1. Lower Extremity David S. Hartman, M.D. Department of Radiology

2. Goals • To teach clinically relevant gross anatomy • To make it easier to understand gross anatomy • To introduce a clinical lexicon

3. Organization • 4 presentations to the entire class • Lower extremity/thorax • Abdomen/pelvis/perineum • Upper extremity/back • Head and neck • Optional review session before each examination

4. Examinations • 4 radiolgic unknowns on each examination • Images used for the exams are displayed in the lab • Each examination unknown is labeled in PowerPoint

5. Cases in MDL \\hersheymed.net\files\MMS\Public\education\radiology\lab-thorax-8-2007.pps Cases can be viewed by any computer in the institution

6. Learning Objectives: Identify all objects indicated by arrows on the radiolgical images in this presentation The same images are on the computers in the lab

7. RadiographicAnatomy Of The Foot

8. Frontal foot MetatarsalsCuneiformsNavicularCuboidTalusCalcaneus 488

9. AP Foot Metatarsals Medial Cuneiform Intermediate Cuneiform Cuboid Navicular Talus

10. Oblique Foot Metatarsals Lateral Cuneiform Cuboid Navicular Talus

11. Lateral cuneiform Metatarsals Cuboid Talus Calcaneus Lateral Foot 489

12. Talus Navicular Cuboid Calcaneus Lateral Foot

13. Fell from ladder Fracture calcaneus

14. Angiographic Anatomy of the Lower Extremity

15. Anterior Thigh External iliac artery Inguinal ligament Common femoral artery Profunda femoris artery Superficial femoral artery 477

16. Common femoral art Profunda femoris art Superficial femoral art

17. Posterior Knee Popliteal artery Anterior tibial artery Peroneal artery Posterior tibial art 483 LAT MEDIAL

18. AnteriorKnee Anterior tibial artery Lat MEDIAL 485

19. Anterior Ankle Medial Anterior tibial artery Dorsalis pedis artry 485

20. AP Knee Superficial femoral artery Popliteal artery Anterior tibial artery Posterior tibial artery Peroneal artery LATERAL

21. Lateral Ankle Posterior Tibial Artery Anterior Tibial Artery Dorsalis Pedis Artery

22. Rt Femoral Angiogram 66YO smoker, claudication Marked narrowing of the SFA with extensive collaterals which will reconstitute the popliteal a

23. Following angioplasty

24. MR Anatomy of the Knee

25. ViewingMultiplanarImages(CT, MR, US)

26. View as though facing the patient Axial section Right Left

27. Axial CT image with contrast Anterior Heart Liver Right Left Lung Posterior By convention we look from below

28. Coronal Right Left Coronal suture

29. Coronal CT image with contrast Superior Right Lung Right Left Heart Inferior By convention view the image as though facing the patient

30. Sagital Sagital suture

31. Sagital CT image with contrast Superior Aorta Anterior Posterior Heart Inferior By convention view the image as though the patient is facing to our left

32. MR Anatomyof the Knee(Sagital)

33. Left Knee From Above ANT Medial Meniscus LAT Anterior Cruciate Posterior Cruciate Lateral Meniscus 474

34. Sagital knee Quadriceps tendonPatellaMeniscusAnterior hornPosterior hornPatella tendon FEMUR TIBIA 476

35. Parasagital Cut Medial Lateral

36. Knee MR, Most Medial Parasagital Medial femoral condyle Medial condyle of tibia Medial meniscus Anterior horn Post horn Gastrocnemius

37. Anterior cruciate Lateral meniscus Fibula Posterior cruciate Medial meniscus Tibia Right Knee from the Front 475

38. Right Knee, Posterior View Medial condyle Lateral condyle Medial meniscus Lateral meniscus Posterior cruciate ligament Anterior cruciate ligament Lateral Medial 475

39. Parasagital Cut MEDIAL LATERAL

40. Knee MR, Medial Parasagital Femur Posterior cruciate Gastroc- nemius muscle Tibia

41. 32 YO man, knee pain Ruptured posterior cruciate ligament

42. Parasagital Cut MEDIAL LATERAL

43. Knee MR, Lateral Medial Parasagital Femur Anterior cruciate ligament Tibia

44. Parasagital Cut MEDIAL LATERAL

45. Knee MR, Most Lateral Parasagital Quad- riceps tendon Lateral femoral condyle Lateral meniscus Ant horn Post horn Patella Lateral condyle of the tibia Patella tendon

46. Lower Extremity David S. Hartman, M.D. Department of Radiology