MSK Rotation 

 

Faculty RepresentativeDr. Glenn Garcia, Dr. Deborah Stedman, Dr. Brian Trieu

 

Schedule 

Resident:  

  • Monday- Friday at Victory Lakes(League City Campus) if MSK procedure


Please see Qgenda for attending schedules 

 

Hours 

8:00 AM – 5:00 PM or if dismissed earlier by MSK faculty

 

Location:  

  • UTMB Main (Galveston)) 

  • PACS Worklist:  MSK Unread Last 30 Days Unread 

  • Attending assignment:  

  • Check Qgenda for attending schedules 

  • UTMB Victory lakes (Ground Floor, Radiology reading room) 

  • PACS Worklist:  MSK Unread Last 30 Days Unread 

  • Attending assignment: 

  • Check Qgenda for attending schedules 

 

Conferences:  

Daily, Noon Conference, UH conference room.  

Multidisciplinary Conferences 

Rheumatology conference 

  • When: Friday 1:00 PM  

  • Where: at Galveston(Main)Cooley Conference Room2.414 Clinical Science Bldg. 

 

Pertinent contacts information 

Reading room 

  • Main: 409-747-2853, 409-772-7158 

  • VL:  

  • Resident reading room: 51217 

  • Dr. Stedman’s Office: 51410 

 

Imaging Library 

  • Main    21110 / 21191 

  • VL        51756 

 

 

DX 

CT 

MRI 

Main 

27361 

24229 / 21760 

21554 / 20917 / 26910 

Main ER 

23933 

23480 

 

Jennie Sealey 

 

67917 / 67566 

67791 

LCC 

 

51417 

51407 

LCC ER 

53213 / 53214 

53213 / 53214 

 

TDC 

26162 

26162 

29170 

 

Dialing 5-digit Numbers (if you dial from mobile): 
            o If starts with 2 then dial 409-772-**** 
            o If starts with 7 then dial 409-747-**** 
            o If starts with 5 then dial 832-505-**** 
            o If starts with 6 then dial 409-266-**** 

 

Protocols 

 

 

 

 

 

Goals and Expectations 

 

 

The training program will consist of MSK 1, MSK 2 and MSK CROSS SECTIONAL rotations. MSK1 and MSK 2 rotationfocus on plain film interpretation interpreting at least 30-40 exams per day The MSK CROSS SECTIONAL resident will focus on all cross-sectional imaging and plain film interpretation and will be covered by the most senior resident.   

 

All level residents will assist in bone and joint procedures with exposure to ultrasonography and other interventions.  On a daily basis all MSK residents will check and chart all the procedure schedules and inform the MSK attendings of any planned procedures. ALL Epic Inpatient and Outpatient IR lists should be checked for  MSK procedures and protocolled accordingly!!!  He/she is to collect the clinical information, images, lab data, etc. and present it to the MSK attendings in order to plan the exam appropriately in advance. The technologists will contact the resident when the patient arrives. The MSK resident will obtain informed consent for the procedure.  Residents will observe, perform and dictate MSK procedures.  Residents should ensure all appropriate testing is ordered on any patient specimen collected!!  This may require contacting the ordering team.  Residents are to participate in as many procedures as possible.  Any participation in procedures must be entered by the resident into New Innovations.    

 

Residents will be expected to protocol cross sectional CT/MR studies and IR procedures daily in Epic.  The resident is to protocol all cases after utilizing any prior imaging and the MSK protocol file to optimize the study protocol. Help from attending MSK radiologists should be sought, especially during the first few weeks of the first rotation.  Before bringing a case to the attending’s attention, the resident should fully investigate all aspects of the case (reason for ordering exam, patient condition and ability to tolerate MRI, previous exams of all types). The resident should propose a protocol for the exam that will be reviewed and amended by the attending as necessary. Residents should serve as the first line for protocoling exams, but should feel free to call upon staff for assistance at any time. 

 

MSK 1 & 2 RESIDENT DUTIES: 

 

Residents will be expected to review and dictate cases which will be checked by faculty. Residentwill be expected to compare exams with appropriate prior studies. MSK residents will work together to ensure that all the images are interpreted in a timely fashion. MSK 1 & 2 residents will serve as back-up for the MSK CROSS SECTIONAL resident if assistance is needed.  

