– Position: – place patient in a beach chair position w/ torso flexed 45 deg and the knees flexed to 30 deg; – move patient to the edge of the table (operative side), and use a McConnel positioner to prevent the patient from failing off the table; – patient must lie … Read more
Problem: 1) The busy surgeon is faced with a mounting amount of documentation challenges which interferes with already hardpressed time constraints. (Any surgeon that disputes the increasing amount of documentation is probably not aware of current CMS guidelines). Most surgeons are probably not aware of what CMS requires and does not require (and has not felt … Read more
– Discussion: – used to show ulnar variance; – technique: – shoulder is abducted 90 deg, the elbow flexed 90 deg, and forearm is held in neutral rotation; – AP View: – patient places the forearm flat on … Read more
– Discussion: – used to better visualized the acromio-clavicular joint by eliminating overlying structures; – Technique: – AP view w/ beam is directed at the a-c joint with 10 deg cephalic tilt; – use 1/3 to 1/2 the voltage used for the AP shoulder view (soft tissue technique)
– See: – Shoulder Arthrography – MRI – Impingement Radiographic Series: – axillary view: may reveal an Os Acromiale, which is associated w/ impingment; – scapular outlet view – allows assessment of acromial morphology; – examination of cadavera reveal: … Read more
– Indications: – painful or unstable wrist joint w/ advanced destruction due to OA, RA, post traumatic arthritis, SLAC wrist, spastic flexion contracture, degenerative scaphoid non-union, unsuccessful wrist arthroplasty, and Keinbock’s dz; – this procedure is more beneficial for young, active pts or middle aged pts, but not for elderly pts; – PreOp Considerations: – in … Read more
– Discussion: – arthrography may be used in diagnosis of carpal instability because it is technically easy & is only minimally invasive; – normally there should be no communication between the radiocarpal, mid-carpal, and distal radial-ulnar joints; – it is noteworthy that in normal wrists there may be communications … Read more
– Discussion: – consequences of anterior instability include Bankart lesion, Hill Sachs lesion, erosion of the anterior glenoid, loose body formation, and stretching of the joint capsule; – features: – degree of trauma involved – distinguish between traumatic dislocations and recurrent … Read more
– See: brachial plexus – Discussion: – hx: persistant pain > 6 months: (poor prognosis); – diff dx: – breast cancer (lower plexus and painful) – radiation therapy (upper plexus and painless) – … Read more
– Discussion: – useful in identifying anterior glenoid abnormalities (Bankart Lesion) in pts w/ hx indicating traumatic instability of the shoulder; – Technique: – pt is placed prone on x-ray table w/ involved shoulder on a pad raised 7.5 cm from the top of the table; – head & … Read more