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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
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
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
Let's talk about a variation that occurs in about 1%-2%
0:03
of the population called the Buford Complex or
0:06
Buford Variation, which means I'm going to ignore the
0:09
joint fluid, I'm going to ignore the subacromial arch
0:12
impingement, the peritendinitis, the small partial thickness
0:16
concealed tear of the footprint, I'm even going to ignore
0:20
the plastic deformation of the infraposteure recess of
0:24
the shoulder as a sign of chronic micro instability.
0:29
And I'm going to focus on this.
0:30
A large triangular pseudomass that looks like
0:34
a piece of labrum that's avulsed with a big
0:37
cavernous space between it and the glenoid.
0:40
That cavernous space is a normal sulcus where the
0:43
patient doesn't have an anterosuperior labrum.
0:49
Rather, the labrum is replaced by a large
0:52
cord like structure that is made up of a
0:55
short stubby SGHL and a large cord like MGHL.
1:01
And here it is in the coronal projection.
1:02
Let's go right to it.
1:04
Look at that thick, vertically descending MGHL.
1:09
You know from prior discussions,
1:11
the MGHL can go up and down.
1:13
It can go obliquely, forming a Z shape with the
1:17
superior glenohumeral ligament, the oblique MGHL,
1:21
and the IGHL, or it can be completely horizontal.
1:25
It's often variable and perforated.
1:27
But this one continues on down
1:28
as a very thick, vertical line.
1:30
Pseudomass like chord structure with an intervening
1:34
space between, not to be confused with a labral tear.
1:37
As we get down lower, that space will close.
1:41
And indeed, it does.
1:43
It usually closes by the time we reach the inferior third.
1:47
And now it looks like a beautiful, smooth, black triangle.
1:52
We'll ignore, for now, any changes in
1:55
the posterior labrum, which are scant.
1:57
We'll also ignore these.
1:59
linear or laminar tears in the biceps long head
2:02
with the synovitic proliferation around them.
2:05
But we won't ignore this thick, large MGHL or cord like
2:10
MGHL descending from our triangular pseudomass that
2:15
has the SGHL emanating from it right there, the MGHL
2:19
coming straight down, and a sulcus between it and the
2:24
underlying glenoid cup, the so called Buford complex.
Return of the Buford Complex
HIDEInteractive Transcript
0:00
Let's talk about a variation that occurs in about 1%-2%
0:03
of the population called the Buford Complex or
0:06
Buford Variation, which means I'm going to ignore the
0:09
joint fluid, I'm going to ignore the subacromial arch
0:12
impingement, the peritendinitis, the small partial thickness
0:16
concealed tear of the footprint, I'm even going to ignore
0:20
the plastic deformation of the infraposteure recess of
0:24
the shoulder as a sign of chronic micro instability.
0:29
And I'm going to focus on this.
0:30
A large triangular pseudomass that looks like
0:34
a piece of labrum that's avulsed with a big
0:37
cavernous space between it and the glenoid.
0:40
That cavernous space is a normal sulcus where the
0:43
patient doesn't have an anterosuperior labrum.
0:49
Rather, the labrum is replaced by a large
0:52
cord like structure that is made up of a
0:55
short stubby SGHL and a large cord like MGHL.
1:01
And here it is in the coronal projection.
1:02
Let's go right to it.
1:04
Look at that thick, vertically descending MGHL.
1:09
You know from prior discussions,
1:11
the MGHL can go up and down.
1:13
It can go obliquely, forming a Z shape with the
1:17
superior glenohumeral ligament, the oblique MGHL,
1:21
and the IGHL, or it can be completely horizontal.
1:25
It's often variable and perforated.
1:27
But this one continues on down
1:28
as a very thick, vertical line.
1:30
Pseudomass like chord structure with an intervening
1:34
space between, not to be confused with a labral tear.
1:37
As we get down lower, that space will close.
1:41
And indeed, it does.
1:43
It usually closes by the time we reach the inferior third.
1:47
And now it looks like a beautiful, smooth, black triangle.
1:52
We'll ignore, for now, any changes in
1:55
the posterior labrum, which are scant.
1:57
We'll also ignore these.
1:59
linear or laminar tears in the biceps long head
2:02
with the synovitic proliferation around them.
2:05
But we won't ignore this thick, large MGHL or cord like
2:10
MGHL descending from our triangular pseudomass that
2:15
has the SGHL emanating from it right there, the MGHL
2:19
coming straight down, and a sulcus between it and the
2:24
underlying glenoid cup, the so called Buford complex.
Report
Description
Faculty
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
Tags
Shoulder
Musculoskeletal (MSK)
MRI
Idiopathic
Congenital
Bone & Soft Tissues
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