Slide 1 ___________________________________ Musculoskeletal Specialty Review ___________________________________ ___________________________________ ___________________________________ © 4 June 2014 ___________________________________ ___________________________________ ___________________________________ Slide 2 ___________________________________ Musculoskeletal Specialty Review: ___________________________________ Trauma & Tumors ___________________________________ Christopher Cerniglia, DO, MEng Chief, Division of Musculoskeletal Imaging Department of Radiology UMass Memorial Medical Center ___________________________________ Program Director, Musculoskeletal Fellowship Associate Director, Radiology Residency Program University of Massachusetts Medical School ___________________________________ ___________________________________ ___________________________________ Slide 3 ___________________________________ Outline • Cases ___________________________________ • Trauma ___________________________________ • Tumors ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 4 CASES ___________________________________ ___________________________________ ___________________________________ ___________________________________ 4 June 2014 ___________________________________ ___________________________________ ___________________________________ Slide 5 ___________________________________ Case 1 • Hx: Trauma ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 6 ___________________________________ Case 1 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 7 ___________________________________ Question 1 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 8 ___________________________________ Case 2 • Pain s/p trauma ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 9 ___________________________________ Case 2 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 10 ___________________________________ Question 2 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 11 ___________________________________ Case 3 • Hx: Clip injury while playing football ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 12 ___________________________________ Case 3 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 13 ___________________________________ Question 3 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 14 ___________________________________ Case 4 • Palpable Mass x 1 month ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 15 ___________________________________ Case 4 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 16 ___________________________________ Question 4 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 17 ___________________________________ Case 5 • Slowly Enlarging Palpable Mass ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 18 ___________________________________ Case 5 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 19 ___________________________________ Question 5 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 20 ___________________________________ Case 6 • Medial Volar Hand Mass ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 21 ___________________________________ Case 6 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 22 ___________________________________ Question 6 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 23 ___________________________________ Case 7 • 51 year old female with several week history ___________________________________ of knee pain. ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 24 ___________________________________ Case 7 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 25 ___________________________________ Question 7 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 26 ___________________________________ Case 8 • 40 year old with right thigh pain ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 27 ___________________________________ Case 8 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 28 ___________________________________ Question 8 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 29 ___________________________________ Trauma & Sports Injuries ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 30 ___________________________________ TRAUMA • Axial Trauma ___________________________________ – Spine – Pelvis • Appendicular Trauma – Upper Extremity ___________________________________ – Lower Extremity • Sequela & Complications ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 31 ___________________________________ TRAUMA • Axial Trauma ___________________________________ – Spine – Pelvis • Appendicular Trauma – Upper Extremity ___________________________________ – Lower Extremity • Sequela & Complications ___________________________________ ___________________________________ ___________________________________ ___________________________________ Slide 32 ___________________________________ SPINE • Mechanism of injury – Flexion ___________________________________ – Extension – Axial load/burst – Distraction – Translation • Fracture/ligament injury patterns ___________________________________ • Column concept/stability – Cervical – Thoracic – Lumbar – Sacrum/coccyx ___________________________________ ___________________________________