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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, 4 min.
1 topic,
7 topics, 30 min.
37 topics, 1 hr. 24 min.
Coronal Anatomy: Bony Anatomy
3 m.Coronal Anatomy: Hyaline Cartilage
3 m.Coronal Anatomy: Variance
4 m.Coronal Anatomy: Triangular Fibrocartilage
5 m.Coronal Anatomy: Peripheral TFCC Relationships
5 m.Coronal Anatomy: Intrinsic Ligaments Part 1
3 m.Coronal Anatomy: Intrinsic Ligaments Part 2
4 m.Coronal Anatomy: Extrinsic Ligaments Part 1
1 m.Coronal Anatomy: Extrinsic Ligaments Part 2
1 m.Coronal Anatomy: Extrinsic Ligaments Part 3
2 m.Coronal Anatomy: Extrinsic Ligaments Part 4
1 m.Coronal Anatomy: Extrinsic Ligaments Part 5
2 m.Coronal Anatomy: Extrinsic Ligaments Part 6
2 m.Diagramatic Anatomy: Extrinsic Ligaments Part 7
2 m.MRI Correlation: Extrinsic Ligaments Part 8
2 m.Coronal Anatomy: Extrinsic Ligaments Part 9
2 m.Coronal Anatomy: Extrinsic Ligaments Part 10
2 m.Coronal Anatomy: Extrinsic Ligaments Part 11
2 m.Coronal Anatomy: Extrinsic Ligaments Part 12
2 m.Extrinsic Ligaments: Thumb Part 1
1 m.Extrinsic Ligaments: Thumb Part 2
1 m.Extrinsic Ligaments: Thumb Part 3
2 m.Axial Anatomy: Radioulnar Joint
4 m.Proximal Anatomy: Nerves, Tendons & Vessels
4 m.Axial Anatomy: Extensor Tendons
4 m.Axial Anatomy: Extensor Tendons on MRI
3 m.Axial Anatomy: The Carpal Tunnel
5 m.Axial Anatomy: Guyon’s Canal
4 m.Axial Anatomy: Intrinsic Ligaments
3 m.Axial Anatomy: Extrinsic Ligaments
2 m.Axial Anatomy: Collateral Ligaments
3 m.Axial Anatomy: Extrinsic Ligaments Part 2
2 m.Sagittal Anatomy Part 1
2 m.Sagittal Anatomy Part 2
2 m.Sagittal Anatomy Part3
3 m.Sagittal Anatomy Part 4
4 m.Sagittal Anatomy Part 5
4 m.9 topics, 26 min.
Triangular Fibrocartilage: The Importance of the TFC
2 m.Triangular Fibrocartilage: Cartilage Anatomy
3 m.Triangular Fibrocartilage: Bony Architecture
6 m.Triangular Fibrocartilage: Anatomic Boundaries
7 m.Triangular Fibrocartilage: Micrograph View
3 m.Triangular Fibrocartilage: Magnified MRI
3 m.Triangular Fibrocartilage: Zooming Out on MRI
2 m.Triangular Fibrocartilage: Capsulo-synovial Reflections
3 m.Triangular Fibrocartilage: Focus on the Ulnar Styloid
3 m.19 topics, 1 hr. 32 min.
Case Review: Focus On Instability Part 1
3 m.Case Review: Focus On Instability Part 2
4 m.Case Review: Focus On Instability Part 3
4 m.Case Review: Focus on Instability
5 m.Case Review: 21 Year Old Male, Jammed Wrist and Now Has Pain
7 m.Case Review: Staging SLAC Wrist
5 m.Case Review: 52 Year Old Male with Medial Wrist Pain
9 m.Case Review: 15 Year Old Gymnast with Wrist Pain
8 m.Case Review: 14 Year Old Male Who Fell On Outstretched Hand
7 m.Case Review: 15 Year Old Female with Ulnar Sided Pain
8 m.Case Review: 42 Year Old Woman with Ulnar Sided Pain
6 m.Case Review: Additional Findings Discussion From Previous Case
7 m.Case Review: 42 Year Old Female – Assessing Variance
8 m.Case Review: 56 Year Old Male – Wrist Instability Overview
3 m.Case Review: 56 Year Old Male – Classifying Carpal Instability
4 m.Case Review: 56 Year Old Male – Classifying Carpal Instability Part 2
4 m.Case Review: 56 Year Old Male – Classifying Instability in the Short Axis
4 m.Case Review: 56 Year Old Male – Classifying Instability in the Sagittal Plane
4 m.Case Review: 56 Year Old Male – Classifying Instability – Dislocations
4 m.11 topics, 1 hr. 4 min.
Scapholunate Injury from FOOSH
4 m.Differentiating Between Type 1 & 2 Lunates
2 m.Necrosis of the Lunate
8 m.Non-Stener UCL Injury
6 m.Professional Athlete with Hyperextension Injury
9 m.High Grade Stener Lesion
7 m.Microtrabecular Fracture of the Scaphoid
9 m.High Grade Waist Fracture of the Scaphoid
7 m.Radial Pulley Injury
6 m.Degenerated TFC
8 m.Peripheral TFC Injury with Styloid Remodeling
5 m.0:01
In this section, we're going
0:02
to classify carpal instability.
0:04
Let's have a quick scroll.
0:06
You are all noticing extensive arthrosis,
0:09
especially in the radial styloid, but erosions
0:12
throughout the carpal bone, seen on the PD fat set.
