Dr. OMID BANDARCHI
@OBandarchi
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●M.D. RADIOLOGIST ●PERSONALIZED FITNESS,WELLNESS & LIFESTYLE MEDICINE ●MEMBER 𝓸𝓯 IDRA ●CEO at UIPHCG
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Look at your own leg and picture its anatomy 👌 It's amazing👍
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Very smart way of doing the neuroexam of the hand in just a few seconds👍
Easy & helpful👏👏👏
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I love this infographic ♥️ In one page mentioned the relative incidence of fracture in each carpal bone and explained briefly for each entity. It's really useful 👌
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NORMAL SHOULDER MEASUREMENTS on AP view:
●GHJ space <6 mm.
●ACJ should be no greater than 7 mm.
●Coracoclavicular distance no greater than 13 mm
●AHD (Acromiohumeral distance) <7 mm is highly suggestive of a large rotator cuff tear.
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These 4 conditions may be confusing.
♦️SPONDYLOSIS(vertebral arthritis)= degenerative OA of the spine.
♦️SPONDYLOLYSIS(pars interarticularis Defect)= Stress Fx.
♦️Spondylolisthesis: explained in detail.
♦️Spondylitis=inflamed spine :
Pott's Disease, Ankylosing Spondylitis
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If you remember, once in a while we review the anatomy of the specific parts of the body! Today we are going to briefly review the anatomy & injuries (a few injuries) of the shoulder 👍
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🛑Absolutely wonderful illustrations of the KNEE ANATOMY as well as COMMON INJURIES OF THE KNEE👏👏👍 It’s really good when quick review of knee is needed.
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Nice infographic addressing the low back pain, its common causes, treatment options, some good lifting tips,...etc👏👏👏👏👏
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3 important shoulder spaces that bordered by triceps :
💥Quadrangular space contains :
• Axillary nerve
• Posterior humeral circumflex artery
💥Triangular space
contains scapular circumflex artery
💥Triangular interval contains
•Profunda brachii artery
•Radial nerve
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🔴PLANTAR FASCIITIS occurs due to degenerative irritation at origin of plantar fascia.
It's more seen in people with :
-Foot arch problems (both flat feet & high arches)
-Run long distances
-Obese
-Having a tight Achilles tendon
-Wearing shoes with poor arch support or soft soles
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🛑I really love this infographic, partly because of my chronic shoulder pain. In this poster you will see:
The Shoulder Joint Anatomy & Common Shoulder Injuries as well as Shoulder Exercises For Strengthening The Soulder 👏👏👍🌟
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🔴Mechanisms of ANKLE SPRAIN :
Inversion
Eversion
High ankle sprain.
👉Inversion(supination) injuries are most common often involve external rotation of foot relative to tibia,in addition to inversion of foot itself.
🔴Ankle sprain based on location:
Lateral
Medial
Syndesmotic
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The most important determinators in analysis of a potential BONE TUMOR are :Morphology of bone lesion on plain radiograph & age of patients. It's important to realize that plain radiograph is extremely useful for differentiating these lesions.CT & MR are helpful in selected cases
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MRI SEQUENCES!
MRI sequences & series refered to different parameters & techniques used to acquire images of the area of concern in body. Four basic MR sequences:T1W,T2W, FLAIR , DWI.
A nice poster by Dr Robert Mariasi shows what pathologies can be assessed best in each sequence
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The review of shoulder anatomy addressed in one of my recent tweet. Now,we are going to review the Knee anatomy and its injuries (a few injuries) 👍
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🛑An absolutely wonderful,beautiful meanwhile easy demonstration of the correct examination of the "Sensory AND Motor" innervetion of the hand. Here showing you sensory and in the comment of this tweet motor innervation...
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🛑This beyond excellence infographic,mentions HIP & KNEE injuries,as well as beautifully showing some useful and correct exercises for strengthening the HIP & KNEE 👏👏👍
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MUSCLE CRAMPS:
an involuntary,painful,sustained contraction of muscle fibers,happening mostly in CALF & could be primary(idiopathic) or secondary (dehydration,metabolic,.).
💥HOWEVER, based on New research :
source of cramps is HYPERACTIVITY of MOTOR NEURONS, RATHER THAN MUSCLES
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✔️Peroneal longus & brevis are the only muscles in lat compartment of leg & both innervated by superficial peroneal n.
🛑Their common functions:
1.Eversion.