 

During the first MSK rotationthe radiology resident will be expected to: 

 

1.   Dictate a succinct, precise and coherent radiology report. 

2.   Describe pertinent normal anatomy in a MSK radiograph. 

3.   Establish a diagnosis and provide an appropriate description of a fracture involvinthe peripheral skeleton. 

4.   Discuss the imaging findingof septic arthritis, osteomyelitis, and metastatic diseases. 

5.   Evaluate orthopedic follow-up imaging including the imaging findingoloosening and infection of orthopedic hardware. 

6.   Function as a consultant to clinicians for radiographic evaluation of MSK trauma and orthopedic follow-up. 

7.   Participate actively in the MSK division’s academic program (e.gteaching medical 

students on the rotationquality assurance, etc…) 

 

A resident test at the end of the rotation will focus on radiology of the musculoskeletal system with lesser emphasion other topics introduced while on service. 

 

 

During the second MSK rotation, radiology resident will be expected to: 

 

Discuss the imaging findings and provide an appropriate differential diagnosis for: 

 

1.   Articular diseases. 

2.   Benign and malignant bone tumors. 

3.   Metabolic and endocrine diseases. 

4.   Miscellaneous diseaseentities (as listed below). 

5.   Soft tissue lesions. 

6.   Congenital syndromes. 

7.   Consolidate the objectives othe first rotation 

8.   Function as a consultant for conventional radiographic evaluation of MSK 

pathology and for planning the MSK imaging to solve particular problem. 

9.   Participate actively in the MSK division’s academic program (e.gteaching medical 

students on the rotation.) 

 

 

A resident test at the end of this rotation will focus on arthritis, metabolic diseases, trauma and tumors othe musculoskeletal system with lesser emphasis on other topics encountered while on service. 

 

 

MSK CROSS SECTIONAL RESIDENT DUTIES: 

 

During the MSK CROSS SECTIONAL rotation, the radiology resident will be expected to: 

 

1.   Interpret with competence MR and CT imaging studies of the joints, extremities, musculoskeletal system in a timely fashion.  The resident is to ensure that all appropriate comparison exams are available and reviewed.  

2.   Plain film interpretation 

3.   Act as a consultant on MSK imaging studies 

4.   Participate actively in the teaching of junior residents, other residents, interns, and medical students 

 

RESOURCES 

Books – links via moody library 

 

Anatomy 

 

1.   Netter FH, Atlas of Human Anatomy, CB_GEIGY 

2.   Kang HS, Resnick D, MRI of the Extremities an Anatomic Atlas, Saunders. 

3.   El Khoury GY, Bergman RA, et al, Sectional Anatomy by MRI/CT, Churchill 

Livingstone. 

4.   Sarai, Ernst et al GAR CD 

 

Arthrography 

 

1.   Freiberger and Kaye, Arthrography Appleton-Century-Crofts. 

 

CT 

 

1.   Lee & SagelComputed Body Tomography with MRI Correlation 3rd Edition, 1998Lippincott-Raven, Chapter 22 - Musculoskeletal. 

2.   Pretorius ES, Fishman EK. Helical (Spiral) CT othe Musculoskeletal System. Radiol 

Clin A 

 

Emergency Radiology 

 

1.   Harris, The Radiology of Emergency Medicine, Williams & Wilkins. 

 

General MSK: 

 

1.   Resnick & Niwayama, Diagnosis oBone and Joint Disorders 2nd ed., Saunders, Vols. 1-6. 

 

Orthopedics 

 

1.   Berquist TH, Imaging Atlas of Orthopedic Appliances and Prostheses, Raven Press, 

1995. 

 

Pediatrics 

 

1.   Swischuck Emergency Radiology 

2.   Ozonoff, Pediatric Orthopedic Radiology, W. B. Saunders and Co. 

3.   Taybi, Radiology of Syndromes, Year Book Medical Publishers. 

 

 

Technique 

 

1.   Bernau & Berquist, Orthopedic Positioning in Diagnostic Radiology, Urban & Schwarzenberg. 

2.   Lusted & Keats, An Atlas of Roentgenography Measurement, YeaBook Medical 

Publishers. 

 

Trauma 

 

1.   Rogers LF, Radiology of Skeletal Trauma, Vol. I & II, Churchill Livingston. 

 

Tumor 

 

1.   Bone and Joint Imaging Donald Resnick. W. B. Saunders 

2.   Mirra JMBone Tumors: Clinical, Radiologic, and Pathologic Correlations, Lea Feabiger. 

3.   GreenspanBone Tumors Differential Diagnosis 

4.   Kransdorf, Soft Tissue Tumors