STANFORD UNIVERSITY MEDICAL CENTER



|Rotation: MSK |Rotation Duration: 4 wks |Month(s): 3 |

|Institution: Stanford, VA |Call Responsibility: None |Night(s): covered by Junior call |

|Responsible Faculty Member(s): |Location: |

|Chris Beaulieu MD PhD |Stanford bone board (one month) |

|Kate Stevens MD |VA/SMOC: (2 months) |

|Sandip Biswal MD | |

|Garry Gold MD, MSEE | |

|Amelie Lutz, MD | |

| |Phone Numbers: |

| |Stanford Hospital: |

| |MSK Fellow Pager 14589, |

| |14598, 14603 |

| |MSK Room SUH 3-6737 |

| |MSK Room Fax 4-3275 |

| |MRT/Claudia 8-6976 Hosp MR Rd. Rm 3-6955 |

| |Ultrasound SUH 3-3498 |

| |OPD 1-6790 |

| |Blake MRI 5-9413 |

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| |North campus (SMOC): |

| |Reading room 1-7370 |

| |Reading Room 1 1-7343 |

| |Reading Room 2 1-7344 |

| |Fluoroscopy 1-7351 |

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| |VA hospital: 650-493-5000 (+ extension) |

| |Front desk-64489 |

| |Reading room-63250 |

|Technologists/Technical Staff: |Training Level: |

|Aubrey Grey, lead fluoroscopy technologist |Years 1-3 |

|Michelle Thomas, lead CT technologist SUH | |

|Teresa Nelson, lead MRI technologist SUH | |

|MRI technologists: | |

|Jill Bingelli | |

|Jorge Castaneda | |

|Martin Chavez | |

|Mark Coleman | |

|Samuel Dong | |

|Greg Dowdall | |

|Kim Duong | |

|Eric Gabriel | |

|Tony Galletta | |

|Robert Heriford | |

|Diane Jenuleson | |

|Darwin Jones | |

|William Keirn | |

|Sherrie Lee | |

|Navy Lu | |

|Connie Lund | |

|Michael Ody | |

|Jane Patrick | |

|Leah Pericolosi | |

|Steven Scherer | |

|Jason Smith | |

|Thanh Tang | |

|Kendall Thomas | |

|Carol Torbett | |

|Shannon Walters | |

|Michele Yerondopoulos | |

|Goals & Objectives: |

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|A note about goals and objectives- The goals and objectives outlined in this document are based upon the six core competencies as defined by the |

|ACGME. As residents gain experience and demonstrate growth in their ability to care for patients, they assume roles that permit them to exercise |

|those skills with greater independence. This concept—graded and progressive responsibility—is one of the core tenets of American graduate medical |

|education. This document should provide you a framework for the stepwise progression of your knowledge and skills. |

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|MSK Rotation 1-Stanford hospital bone board-first year |

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|By the end of the first year rotation (including Santa Clara Valley), residents are expected to recognize fractures and dislocations in trauma and |

|to have an approach to further workup (CT, MRI) of patients as needed. Residents are also expected to have basic understanding of arthritis, |

|orthopedic hardware, and bone tumors, although these are not likely to be dealt with on call. |

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|Patient Care |

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|Goal: |

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|Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the |

|promotion of health. Residents are expected to: |

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|Knowledge Objectives: |

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|Gain skill in interpretation of digital (and occasional conventional) radiographs of MSK system. |

|Understand radiographic positioning for common views of the spine and extremities. |

|Describe the indications for MSK radiographs, as well as to recognize the limitations of radiographs, and to know when CT or MRI is necessary. |

|Learn key principles in interpretation of trauma CT, including description of fractures affecting the pelvis, knee, ankle and foot, shoulder, |

|elbow, and wrist and hand. |

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|Skill Objectives: |

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|Become facile with GE Centricity PACs, Centricity RIS, Nuance RadWhere voice-recognition dictation, and EPIC. Utilize available information |

|technology to manage patient information. |

|Provide concise, accurate reports. |

|Learn to accurately interpret postoperative and trauma radiographs of the peripheral skeleton and spine. |

|As part of pediatric radiology, gain a basic understanding of how to interpret pediatric bone radiographs, particularly fractures specific to |

|children (e.g. greenstick fractures, torus fractures, Salter-Harris injuries). |

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|Behavior and Attitude Objectives: |

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|Work with the health care team in a professional manner to provide patient-centered care. |

|Notify referring clinician for urgent, emergent, or unexpected findings, and document in dictation. |