2. In walking:mediolateral stability.
✔️P.longus also supports lat&transverse arches of the foot
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🛑The artful poster of "ANATOMY & INJURIES OF THE SHOULDER"👏👏👏👌
I always admire the medical illustrators. They're professional artist with advanced education in both the life sciences & visual communication and capable of transforming complex information into visual images.
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Hyperlordosis= saddleback=swayback
is an excessive vertebral curvature (lordosis) & a common contributor to chronic nonspecific LBP. Common causes: pregnancy,tight low back muscles،obesity..
Analysis of chronic LBP therapies shown stronger evidence of effectiveness of exercise...
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This infographic is really excellent👍
You can review"SPINAL CORD INJURIES"
amazingly fast but Not furious 😅
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Surface anatomy of the foot : Lateral and superolateral views👍
From: UpToDate
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A beautiful clip about "Bulging disc" ! 👍
Credit: Dr Wealz
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Lumbar spine = lower back
"LOW BACK PAIN" is classified as ACUTE (a few days to a few weeks) & CHRONIC (lasts for more than 3 months & often gets worse).
Common causes of low back pain & schematic demarcation of dermatoms demonstrated 👍
Poster from:
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A very useful chart as a guide to possible reason of your knee pain👍
Paying attention to the precise location of pain in the knee, can help you narrow down its causes.
From:
Illustration by Jason Hoffman
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Extensor tendons of hand injuries are very common injuries, which inappropriately treated can cause severe lasting impairment for the patient. In the literature regarding flexor tendon injuries has been widely reviewed, unlike extensor injuries.
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In shoulder x-ray don't forget:
✔️Acromioclavicular joint injury.
If AC distance >8mm [some references say >7mm(males), >6mm(females):
ABNORMAL👉acromioclavicular injury.
✔️To assess coracoclavicular ligament, CC distance is important (11-13mm),No more than 5 mm difference R& L
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✴️Updated relative incidence of carpal bone fractures illustrated. Besides SCAPHOID, the TRIQUETRUM is most affected,but rarely causes complication.
✴️TRAPEZOID is the least commonly Fx, because its anatomical shape & position make it trapezoid highly stable & difficult to Fx.
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Absolutely wonderful article by NEJM about Sciatica & conditions simulating sciatica👌Don't forget to see 2 comments of this tweet. Sciatica is pain that radiates from the buttock downward along the course of the sciatic nerve
The largest nerve in our body
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✔️Nice illustrations as well as wonderful schematic flowcharts of the lower limb vein👌
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Patellofemoral pain syndrome(PFPS)=runner's knee is anterior knee pain involving patella & retinaculum that exclude other intraarticular & peri-patellar pathology. Chondromalacia is softening of patellar articular cartilage, occurs in only a subset of these patients...
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Surface anatomy of the
●Anterior & Medial thigh,
●Hip region & Lateral thigh,
●Posterolateral views
beautifully shown 👍
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🛑This beautiful illustration, showing the major branches of the ulnar nerve at the wrist.
Source :
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Absolutely wonderful demonstration of RADICULOPATHIES by RoshReview👍
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🛑Look at your own Antecubital foss & Antebrachium! Enjoy its anatomy👌
Cubital Fossa is a triangular-shaped depression between forearm& arm on anterior surface of elbow, with apex of triangle pointing distally. It's also known as antecubital because lies anteriorly to the elbow
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🛑SIMPLE MEANWHILE BEAUTIFUL ILLUSTRATION OF THE LIGAMENTS & TENDONS OF THE KNEE👌👏👏
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After review of anatomy of the shoulder and the knee, it's time for the review of the Hip & Pelvis Anatomy & its a few injuries👍
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🔴2 TIPS:
1.Posterior malleola?
Ends of tibia & fibula called malleoli. Tibia has a med & a post malleoli. Fibula forms lat malleoli.
2.Mortis?Two meaning:
Aside from bein one of the ankle radiographic views, it's a rectangular socket known as ankle mortise shown in image⬇️
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Dupuytren contracture is a condition that causes one or more fingers to bend toward the palm of the hand. The affected fingers can't straighten completely. It's due to thickening, shortening & fibrosis of palmar fascia.Usually affects 4th & 5th fingers.
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The axillary & radial innervate muscles of the posterior shoulder & upper arm, respectively, and give off cutaneous branches as well. The radial nerve continues deep to intermuscular septum (between medial head of the triceps & brachialis) to innervate posterior forearm and hand.
