1. Radiology Anatomy of the Spine and Upper Extremity
Timothy J. Mosher, MD
Department of Radiology
Phone:

2. Learning Objective
Identify anatomic structures of the spine and upper extremities on standard radiographic and cross-sectional images

3. SPINE

4. Visual Human Sagittal View
7 Cervical Vertebra
12 Thoracic Vertebra
5 Lumbar Vertebra
5 Sacral Vertebra (fused)
3 Coccygeal Vertebra (fused)

5. Lumbar Vertebral Body NETTER 143 SPINE BODY PEDICLE TRANSVERSE PROCESS
SPINOUS PROCESS
LAMINA

6. Lumbar Vertebral Body 27 year old fall from roof BODY PEDICLE
TRANSVERSE
PROCESS (fractured)
27 year old fall from roof
SPINOUS PROCESS
LAMINA

7. SPINE FROM THE FRONT
BODY
NETTER 143 SPINE
TRANSVERSE
PROCESS

8. SPECIMEN RADIOGRAPH L4 SPEC X RAY SPINE BODY PEDICLES SPINOUS PROCESS
TRANSVERSE PROCESSES

9. SPINE FROM THE BACK NETTER 143 SPINE TRANSVERSE PROCESS LAMINA
SUP ART
FACET
TRANSVERSE
PROCESS
LAMINA
NETTER 143 SPINE
INF ART
FACET
SPINOUS PROCESS

10. SPECIMEN RADIOGRAPH L4
SPEC X RAY SPINE
Lamina and Facets

11. AP Lumbar Spine
DRAWING AP LS

12. AP Lumbar Spine
MS 185 NL AP LS

13. AP Lumbar Spine MS 185 NL CONE AP LS BODY PEDICLE LAMINA SPINOUS
TRANSVERSE
PROCESS
SPINOUS
PROCESS

14. Spine Viewed from Side NETTER 143 SPINE BODY PEDICLE TRANSVERSE
PROCESS
NETTER 143 SPINE
LAMINA
SPINOUS PROCESS

15. Spine Viewed from Side NETTER 143 SPINE PARS INTRAARTICULARIS
SUPERIOR FACET
NETTER 143 SPINE
INFERIOR FACET

16. Lateral Lumbar Spine
DRAWING LAT LS

17. Lateral Lumbar Spine
BODY
PEDICLE
SPINOUS PROCESS
MS 185 LAT LS

18. Lateral Lumbar Spine
SUPERIOR FACET
PARS
INFERIOR FACET
MS 185 LAT LS

19. CT Lumbar Spine Sagittal Reconstructions

20. Facet Joints Axial View
Inferior Facets
Superior Facets
Cervical
Thoracic
Lumbar

21. Facet Joints Sagittal Reconstructions
Cervical
Thoracic
Lumbar

22. Intervertebral Disc Space
NEURAL
FORAMEN
NETTER 144 SPINE ART
INTERVERTEBRAL DISC

23. Nerve Roots LAT ARTIC LUMB BODY DISC PEDICLE SPINOUS PROCESS
INF FACET
SUP FACET
LAT ARTIC LUMB
BODY
DISC
PEDICLE
SPINOUS
PROCESS
NERVE ROOT

24. Sagittal Section Lumbar Spine
Intervertebral Disc
Body
Nucleus Pulposa
Annulus Fibrosa
Body
Sagittal Section Lumbar Spine

25. MRI: Intervertebral Disc
Spinal Cord
(Cauda Equina)
Intervertebral Disc
Nucleus Pulposa
Annulus Fibrosa

26. Cauda Equina
MRI Myelogram

27. Neural Foramen Pedicle (L3) Pedicle (L4) L3 Nerve Root
L3/L4 Intervertebral Disc
Pedicle (L4)

28. Neural Foramina Cervical Spine
Vertebral Body
Nerve Roots
Cervical Spinal Cord
Facet Joint
Viewed from bottom

29. Spinal Ligaments

30. Spinal Ligament Anterior Longitudinal Spinal Ligament
Posterior Longitudinal Spinal Ligament

31. Case Study: 17 year-old Male involved in a MVA
Do you see a fracture?
Fracture of C7 vertebral body

32. Case Study: 17 year-old Male involved in a MVA
Right
Left
What other structures are likely to be injured?
Bilateral Facet Dislocation at C6/7

33. Case Study: 17 year-old Male involved in a MVA
Spinal Cord Injury
Anterior Longitudinal Spinal Ligament
Posterior Longitudinal Spinal Ligament

