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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.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
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.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
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.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
1 topic, 5 min.
1 topic, 4 min.
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.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.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.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.6 topics, 50 min.
4 topics, 14 min.
6 topics, 25 min.
0:00
In looking at the anatomy of the glenohumeral ligaments,
0:02
it's probably helpful for me to just introduce
0:04
the concept of some anterior variations, which are
0:07
known as Buford variations, or Buford complexes.
0:13
So, the superior labrum is going to be
0:15
smaller at the top than it is at the bottom.
0:18
And, this is a hard and fast rule.
0:21
So as you go down, the labrum should get blacker and bigger,
0:24
and more triangular, more clearly triangular like this.
0:28
And if it doesn't, you've got a problem.
0:31
But starting up high, we've got our
0:32
small, we've got our small labrum here.
0:34
Let me color it, right there.
0:37
And then taking off from it, we have the superior
0:39
glenohumeral ligament, which is right there.
0:43
So what if you didn't have a labrum, or you had a
0:46
labrum that wasn't really anchored onto the glenoid?
0:50
So in other words, the labrum was, say, over here.
0:55
And then the SGHL came off that, and you had a
0:57
big space between the labrum and the underlying
1:02
glenoid, so yellow for the space, or recess.
1:06
And that might be filled with fluid.
1:07
It would look like, to you, that
1:09
the labrum has come detached.
1:12
Now, what'll strike you is, nothing's inflamed.
1:15
There's no effusion.
1:17
The rest of the structures are in their normal position.
1:20
And this thing looks like a large, gray mass.
1:23
Now, I didn't color it gray, I made it red.
1:25
And I'll stay with red, because it's just easier to see.
1:27
But it can get, it can get fairly large.
1:30
Let me see if it'll color for me.
1:31
Then as we scroll down, the middle glenohumeral
1:37
ligament comes off the undersurface of it.
1:40
So if we were looking at it sagittally, let's say we
1:43
had a piece of labrum here, and we had the SGHL coming
1:47
off that, the MGHL might come off conjointly and be
1:51
very thick like a big fat cord, or a cord-like MGHL.
1:57
To make matters even more complex, if the biceps has
2:00
a very far anterior takeoff, It may take off right
2:03
in the neighborhood, and that adds to this mass
2:07
like character of this triangular black structure
2:09
in the front with this big, gaping recess behind it.
2:14
That is really the essence of the Buford
2:17
variations or the Buford complexes.
2:20
And you can see that the biceps might come off in the front
2:23
or might come off in the back and not, not be part of it.
2:27
The MGHL might be very thick and cord-like.
2:30
And come off right underneath it, or
2:32
it might come off a little bit lower.
2:34
So this is why we refer to these as Buford variations.
2:38
And we're going to show you an example of such
2:40
in an actual case so that you get a feel for it.
2:42
But this is a quick, nice introduction to it.
Interactive Transcript
0:00
In looking at the anatomy of the glenohumeral ligaments,
0:02
it's probably helpful for me to just introduce
0:04
the concept of some anterior variations, which are
0:07
known as Buford variations, or Buford complexes.
0:13
So, the superior labrum is going to be
0:15
smaller at the top than it is at the bottom.
0:18
And, this is a hard and fast rule.
0:21
So as you go down, the labrum should get blacker and bigger,
0:24
and more triangular, more clearly triangular like this.
0:28
And if it doesn't, you've got a problem.
0:31
But starting up high, we've got our
0:32
small, we've got our small labrum here.
0:34
Let me color it, right there.
0:37
And then taking off from it, we have the superior
0:39
glenohumeral ligament, which is right there.
0:43
So what if you didn't have a labrum, or you had a
0:46
labrum that wasn't really anchored onto the glenoid?
0:50
So in other words, the labrum was, say, over here.
0:55
And then the SGHL came off that, and you had a
0:57
big space between the labrum and the underlying
1:02
glenoid, so yellow for the space, or recess.
1:06
And that might be filled with fluid.
1:07
It would look like, to you, that
1:09
the labrum has come detached.
1:12
Now, what'll strike you is, nothing's inflamed.
1:15
There's no effusion.
1:17
The rest of the structures are in their normal position.
1:20
And this thing looks like a large, gray mass.
1:23
Now, I didn't color it gray, I made it red.
1:25
And I'll stay with red, because it's just easier to see.
1:27
But it can get, it can get fairly large.
1:30
Let me see if it'll color for me.
1:31
Then as we scroll down, the middle glenohumeral
1:37
ligament comes off the undersurface of it.
1:40
So if we were looking at it sagittally, let's say we
1:43
had a piece of labrum here, and we had the SGHL coming
1:47
off that, the MGHL might come off conjointly and be
1:51
very thick like a big fat cord, or a cord-like MGHL.
1:57
To make matters even more complex, if the biceps has
2:00
a very far anterior takeoff, It may take off right
2:03
in the neighborhood, and that adds to this mass
2:07
like character of this triangular black structure
2:09
in the front with this big, gaping recess behind it.
2:14
That is really the essence of the Buford
2:17
variations or the Buford complexes.
2:20
And you can see that the biceps might come off in the front
2:23
or might come off in the back and not, not be part of it.
2:27
The MGHL might be very thick and cord-like.
2:30
And come off right underneath it, or
2:32
it might come off a little bit lower.
2:34
So this is why we refer to these as Buford variations.
2:38
And we're going to show you an example of such
2:40
in an actual case so that you get a feel for it.
2:42
But this is a quick, nice introduction to it.
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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