Slide 1

MR Imaging of the Rotator Cuff Timothy G. Sanders, M.D. Slide 2 MRI Technique -T1 and T2 FS -Oblique Coronal -T1 and T2 FS -Oblique Sagittal -T2 FS and GRE -Axial Slide 3 Osseous Outlet and Acromion Rotator Cuff Surrounded by a Bony Arch Mechanical Impingement leads to degeneration of the cuff Anterior Acromion Most Important Structure Leading to Impingement Slide 4 Slide 5 Slide 6 Normal Osseous Outlet Coracoid Clavicle Acromion Slide 7 Slide 8 Acromial Types Type I Slide 9 Acromial Types Type II Slide 10 Acromial Types Type III Slide 11 Acromial Types Type IV Slide 12 Acromial Down Sloping Normal Axis of Acromion Anterior Down Sloping Anterior Down Sloping Evaluated on Sagittal Images Axis of Acromion Slide 13 Acromial Down Sloping Lateral Down Sloping Evaluated on Coronal Images Normal Axis of AcromionLateral Down Sloping Axis of Acromion Slide 14 Acromial Spur -Spur -Contains Marrow Signal -Deltoid Tendon (Mimics Spur) -Black (No Marrow Signal) Slide 15 Os Acromiale Slide 16 Ossification Center Usually Closes by 22-25 y.o. Normal Appearing Anterior Acromion on Axial Image Slide 17 Os Acromiale (Axial Images) -Can be unstable resulting in impingement of Rotator Cuff during contraction of the deltoid Slide 18 Os Acromiale (Sagittal Images) Double AC Joint SignNormal AC Joint Slide 19 Os Acromiale Double AC Joint AC JointOs Acromiale Slide 20 Acromion Type (I, II, III) Anterior/ Lateral Down Sloping Inferior Spur Os Acromiale Slide 21 Coracoacromial Ligament -Normal Ligament