Shoulder MRI Fellowship Practice Cases

<div class="entry-content">
		<div id="tve_flt" class="tve_flt tcb-style-wrap"><div id="tve_editor" class="tve_shortcode_editor tar-main-content"><div class="thrv_wrapper thrv_text_element">This course includes the 25 essential cases a radiologist needs to master to confidently&#160;diagnose shoulder conditions on MRI.<a href="https://mrionline.com/remote-fellowships/" class="">Browse all Radiology Remote Fellowships</a><h2 class="" dir="ltr">Desired Outcomes</h2>Upon completion of this activity, participants should be better able to:<ul class=""><li dir="ltr">Interpret essential pathologies for shoulder MRI</li><li dir="ltr">Diagnose shoulder conditions for MRI</li></ul>Bibliography: Suggested reading resources and references can be found within each case discussion.<h1 class="">Credit Information</h1><h3 class="" dir="ltr">Accreditation Statement</h3>MRI Online is accredited by the Accreditation Council for Continuing Medical Education (ACCME)to provide continuing medical education for physicians.<h3 class="">Credit Designation Statement</h3>MRI Online designates this Enduring activity for a maximum of 15&#160;AMA PRA Category 1 Credits&#8482;.&#160;Physicians should claim only the credit commensurate with the extent of their participation in the activity.This activity is valid for credit from November 6, 2023 to November 6, 2026.Content is reviewed and updated on an ongoing basis.CME Planning Committee&#160;Suresh K. Mukherji, MD, MBA, FACRProfessor of Radiology, University of IllinoisProfessor of Radiation Oncology, Robert Wood Johnson Medical School, Rutgers UniversityFaculty, Otolaryngology Head Neck Surgery, Michigan State UniversityNational Director of Head &amp; Neck RadiologyProScan ImagingStephen J. Pomeranz, MDChief Medical Officer and FounderProScan ImagingFounderMRI OnlineDavid M. Yousem, MBA, MDProfessor of RadiologyVice Chairman and Associate DeanJohns Hopkins UniversityDaniel Arnold, MBACEO and Co-FounderMRI OnlinePaul BohartSenior Content ManagerMRI OnlineJennifer A. Hall, MSDirector, FellowshipsMRI OnlineDeanna M. Heier, PhDVP, Educational Strategy and OperationsMRI Online<h1 class="">Disclosure Statements</h1>CME Planning CommitteeThe CME Planning Committee members have no relevant financial relationships to disclose.FacultyThe Faculty for this activity have no relevant financial relationships to disclose.Staff and Content reviewersAll MRI Online staff involved in the development of content for this activity have norelevant financial relationships to disclose.Commercial SupportThere is no commercial support for this activity.Course content is peer-reviewed for content validity by persons that do not have conflicts of interest related to the content and to verify the educational material is evidence-based, fair, balanced, and free from commercial bias.</div></div></div><div class="tcb_flag"></div>
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Shoulder

Stephen J Pomeranz

Jenny T Bencardino

Edward Smitaman

Gain confidence reading and reporting on Shoulder MRI Cases with the Medality Fellowship Certificate Program. Practice using real-world, scrollable cases, earn CME, and receive a Fellowship Certificate™ upon completion!

Case Review

Musculoskeletal (MSK)

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Practice Cases

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Course Evaluation

Post-Course Activities

Welcome to the Shoulder MRI Fellowship Practice Cases course! In this course, you&rsquo;ll be presented with a series of worklists, comprised of 25 essential cases you must review to receive your Fellowship Certificate.

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Access Full Fellowship Certificate Program at Anytime <a href="https://mrionline.com/proficiency/shoulder-mri-fellowship-certificate/" style="text-decoration:none">Here</a>&nbsp;

Shoulder MRI Practice Cases

Patient History
58-year-old male with left shoulder pain, weakness, and decreased range of motion. No known injury. 

Findings
ROTATOR CUFF:  Generalized interstitial swelling and tendinopathy altering the morphology of the deep fibers of the supraspinatus is noted in the region of the footprint and critical zone. Diminutive concealed interstitial delamination of the footprint. Infraspinatus intact. Delamination and attachment of the outer or superficial fibers of the subscapularis have allowed the biceps to interstitially sublux into it. Teres minor normal. 

SUBACROMIAL/SUBDELTOID BURSA: Mildly swollen. 

MUSCLES (ROTATOR CUFF/DELTOID, TRAPEZIUS, PECTORALIS): Mild volumetric atrophy without fatty replacement.

BICEPS TENDON: Biceps dislocation accompanied by tear of the transverse humeral ligament along with its coracohumeral ligament contribution. Biceps has subluxed into the interstitium of the subscapularis sitting atop or superficial to an intact middle glenohumeral ligament. Extraarticular longitudinal biceps sheath fluid distended. 

AC JOINT: Moderate hypertrophy and mild inflammation slightly greater than expected age.

CORACOCLAVICULAR LIGAMENTS: Intact conoid and trapezoid ligaments.

SUBACROMIAL ARCH/OUTLET: Mild tapering or spurring at the takeoff of the coracoacromial ligament from the acromion seen in the sagittal projection.

SUBCORACOID ARCH: Coracohumeral distance is mildly narrowed due to hypertrophic change of the lesser tuberosity. Delaminated superficial fibers of the subscapularis and its contribution to the transverse ligament along with that of the coracohumeral ligament is torn resulting in biceps pulley mechanism failure and biceps medial interstitial dislocation.

GLENOHUMERAL JOINT: Mild craniad decentering of the humeral head. No anteroposterior decentering. No penetrating chondromalacia.

GLENOID LABRUM: Normal. No SLAP lesions.

SKELETON: Hypertrophy of the lesser tuberosity. Shallow broad bicipital groove may contribute to biceps pulley mechanism failure.

SUBCUTANEOUS SOFT TISSUES: Capsular fluid is aggregated in the subcoracoid bursa but no soft tissue mass is identified.

AXILLA: Normal. No adenopathy. No entrapment neuropathy.

Impressions
Biceps pulley mechanism failure includes interstitial dislocation of the biceps long head, tear of the transverse humeral ligament, and delamination or detachment of the superficial component of the subscapularis.

Case