34. Upper Extremity

35. Radiographic Anatomy
X-RAY BEAM
DRAWING SHOULDER
FILM

36. LEFT SHOULDER (FRONT) NETTER 392 FRONT SHOULD CLAVICLE ACROMION
CORACOID
GLENOID
SCAPULA
HUMERUS
NETTER 392 FRONT SHOULD

37. SHOULDER (BACK) NETTER 393 BACK SHOULD CLAVICLE ACROMION SPINE GLENOID
HUMERUS
SCAPULA
NETTER 393 BACK SHOULD

38. AP Shoulder Clavicle Acromion Coracoid Glenoid Greater Tuberosity
Humerus

39. LEFT SHOULDER AXILLARY VIEW
FILM
X-RAY
TUBE
DRAWING AXILLARY

40. RIGHT SCAPULA FROM BELOW
CORACOID
GLENOID
SPINE
SCAPULA FROM BELOW
BODY
ACROMION

41. LEFT SHOULDER (AXILLARY)
Coracoid
Anterior
Lesser Tuberosity
Clavicle
Humerus
Acromion
Glenoid
MS 29 AX SHLD

42. Case Study: 52 year old male with shoulder pain
Do you identify the cause of the shoulder pain?

43. MRI Anatomy of the Shoulder

44. MUSCLES FROM THE FRONT NETTER 396 MUG SHOULD SUPRASPINATUS
SUBSCAPULARIS
NETTER 396 MUG SHOULD

45. Rotator Cuff Muscles Sagittal View
Supraspinatus
Infraspinatus
Subscapularis
Teres Minor
Anterior

46. Rotator Cuff: Subscapularis
Sagittal View
Coronal View

47. Rotator Cuff: Supraspinatus
Sagittal View
Coronal View

48. MUSCLES FROM THE BACK NETTER 396 MUSC POST SHOULD SUPRASPINATUS
INFRASPINATUS
NETTER 396 MUSC POST SHOULD
TERES MINOR

49. Rotator Cuff: Infraspinatus
Sagittal View
Coronal View

50. Rotator Cuff: Teres Minor
Sagittal View
Coronal View

51. Anatomy Considerations in Rotator Cuff Tears

52. Impingement of the Rotator Cuff
Coracoacromial Arch
Acromion
AC Joint
Coracoacromial liagment
Coracoid Process
Supraspinatus
Subscapularis
Anterior View

53. MRI Anatomy of the Rotator Cuff

54. MRI Anatomy of the Rotator Cuff

55. Rotator Cuff Tear
Contrast leaking into subacromial bursa through tear in supraspinatus
Contrast injected into glenohumeral joint

56. ROTATOR CUFF TEAR
10/30/03
1/30/04

57. The Elbow

58. LEFT ELBOW FROM FRONT NETTER 407 FRONT ELBOW Humerus Medial Epicondyle
Lateral Epicondyle
Capitulum
Trochlea
NETTER 407 FRONT ELBOW
Ulna
Radial Head
Medial
Lateral

59. Elbow from the Back Humerus Medial Epicondyle Lateral Epicondyle
Olecranon fossa
Olecranon
Ulna
Radial Head

60. AP ELBOW NETTER 407 FRONT ELBOW Humerus Medial Epicondyle
Lateral Epicondyle
Capitulum
Trochlea
NETTER 407 FRONT ELBOW
Ulna
Radial Head
Medial
Lateral

61. Medial View of Elbow Humerus Coronoid Radial Head Medial Epicondyle
Olecranon
Ulna

62. Medial View of Elbow Humerus Coronoid Radial Head Medial Epicondyle
Olecranon
Ulna

63. The Wrist

64. The Wrist Palmar View Carpal Bones (Proximal Row)
Lunate
Triquetrum
Scaphoid
Pisiform
Radius
Ulna

65. The Wrist Palmar View Carpal Bones (Proximal Row)
Lunate
Scaphoid
Triquetrum
Pisiform
Radius
Ulna

66. The Wrist Palmar View Carpal Bones (Distal Row)
Trapezoid
Trapezium
Hamate
Capitate
Radius
Ulna

67. The Wrist Palmar View Carpal Bones (Distal Row)
Trapezoid
Trapezium
Capitate
Hamate
Radius
Ulna

68. MR Anatomy of the Wrist
Capitate
Lunate
Radius
Coronal Wrist