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Imaging for Upper Quarter Sports Injuries

Presented by Dr. Robert Boyles

Overutilization of musculoskeletal imaging can be just as deleterious as underutilization. In fact, it has been shown that overutilization of imaging can actually lead to harm. It’s essential that clinicians recognize when imaging is necessary and if so, which imaging modality it most appropriate. Fortunately, there are well-established guidelines to aid in this process. Most are based on a sound hypothesis from the history and physical exam. This course covers basic principles of diagnostic imaging modalities as they apply to the health care provider when evaluating sports injuries. The emphasis is on plain film radiography. Other types of imaging, including contrast films, magnetic resonance imaging, and computed tomography will also be introduced as deemed clinically relevant.

Meet your instructor

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Dr. Robert Boyles

Dr. Robert Boyles is a clinical professor and former program director of the University of Puget Sound’s Doctor of Physical Therapy program in Tacoma, Washington. Previously, he was on faculty as associate professor and director of clinical education of the US Army-Baylor University DPT program. His primary areas of…

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Chapters & learning objectives

Cervical Spine

1. Cervical Spine

The participants will be able to apply the Canadian C-Spine Rule to athletes with a neck injury. The chapter will also be able to identify what is normal and abnormal in structures of the cervical spine, including the George line, the cervical gravity line, prevertebral soft tissue, fractures of the spine, and degenerative changes, as they apply to sports injuries.

Elbow

2. Elbow

In this chapter, Bob Boyles will discuss the elbow extension test for acute fracture screening, as well as identify what is normal and abnormal in elbow dislocations and ossification. The chapter also describes imaging for fractures of the forearm and pediatric injuries, including dislocation of the radial head, little league elbow, UCL injuries and nerve entrapment.

Head

3. Head

Neuroimaging, CT scans and MRI imaging play significant roles in identifying and characterizing head injuries. In this chapter, the learner will be able to compare and contrast the appropriateness of the different types of imaging for the head, following the American College of Radiology (ACR) Appropriateness Criteria. The chapter discusses the New Orleans Criteria, Canadian CT Head Rules, and the ACR Guidelines for Orbital Trauma.

Shoulder

4. Shoulder

Shoulder injuries are common in many athletes, all of which use plain films for the initial investigation. In this chapter, the participant will be able to describe the three film views, as identified by the shoulder trauma protocols, as well as reasoning for further investigation using CT or MRI scans. Imaging surrounding fractures, labral injuries and dislocations are covered in this chapter.

Hand and Wrist

5. Hand and Wrist

Bob Boyles will discuss the five views of imaging for the hand and wrist and how to determine the appropriateness of each view. The learner will compare normal and abnormal imaging for a fractures and ligament injuries in the hand and wrist.

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