0:16
Yes, there is a radial fracture.
0:19
There is deformity of the radial styloid.
0:22
And in the introductory section, I reminded you that
0:25
there are three arcs of Gallula, one arc along the
0:29
proximal aspect of the proximal carpal row, another arc
0:33
along the distal aspect of the proximal carpal row, and
0:36
finally the third arc around the capitate and hamate.
0:42
These three arcs will help you decide
0:45
what type of carpal instability you have.
0:49
For if there is dissociation in one row, in
0:52
other words the relationship of this bone to
0:54
this bone, or this bone to the bone next to it
0:56
is altered, we call that Dissociative Carpal
1:00
Instability or Carpal Instability Dissociative (CID).
1:05
We do have dissociation between the scaphoid
1:08
and the lunate, scapholunate dissociation
1:12
due to failure of the scapholunate ligament.
1:15
But there's oh so much more to be discussed.
1:19
What is non-dissociative carpal instability
1:23
or carpal instability non-dissociative (CIND)?
1:27
That is when you have a derangement between
1:30
the radius and the bones next to it, and we do.
1:33
We've got this deformed, overgrown styloid
1:36
with irregularity of the scaphoid fossa.
1:40
Or you have derangement between one
1:42
carpal row and the other carpal row.
1:45
We have that too.
1:46
We have the capitate pistoning
1:49
proximally into this opening space.
1:52
So the capitate is settling between
1:54
the scaphoid and the lunate.
1:57
So in the purest sense, we do have carpal
2:00
instability, non-dissociative, between two carpal
2:04
rows, but also between the radius and the scaphoid.
2:08
So what happens when you have both of them?
2:12
Both disruption of the same row
2:15
and disruption between rows.
2:18
The radiocarpal row or the intercarpal
2:20
rows from this row to the next row.
2:23
Then we will call that complex instability
2:27
or complex carpal instability (complex).
2:33
What is adaptive carpal instability?
2:37
That is when the origins of instability
2:41
are proximal or distal to the wrist.
2:44
So those are the four basic
2:45
types of carpal instability.
2:46
Let's do them one more time.
2:48
Carpal instability, dissociative (CID),
2:52
same row, either this row or that row.
2:55
Carpal instability, non-dissociative, between rows.
3:00
Carpal instability, complex, both of them are going
3:04
on at the same time, in the same row and between rows.
3:08
And finally, adaptive, where the
3:10
abnormality is not in the wrist, but it's
3:13
either distal or proximal to the wrist.
Interactive Transcript
0:01
In this section, we're going
0:02
to classify carpal instability.
0:04
Let's have a quick scroll.
0:06
You are all noticing extensive arthrosis,
0:09
especially in the radial styloid, but erosions
0:12
throughout the carpal bone, seen on the PD fat set.
0:16
Yes, there is a radial fracture.
0:19
There is deformity of the radial styloid.
0:22
And in the introductory section, I reminded you that
0:25
there are three arcs of Gallula, one arc along the
0:29
proximal aspect of the proximal carpal row, another arc
0:33
along the distal aspect of the proximal carpal row, and
0:36
finally the third arc around the capitate and hamate.
0:42
These three arcs will help you decide
0:45
what type of carpal instability you have.
0:49
For if there is dissociation in one row, in
0:52
other words the relationship of this bone to
0:54
this bone, or this bone to the bone next to it
0:56
is altered, we call that Dissociative Carpal
1:00
Instability or Carpal Instability Dissociative (CID).
1:05
We do have dissociation between the scaphoid
1:08
and the lunate, scapholunate dissociation
1:12
due to failure of the scapholunate ligament.
1:15
But there's oh so much more to be discussed.
1:19
What is non-dissociative carpal instability
1:23
or carpal instability non-dissociative (CIND)?
1:27
That is when you have a derangement between
1:30
the radius and the bones next to it, and we do.
1:33
We've got this deformed, overgrown styloid
1:36
with irregularity of the scaphoid fossa.
1:40
Or you have derangement between one
1:42
carpal row and the other carpal row.
1:45
We have that too.
1:46
We have the capitate pistoning
1:49
proximally into this opening space.
1:52
So the capitate is settling between
1:54
the scaphoid and the lunate.
1:57
So in the purest sense, we do have carpal
2:00
instability, non-dissociative, between two carpal
2:04
rows, but also between the radius and the scaphoid.
2:08
So what happens when you have both of them?
2:12
Both disruption of the same row
2:15
and disruption between rows.
2:18
The radiocarpal row or the intercarpal
2:20
rows from this row to the next row.
2:23
Then we will call that complex instability
2:27
or complex carpal instability (complex).
2:33
What is adaptive carpal instability?
2:37
That is when the origins of instability
2:41
are proximal or distal to the wrist.
2:44
So those are the four basic
2:45
types of carpal instability.
2:46
Let's do them one more time.
2:48
Carpal instability, dissociative (CID),
2:52
same row, either this row or that row.
2:55
Carpal instability, non-dissociative, between rows.
3:00
Carpal instability, complex, both of them are going
3:04
on at the same time, in the same row and between rows.
3:08
And finally, adaptive, where the
3:10
abnormality is not in the wrist, but it's
3:13
either distal or proximal to the wrist.
Report
Faculty
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
Tags
Trauma
Non-infectious Inflammatory
Musculoskeletal (MSK)
MRI
Hand & Wrist
Acquired/Developmental
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