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Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
MRI Mastery Series: Shoulder - Pre-course Activities
1 topic, 5 min.
Lesson
Sample Lesson - 53 Year Old Female, Injured While Playing Softball
1 topic, 4 min.
Lesson
Shoulder MRI: Assessing Instability - Anatomy
10 topics, 50 min.
Introduction to Shoulder Instability
6 m.Axial Anatomy on MRI
5 m.Axial Anatomy: The Biceps Pulley
5 m.Axial Instability Search Pattern
9 m.Axial Shoulder: The Structures that Give Radiologists Fits
6 m.Introduction to the Buford Complex
3 m.The Glenoid Cup
6 m.Dynamic and Passive Stabilizers in the Sagittal Projection
6 m.Dynamic and Passive Stabilizers in the Coronal Projection
7 m.Return of the Buford Complex
3 m.Lesson
Shoulder MRI: Assessing Instability - Protocols
7 topics, 53 min.
Key Pulsing Sequences for the Shoulder
6 m.Utilizing the ABER view in the Coronal Projection
9 m.The Value of the T2 Sequence in Shoulder Imaging
7 m.Arthrographic Analysis of the Axial Projection
11 m.Arthrographic Analysis in the Coronal Projection
9 m.Arthrographic Analysis in the Sagittal Projection
6 m.Shoulder Projections Summary
8 m.Lesson
Shoulder MRI: Assessing Instability - Pathology
11 topics, 50 min.
On-Track/Off-Track: ABER Summary
6 m.On-Track/Off-Track: Mid-Range Summary
3 m.On-Track/Off-Track: Assessing Glenoid Bone Loss
8 m.On-Track/Off-Track: The Nofsinger Technique
3 m.On-Track/Off-Track: Stable Hill-Sachs Lesions
3 m.On-Track/Off-Track: The Hill-Sachs Concept
4 m.On-Track/Off-Track: Dislocation Mechanics
4 m.On-Track/Off-Track: Dynamic Examination after Bankart Repair
6 m.On-Track/Off-Track: Using Measuring Tools on MRI
6 m.Posterior Macro & Micro Instability
7 m.Posterior Labral Pathology
6 m.Lesson
Shoulder MRI: Assessing Instability - Case Review
23 topics, 2 hr. 31 min.
17 Year Old Male – Known Dislocation
15 m.21 Year Old Male Pitcher; Decreased Range of Motion
9 m.21 Year Old Involved in a Collision Accident
9 m.54 Year Old Female with Complex Multidirectional Microinstability
7 m.49 Year Old Male, Weightlifter, Experiencing Instability
6 m.68 Year Old Male Golfer with Pain for a Month
6 m.15 Year Old Male – Fell On Outstretched Hand
8 m.55 Year Old Female, Pain in Shoulder Extending to Elbow After Arm Was Jerked
9 m.25 Year Old Male, Pain When Swinging Arm
8 m.53 Year Old Male, Motor Vehicle Accident 6 Weeks Ago, Now Experiencing Pain and Spasms
8 m.17 Year Old Male with a History of Dislocation
6 m.51 Year Old Female: Rule Out Rotator Cuff Tear
5 m.The GLOM Lesion
3 m.56 Year Old Patient with Axillary Nerve Dysfunction Post Dislocation
2 m.69 Year Old Male, Fell and Dislocated Shoulder
10 m.69 Year Old Male with Complex Pattern of Injury
9 m.38 Year Old Male with a Dislocation/Relocation Event
6 m.20 Year Old Male, Recurrent Dislocations and Instability
12 m.20 Year Old Male Pitcher with Recent Dislocation
4 m.17 Year Old Wrestler with Discomfort in the Shoulder
5 m.42 Year Old Male with a Violent Posterior Dislocation
6 m.40 Year Old Male in Motor Vehicle Accident, Irreducible Dislocation
5 m.40 Year Old Male, Post Motor Vehicle Accident
4 m.Lesson
Shoulder "Shark" Week -- Review of Rotator Cuff Anatomy
6 topics, 50 min.
Lesson
The Six Components of the Rotator Cuff
4 topics, 14 min.
Lesson
Identifying The Six Components of Rotator Cuff Tears in Practice
6 topics, 25 min.
0:00
And we're talking on track and off track morphology.
0:04
This is a companion to the A bear position,
0:08
on track, off track summary discussion.