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🛑A wonderful illustration👌
In a tweet a week ago,we learned that on medial side of ankle,there're 2 joints&their lig(s):
1.Intertarsal j👉Talonavicular&Spring lig(s). 2.Ankle j👉Deltoid lig,has a superficial & deep layer & overall consists of 4-5 Lig(s)
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🛑Incredible poster,illustrated normal shoulder anatomy as well as some common shoulder pathologies. This is really great for quick review👌👏👏👏👏
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Wonderful infographic addressing many aspects of the CARPAL TUNNEL SYNDROME (CTS) including causes, prevention, diagnosis, beneficial exercises,..etc. Furthermore beautifully demonstrated the bad positions which can cause this syndrome! In my opinion it's a unique infographic 👌
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Cubital tunnel syndrome is the 2nd most common peripheral nerve entrapment syndrome.There're 5 locations where ulnar n may be compressed around the elbow:
Arcade of Struthers.
Medial intermuscular septum.
Medial epicondyle.
Cubital tunnel(the most common).
Deep flexor aponeurosis
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Ankle sprain classifications👍 Grading,physical exam findings,pathophysiology & treatment. All simplified in one figure👌 RoshReview
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🛑Absolutely wonderful infographic showing differential diagnosis of the wrist pain 👌
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●Tendonitis
vs
●Tendinosis
vs
●Tendinopathy
vs
●Enthesopathy
Tendinitis: acute inflammation due to acute damage or overuse.
Tendinosis: chronic damage due to overuse,abnormal anatomy,or degenerative.
There is significant overlap.
Tendinopathy: encompasses both.
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✴️ERECTION✴️ & ITS DISTURBANCES!
The chief source of innervation in erection is PARA-SYMPATHETIC nervous system, which transmits impulses to corpus cavernosum via pelvic splanchnic nerves.
A complete lesion at level of the S2–S4 segments results in loss of reflex erection,..
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SCIATIC NERVE:
Branches:
-Muscular branches
-Tibial n
-Common fibular n
Motor:
Muscles of posterior thigh,ischial portion of adductor magnus, muscles of posterior, anterior,lateral compartments of leg, foot muscles.
Sensory:
Lateral & posterior leg, Dorsum & sole of the foot
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Absolutely wonderful 👍ACL & PCL in flexion extension-elongation & tension process. Anatomy- VR surgical
Credit:
Anastasios Papadonicolakis (Associated professor of orthopaedic surgery).
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For 23 years, a woman from Taiwan had been suffering from severe constipation.The woman decided to go get herself checked
Abdominal x-ray : In social media went viral as displaced colon & the last segment of her colon as devoid of wrinkles. Is that so?
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🛑Wonderful poster showing how to strengthen the WRIST & FOREARM 👌
🛑Hint: Forearm muscles act on elbow & wrist joints as well as on CMC,MCP & IP joints.Thus,forearm muscles are essential to fine motor actions of upper limb,allowing for complex movements of arm,wrist & fingers
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Femoral head receives its primary blood supply from sup,ant & inf retinacular arteries arising from deep branch of medial circumflex femoral artery,also round ligament arteries
An AP X-ray is sufficient for dx of Proximal femoral fx(PFF). See 2comments
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A wonderful figure with 4 illustrations showing right GHJ ligaments in anterior view & in side view shows articular surfaces of GHJ & longitudinal diameter compare with transverse diameter.
Furthermore in other 2 illustrations, GHJ capsule as well as shoulder muscles depicted👍
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A few knee radiographs presented to you for review and improvement of your visual learning which is very important in radiology training.
All images from "radiologyexpert" ,except the one in top left which is from "radiologymasterclass".
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1)PATELLOFEMORAL PAIN: age<40y; physically active; Ant knee pain during a squat:~91% sensitive & 50% spe.
2)KNEE OA: > 45 y ;activityrelated pain<30 min of morning stiffness,~95% se; 69% sp.
3)MENISCAL TEAR:McMurray test &extension;
Joint line tenderness
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🔴CERVICAL SPINE LIGAMENTS🔴:
ALL,
PLL,
Apical lig,
Alar lig(s)(paired),
Cruciate lig of atlas,
Ant &Post Atlanto-occipital membranes,
Tectorial membrane,
Ligamentum flavum,
Ligamentum nuchae,
Interspinous, Intertransverse & Supraspinous ligaments.
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🛑Amazing SKELETAL muscles👌Here you see muscles in anterior & in the comment of this tweet ,another poster showing posterior aspect. 3 types of muscle: SKELETAL,SMOOTH &CARDIAC.
