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More from @teachplaygrub

Lea Alhilali, MD

@teachplaygrub

Jun 9

1/Need help reading spine imaging? I’ve got your back!

It’s as easy as ABC!

A thread about an easy mnemonic you can use on every single spine study you see to increase your speed & make sure you never miss a thing!

2/A is for alignment

Look for:
(1) Unstable injuries

(2) Malalignment that causes early degenerative change. Abnormal motion causes spinal elements to abnormally move against each other, like grinding teeth wears down teeth—this wears down the spine

3/B is for bones.

On CT, the most important thing to look for w/bones is fractures. You may see focal bony lesions, but you may not

On MR, it is the opposite—you can see marrow lesions easily but you may or may not see edema associated w/fractures if the fracture is subtle

Read 11 tweets

Lea Alhilali, MD

@teachplaygrub

Jun 6

1/Raise your hand if you’re confused by the BRACHIAL PLEXUS!

I could never seem to remember or understand it—but now I do & I’ll show you how!

A thread so you will never fear brachial plexus anatomy again!

2/Everyone has a mnemonic to remember brachial plexus anatomy.

I’m a radiologist, so I remember one about Rad Techs.

But just remembering the names & their order isn’t enough.

That is just the starting point--let’s really understand it

3/From the mnemonic, we start with the roots—the cervical nerve roots.

I remember which roots make up the brachial plexus by remembering that it supplies the hand.

You have 5 fingers on your hand so we start with C5 & we take 5 nerve roots (C5-T1).

Read 20 tweets

Lea Alhilali, MD

@teachplaygrub

Jun 4

1/Having trouble remembering what to look for in vascular dementia on imaging?

Almost everyone w/memory loss has infarcts. Which are important?

The latest @theajnr SCANtastic has what you need to know:

ajnr.org/content/46/5/1…

@TheAJNR 2/Vascular cognitive impairment, or its most serious form, vascular dementia, used to be called multi-infarct dementia.

It was thought dementia directly resulted from brain volume loss from infarcts, w/the thought that 50-100cc of infarcted related volume loss caused dementia

@TheAJNR 3/But that’s now outdated. We now know vascular dementia results from diverse pathologies that all share a common vascular origin.

It’s possible to lose little volume from infarct & still result in dementia.

So if infarcts are common—which contribute to vascular dementia?

Read 20 tweets

Lea Alhilali, MD

@teachplaygrub

Jun 2

1/Having trouble remembering how to differentiate dementias on imaging?

Is looking at dementia PET scans one of your PET peeves?

Here’s a thread to show you how to remember the imaging findings in dementia & never forget!

2/The most common functional imaging used in dementia is FDG PET. And the most common dementia is Alzheimer’s disease (AD).

On PET, AD demonstrates a typical Nike swoosh pattern—with decreased metabolism in the parietal & temporal regions

3/The swoosh rapidly tapers anteriorly—& so does hypometabolism in AD in the temporal lobe. It usually spares the anterior temporal poles.

So in AD look for a rapidly tapering Nike swoosh, w/hypometabolism in the parietal/temporal regions—sparing the anterior temporal pole

Read 16 tweets

Lea Alhilali, MD

@teachplaygrub

May 27

1/Feel perplexed by the lumbosacral plexus??

This plexus doesn’t have to be so complex-us

Here’s what you need to know from this month’s @Radiographics!

@cookyscan1 @RadG_editor doi.org/10.1148/rg.240…

@RadioGraphics @cookyscan1 @RadG_Editor 2/The lumbosacral plexus is like a love story

The lumbar & sacral plexuses met & fell in love

They loved each other so much they came together to create the nerves to the lower extremities!

@RadioGraphics @cookyscan1 @RadG_Editor 3/Lumbosacral plexus is essentially formed by the nerves from L1-S4 (with some other small contributions)

Remember this bc the plexus is to the lower extremitieis and L & 1 look legs and S & 4 look like feet!

Read 12 tweets

Lea Alhilali, MD

@teachplaygrub

May 6

1/Have disagreements between radiologists on the degree of cervical canal stenosis become a pain in the neck?

Worried about sticking your neck out & calling severe cervical stenosis?

This month’s @theAJNR SCANtastic has the latest about Cspine MRI!

ajnr.org/content/46/4/7…

@TheAJNR 2/In the lumbar spine, it is all about the degree of canal narrowing & room for nerve roots.

In the cervical spine, we have another factor to think about—the cord.

Cord integrity is key. No matter the degree of stenosis, if the cord isn’t happy, the patient won’t be either

@TheAJNR 3/Cord flattening, even w/o canal stenosis, can cause myelopathy.

No one is quite sure why.

Some say it’s b/c mass effect on static imaging may be much worse dynamically, some say repetitive microtrauma, & some say micro-ischemia from compression of perforators

Read 16 tweets

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More from @teachplaygrub

Lea Alhilali, MD

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Lea Alhilali, MD

Lea Alhilali, MD

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