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MRI Shoulder: Coronal Oblique Imaging:

- Technique:
    - protocols: fat suppressed T2 wt images and proton density weighted images
    - older protocol: T1 & T2 coronal oblique spin-echo sequences with use of 14 cm field of view and a four-millimeter slice thickness;

- Discussion:
    - it is the most important view for identification of a lesion of rotator cuff, as supraspinatus and infraspinatus are seen in continuity w/ their insertion on greater tuberosity;
          - axis is parallel to supraspinatus muscle and tendon;
          - infraspinatus is seen on posterior images and is more obliquely oriented;
          - it shows relationship between supraspinatus & acromion (& AC joint);
          - sagittal oblique plane, allows optimum visualization of supraspinatus outlet and of the shape of the acromion;
    - coracoclavicular, coracohumeral, & CA ligaments can sometimes be seen;


- Anterior Coronal Oblique Images:
      - supraspinatus tendon may curves anteriorly, which may cause averaging of images w/ rotator interval which may cause an increased signal and false impression of rotator cuff tear

- Case Example: (55-year-old female with large rotator cuff tear which lead to anterior instability) 

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