SKELETAL M. attached to bone via tendon &involved in movement.They're Voluntary unlike 2 other types
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ULNAR NEUROPATHY made simple:
Perfect👍From emedicine.medscape:
The most common site of ulnar nerve entrapment is at or near elbow region,esp,in the region of cubital tunnel or ... The second most likely site is at or near the wrist, esp, Guyon’s canal.
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✴️TENNIS ELBOW (LAT. EPICONDYLITIS)
✔️a form of tendonitis(=tendinitis).
✔️an overuse injury.
Tendinitis: acute injury due to inflammation.
Tendinosis: result of degeneration over time.
✴️5 Types of Tennis elbow can be palpated by specific palpation techniques.
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Piriformis syndrome
a nondiscogenic cause of sciatica from compression of sciatic nerve through or around piriformis muscle.
Its cardinal features: 1)weakness in any or all of the knee flexors,ankle flexors or extensors & foot intrinsics;2)sensory loss may involve all of the foot
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FEMORAL Triangle vs Sheath vs Canal vs Ring:
Contents of FEMORAL TRIANGLE (except femoral n),enclosed in a fascia called FEMORAL SHEATH.
Each structure in femoral sheath enclosed in its own compartment &the most medial is FEMORAL CANAL.
Proximal opening of canal: FEMORAL RING
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🟥Collections of Lat cervical spine radiographs,both normal & pathologic.
You'll see McGregor, Wackenheim & Chamberlain Lines which are helpful to identify presence of basilar invagination.
I almost forgot to say "Double cortical lines" results from obliquity in lateral film.
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Fantastic infographic for quick review of arteries,veins and nerves of the hand 👌👍
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Some normal & abnormal hip radiographs shown. Assess the joint space of pubis symphysis which differs depends on age:
~10 mm at 3 years
~6 mm at 20 years
~3 mm at 50 years
During pregnancy, joint space increase by up to 3mm as a result of hormones such as relaxin to help delivery
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ANATOMY & INJURIES OF SHOULDER👍
A beautiful poster👍In one of my older tweets,I've posted the same subject,but a different poster. As always I admire the medical illustrators👏
They're professional artist who capable of transforming complex medical information into visual images
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♦️ACL prevents tibia from sliding forward along the femur, while PCL prevents the tibia & femur from sliding towards each other.
♦️Lachman test is the most sensitive & specific Ph.ex test to Dx acute ACL injuries.
♦️MRI is the imaging modality of choice.
More in the image⬇️⬇️
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CONGENITAL Pes planus=flat foot is common in infants.
ACQUIRED pes planus is most commonly occurs secondary to posterior tibial tendon dysfunction which mostly seen in ladies over the age of 40 with comorbidities, including diabetes & obesity.
Pes planus types: FLEXIBLE vs RIGID
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Quick study:
Dorsal vs Plantar (Arteries, Veins , Nerves)
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🔴 Radial nerve is the terminal continuation of the posterior cord of the brachial plexus. It therefore contains fibres from nerve roots C5 – T1.
See the comment of this tweet.
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🛑Magnificent infographic👍It's worthy of noticing that in skeletal muscles the "ORIGIN" referred to the ■fixed■ muscle attachment site located proximally while the "INSERTION" is the ■movable■muscle attachment site located distally.
♦️I'll tweet,the POSTERIOR view in a week.
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Knee osteoarthritis (OA), also known as degenerative joint disease of the knee, is typically the result of wear & tear and progressive loss of articular cartilage.
✴️Radiographic Findings of OA:
Joint space narrowing
Osteophyte formation
Subchondral sclerosis
Subchondral cysts
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Above: Carpal & Guyon canal
Below: Anatomy of the carpal canal
Median nerve gives off palmar cutaneous branch before entering the canal(short arrow).Median n. then travels through the canal& gives off motor branch
(long arrow) indicates ulnar nerve as it enters the Guyon canal
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✴️The sacroiliac joint (SIJ) is increasingly recognized as a cause of pain in patients with LOW BACK PAIN as well as in PELVIC GIRDLE PAIN .
✔️There're some simple diagnostic physical exam tests such as One-Finger test, which can identify the SIJ dysfunction as a cause of LBP
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🔴Ankle joint complex made up of 3 j(s): ●talocalcaneal (subtalar),
●tibiotalar (talocrural),
●transversetarsal (talocalcaneonavicular).
-Ankle lig(s) are one of its main stabilizers.
-An intricate relationship exists among 3 j(s) & can't be sparated.
-Biomechanics : soon..
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Femoral N vs Obturator N.
Femoral nerve arises from posterior cords of lumbar plexus (L2-L4) & provides motor innervation to anterior thigh muscles.
