the arthroscopy does not involve deep exploration. MRI is helpful in diagnosing this deep tear in the labial lip.
In anti-Bankart injury, the posterior lower pelvis is separated from the joint pelvis and there is also detachment of the periosteum posterior to the shoulder blade. When the posterior periosteum is torn off in a sleeve-like tear, the posterior pyelometrium is stripped along with the periosteum behind the intact shoulder capsule.
Source: Medical
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