Shoulder Pathology- Bankart Lesion

A Bankart Lesion is a shoulder injury occurring in the part of the shoulder called the labrum. The labrum is a cuff of cartilage that forms a cup for the end of the humerus at the shoulder joint. This cartilage makes the shoulder joint much more stable within the shallow socket, yet enables a wide range of movement for the shoulder. When the labrum of the shoulder joint is torn, the stability and movement of the joint is affected. A Bankart Lesion usually happens when the shoulder pops out of joint (dislocation) because this often tears the labrum. The part of the labrum that is torn is called the inferior glenohumeral ligament. When this ligament is torn, the patient is subject to frequent dislocations. This is a common injury among athletes. The patient will complain of a sense of instability of shoulder joint, repeat dislocations, catching sensations and aching of the shoulder. Diagnostic xrays will sometimes appear normal, so an MRI following an injection of contrast into the joint is helpful in seeing the torn ligament. Treatment ranges from allowing time for rest and healing of ligament (at least six months) , followed by physical therapy, or surgery to repair the torn labrum. Patients who don't have surgery are prone to more dislocations later down the line. Surgery is ninety percent effective that patients will resume normal activities without further dislocations. This is because during surgery the doctor will reattach the torn labrum to the socket of the shoulder joint. This is usually done arthroscopic ally, but sometimes is done with a standard incision depending on the patient's condition.

MRI Image below and paragraph below is from: www.drloweshoulder.com/en/cms

Anterior Instability is diagnosed with a thorough medical history and evaluation. Diagnostic tests such as X-ray and or MRI can and usually are utilized as well. X-rays will be taken to look for any fractures or bony abnormalities. The most effective way to evaluate the soft tissues of the shoulder is with an MRI. It is important to note that a contrast medium should be injected into the joint to ensure that any soft tissues can be seen. In the MRI picture, you see the shoulder if you were looking at it from a bird’s eye view. The red circle shows where the labrum has “come off” the glenoid. The white that you see between the bone and the glenoid is that of the contrast medium. Dependant upon how many cuts (the individual pictures of those views on the MRI) that the labral tear is seen in, shows Dr. Lowe how much of the labrum is involved and how to best deal with the injury. www.drloweshoulder.com/en/cms / ?251

Uterine Fibroids

Fibroid tumors are growths that grow in the muscular wall of the uterus. Fibroids are noncancerous (benign) growths. These tumors range in size, but can grow as big as the size of a cantaloupe. There have been cases of where the fibroids can grow inside the uterus to equal the size of a pregnancy growth of 20 weeks. There are three types of fibroids: Intramural, Subserosal, and Submucosal. The difference in the three are basically the location and depth of the fibroid tumor in the uterus. The most common are the intramural which develop within the uterine wall and expand making the uterus feel larger than normal. This can result in heavier menstral flow and pelvic pain. Uterine fibroids are very common and increase with age until menopause. Twenty to forty percent of women at the age of 35 and older have uterine fibroids significant in size. Growth of fibroids are determined by estrogen levels. Therefore, pregnant women that have fibroids will enlarge during pregnancy. After menopause when estrogen levels are lower, fibroids seem to decrease in size. Typical symptoms include heavy, prolonged and heavy menstrual periods, pelvic pain, back and leg pain, pain during sexual intercourse, abnormally enlarged abdomen, bladder pressure leading t constant urge to urinate, and bowel pressure causing constipation and bloating. Ultrasound , MR and CT are imaging procedures used to diagnose fibroids as well as detect size and location of the fibroids.

Sagittal T2-weighted MRI shows a large heterogeneous fundal uterine fibroid.
Media type: MRI

Polycystic Kidney Disease (PKD)

Polycystic kidney disease (PKD) is a genetic disorder that causes numerous cysts to form in the kidneys over time. The cysts that form are filled with fluid. These cysts will enlarge the kidneys and interfere with the kidneys abilities to filter wastes and extra fluid. There are two forms of PKD . Autosomal dominant PKD, which is the most common inherited form. Symptoms occur between the age of 30-40. Ninety percent of PKD patients are this type. Autosomal recessive PKD is a rare inherited form. This type of PKD begin in early months of life or even in the womb. In a fully developed PKD patient, the enlarged cystic kidney can weigh as much as 20-30 pounds. High blood pressure is a result of PKD. The most common symptoms are pain in the back, ribs and hips and frequent headaches. Complications can be urinary tract infections, hematuria, liver and pancreatic cysts, abnormal heart valves, kidney stones, aneurysms and diverticulosis. Ultrasound, CT and MRI are widely used modalities to diagnose and monitor PKD patients. Unfortunately, PKD patients usually end up on dialysis machines and kidney failure.This is a Axial CT Image of a patient withPolycystic Kidney Disease.