This is in contrast to obturator nerve, which arises from anterior cords (L2-L4) & supplies the medial compartment of thigh.
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🛑Did you know that sitting is the new smoking?
✔️Sitting for too long increases your risk of chronic health problems,such as CVD, diabetes,some cancers,...etc.
✔️It's also bad for your mental health.
✔️Being active is not as hard as you think.
🛑DON'T JUST SIT ,DO SOMETHING!🙂
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🛑When evaluating knee pain, key aspects of patient history include age; location, onset, duration, and quality of pain; mechanical or systemic symptoms; history of trauma,..
🛑For location assessment read the whole explanation below the figure. It's brief meanwhile accurate 👍
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🛑Causes as well as approximate locations of pain in the FRONT as well as BOTTOM of the foot,beautifully demonstrated in these two images👍
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long head of the biceps tendon is intra-articular but extrasynovial, and widely recognized as an important pain generator, especially in anterior shoulder pain. The biceps-labral complex has been identified and broken down into different regions...
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Location of foot and ankle pain! Beautiful figure from UpToDate👍 👏
(A) Posteromedial ankle and heel pain.
(B) Posterior ankle and heel pain.
(C) Anterolateral ankle, midfoot, and forefoot pain.
(D) Plantar foot pain.
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🔴FEMORAL NECK FRACTURE🔴
●Common Fx
●Femoral neck blood supply is retrograde
●Neck of femur has 2distinct areas: ♦️Intra-capsular:
Subcapital,Midcervical,Basicervical.Some considered basicervical as extra-capsular ♦️Extra-capsular:
-Inter-trochanteric
-Sub-tronchanteric
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Beautiful illustrations of muscles of the hip and gluteal region in 2 parts👍 See the part 2 in the comment of this tweet.
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Signs of Osteoarthritis of the Hip illustrated👍
Periosteal thickening at femoral neck ➡️Wibergʼs sign.
If femoral head migrates intoacetabulum with increasing depth of joint socket ➡️ protrusio acetabuli
Migration of femoral head in lateral direction ➡️: decentralizing OA
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🔴A basic radiographic examination of injured ankle consists of an AP-view, a Mortise-view ,a lateral and oblique projections.
Mortise-view is an AP-view taken with leg internally rotated 15-20o
👉♦️Lateral projection view is very important. Detailed explanation in the image.
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The term CELLULITIS commonly indicate a nonnecrotizing inflammation of skin & subcutaneous tissues, usually from acute infection. It follows a breach in skin, although a portal of entry may not be obvious.The 4 cardinal signs of infection: Erythema
Pain
Swelling
Warmth
By Medium
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Plantar fasciitis in contrast to the old& popular beliefs&despite"itis",
it's not due to inflammation,instead,it's the result of degenerative irritation of the plantar fascia origin at the medial calcaneal tuberosity of the heel as well as the surrounding perifascial structures.
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🛑MUSCLES OF THE THUMB 👌shown in image.I'd to mention 2 points:
✔️ABDUCTOR POLLICIS LONGUS
passes in 1st dorsal compartment of wrist.
de Quervain's teno.. is common in this compartment.
✔️ADDUCTOR POLLICIS
Its primary role :providing power for pinching
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✴️Absolutely wonderful👍The surface anatomy and structures of the foot in the medial view as well as the lateral & superolateral view beautifully shown & labeled .
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Extensor tendons of the hand from "PicturingMedicine"👍At the base of the finger, the long tendon from forearm muscles joined by short tendons from small muscles in the hand to form a complicated sheet of tendon fibres over the back of finger and has a central & 2 lateral bands
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🛑Sciatic nerve(SN) arises from lumbosacral plexus in pelvis.Ventral rami of L4 to S3 nerve roots unite to form sciatic nerve.
👉In this way, the sciatic nerve PLUS S4 is the lumbosacral plexus.
👉In the comment:Anatomical variations of SN course in relation to piriformis muscle
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🛑KNOWING THE SURFACE ANATOMY has always been important 👍 While examining the lateral knee , the structures mentioned in the figure should be palpated.
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🔴Are you ready to strengthen your FOOT & ANKLE? 🙂 Here is an amazing infographic about FOOT & ANKLE ANATOMY, ITS COMMON INJURIES as well as FOOT & ANKLE EXERCISES for strengthening. It's an absolutely wonderful infographic 👌👏👏👏
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Arterial blood flow beautifully demonstrated with a chart👍
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Quick review of some common pathologies of the knee👍Excellent especially for visual learners👌
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