0:11
Except this time now, we're not all the way
0:13
in the abduction external rotation position.
0:16
We're starting to move our arm forward.
0:18
Maybe we're throwing a javelin.
0:19
Maybe we are throwing a baseball.
0:22
Or some other sport.
0:24
And as we start to come out of this, This extreme position,
0:28
where the capsule is very taut, now the capsule loosens up.
0:34
And you might say, well, wow, we've got this big
0:36
defect anteriorly, why aren't we dislocating?
0:39
We're not dislocating because, even though we're a little
0:43
loose here, we still have articular surface contact.
0:48
And even here, we start to come forward a little
0:51
bit, but we don't completely dislocate because The
0:55
inferior glenohumeral ligament and capsule is helping
0:59
to keep us in place, at least partially in place.
1:02
There is some translation, no doubt about it.
1:05
The humerus is translated anteriorly.
1:08
Now, what if I had a big hatchet
1:11
chop V shaped defect right here?
1:15
It would get stuck on this little point.
1:19
That point would go in here, and then it
1:22
would allow with further degrees of Anterior
1:27
rotation and less abduction external rotation.
1:32
It would allow this to, to basically
1:34
fulcrum or jump out of this area.
1:38
And you would have an unstable situation.
1:41
So this is known as engagement.
1:45
Now you might think, well, this is kind of strange.
1:47
People that are, you know, throwing
1:50
with their arm all the way back.
1:52
They don't, they're not, they don't dislocate.
1:54
But they lie in bed and their arm comes out.
1:56
Well, here's why.
1:57
They're in this neutral position, this abduction
2:01
external rotation position, if you've got
2:03
a decent capsule or a repair, that's tight.
2:08
But when you're in the mid range position, it's loose, so
2:11
it allows this translation phenomenon, and if this thing is
2:15
big enough, or this thing is deep enough, that's lax, and
2:19
now the shoulder, just lying in bed, flops out of the joint.
2:23
And it has to do, with the capsular laxity from
2:27
the position you're in when you're lying in bed.
On-Track/Off-Track: Mid-Range Summary
HIDEInteractive Transcript
0:00
And we're talking on track and off track morphology.
0:04
This is a companion to the A bear position,
0:08
on track, off track summary discussion.
0:11
Except this time now, we're not all the way
0:13
in the abduction external rotation position.
0:16
We're starting to move our arm forward.
0:18
Maybe we're throwing a javelin.
0:19
Maybe we are throwing a baseball.
0:22
Or some other sport.
0:24
And as we start to come out of this, This extreme position,
0:28
where the capsule is very taut, now the capsule loosens up.
0:34
And you might say, well, wow, we've got this big
0:36
defect anteriorly, why aren't we dislocating?
0:39
We're not dislocating because, even though we're a little
0:43
loose here, we still have articular surface contact.
0:48
And even here, we start to come forward a little
0:51
bit, but we don't completely dislocate because The
0:55
inferior glenohumeral ligament and capsule is helping
0:59
to keep us in place, at least partially in place.
1:02
There is some translation, no doubt about it.
1:05
The humerus is translated anteriorly.
1:08
Now, what if I had a big hatchet
1:11
chop V shaped defect right here?
1:15
It would get stuck on this little point.
1:19
That point would go in here, and then it
1:22
would allow with further degrees of Anterior
1:27
rotation and less abduction external rotation.
1:32
It would allow this to, to basically
1:34
fulcrum or jump out of this area.
1:38
And you would have an unstable situation.
1:41
So this is known as engagement.
1:45
Now you might think, well, this is kind of strange.
1:47
People that are, you know, throwing
1:50
with their arm all the way back.
1:52
They don't, they're not, they don't dislocate.
1:54
But they lie in bed and their arm comes out.
1:56
Well, here's why.
1:57
They're in this neutral position, this abduction
2:01
external rotation position, if you've got
2:03
a decent capsule or a repair, that's tight.
2:08
But when you're in the mid range position, it's loose, so
2:11
it allows this translation phenomenon, and if this thing is
2:15
big enough, or this thing is deep enough, that's lax, and
2:19
now the shoulder, just lying in bed, flops out of the joint.
2:23
And it has to do, with the capsular laxity from
2:27
the position you're in when you're lying in bed.
Report
Description
Faculty
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
Tags
Trauma
Shoulder
Musculoskeletal (MSK)
MRI
Bone & Soft Tissues
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