Description
In this presentation, Dr. Sayed Ali, a radiologist at Temple University in Philadelphia, discusses upper extremity instability, focusing specifically on shoulder and carpal instability as related to sports injuries. He begins by detailing the types of shoulder dislocations, noting that 95-99% are anterior dislocations, typically resulting from falls on outstretched hands (FOOSH injuries). He also mentions the less common posterior dislocations and the extremely rare inferior dislocation. Dr. Ali explains the mechanics and imaging challenges in assessing these injuries, emphasizing the use of different imaging views like the Velpeau view to better visualize dislocations and associated osseous injuries such as Hill-Sachs deformities and bony Bankhart lesions.
He then moves onto carpal instability, again relating it to falls on outstretched hands. He introduces key measurements such as the scapholunate and capitolunate angles, explaining their importance in evaluating scapholunate ligament injuries. According to Dr. Ali, a rupture leads to increased angles and a phenomenon known as dorsal intercalated segmental instability (DISI). He goes on to describe various injuries in a spectrum from less severe perilunate dislocations to complete lunate dislocations, illustrating these conditions with radiographic evidence.
In closing, Dr. Ali answers questions regarding the role of MR arthrograms in managing shoulder instability, highlighting their importance in providing clarity on labral injuries when traditional imaging methods fall short. The session concludes with gratitude expressed from the organizer for Dr. Ali's insights into these complex injuries.