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|Medical Knowledge |

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|Goal: |

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|Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as |

|the application of this knowledge to patient care. Residents are expected to: |

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|Knowledge Objectives: |

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|Understand basic skeletal development and anatomic subdivisions of the skeleton into epiphysis, physis, metaphysis, and diaphysis. |

|Discussed basic bone physiology. |

|Describe the stages different types of fractures go through in the process of healing. |

|Know all the bones of the skeletal system, as well as their anatomy. |

|Identify the common imaging and clinical manifestations of arthritis, bone tumors, bone infections, and metabolic bone disease. |

|Describe fracture and joint dislocation nomenclature and their radiographic appearances. |

|Be familiar with more common orthopedic hardware and hardware complications. |

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|Before the beginning of call, the resident should be familiar with the manifestations and diagnosis of the disease entities listed in Appendix A: |

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|Skill Objectives: |

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|Establish a general approach to interpretation of plain films in trauma, the postoperative state, arthritis and infection. |

|Identify normal and aberrant skeletal anatomy. |

|Accurately diagnose more common osseous diseases. |

|Learn a basic approach to solitary bone lesions. |

|Accurately interpret spine and extremity radiographs. |

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|Behavior and Attitude Objectives: |

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|Recognize limitations of personal competency and ask for guidance when appropriate. |

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|Practice-Based Learning and Improvement |

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|Goal: |

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|Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to |

|continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to |

|be able to: |

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| |

| |

|Knowledge Objectives: |

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|Assess radiographs for quality and suggest methods of improvement. |

| |

|Skill Objectives: |

| |

|Demonstrate independent self-study using various resources including texts, |

|journals, teaching files, and other resources on the internet. |

|Facilitate the learning of students and other health care professionals. |

| |

|Behavior and Attitude Objectives: |

| |

|Incorporate formative feedback into daily practice, positively responding to constructive criticism. |

|Follow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents. |

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|Systems Based Practice |

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|Goal: |

| |

|Residents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call |

|effectively on other resources in the system to provide optimal health care. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Understand how their image interpretation affects patient care. |

| |

|Skill Objectives: |

| |

|Provide accurate and timely interpretations. |

|Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted. |

|Practice using cost effective use of time and support personnel. |

| |

|Behavior and Attitude Objectives: |

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|Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues. |

| |

| |

|Professionalism |

| |

|Goal: |

| |

|Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are |

|expected to demonstrate: |

| |

|Knowledge Objectives: |

| |

|Understanding of the need for respect for patient privacy and autonomy. |

|Understanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning|

|to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. |

|If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate |

|faculty and/or fellow. |

| |

|Skill Objectives: |

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|Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, |

|disabilities, and sexual orientation. |

| |

|Behavior and Attitude Objectives: |

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|Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest. |

| |

|Interpersonal and Communication Skills |

| |

|Goal: |

| |

|Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, |

|their families, and professional associates. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Know the importance of accurate, timely, and professional communication. |

| |

|Skill Objectives: |

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|Produce concise and accurate reports on most examinations. |

|Communicate effectively with physicians, other health professionals. |

|Obtain informed consent with the utmost professionalism. |

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|Behavior and Attitude Objectives: Work effectively as a member of the patient care team. |

|MSK-2nd year / second rotation: VA/SMOC MSK |

|By the end of this rotation, residents should have advanced their understanding of MSK radiographs. Although radiographs will be interpreted at |

|SMOC, residents will begin to gain experience in MSK MRI and CT, as well as basic MSK procedures. |

| |

|Patient Care |

| |

|Goal: |

| |

|Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the |

|promotion of health. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Continue to build on the knowledge objectives gained in rotation 1. |

|Increase skill in interpretation of digital (and occasional conventional) radiographs of MSK system. |

|Understand radiographic positioning for common and less common views of the spine and extremities. |

|Describe the indications for MSK radiographs, as well as to recognize the limitations of radiographs, and to know when CT or MRI is necessary. |

|Increase understanding of principles in interpretation of trauma CT, including description of fractures affecting the pelvis, knee, ankle and foot,|

|shoulder, elbow, and wrist and hand. |

|Select appropriate imaging modality for a particular patient and disease, including radiographic, CT, MR, and bone scan. |

|Protocol MRIs and CT’s for most musculoskeletal indications. |

|Understand the use and interpretation of CT and MRI in the setting of musculoskeletal infection. |

|Understand common indications for musculoskeletal ultrasound. |

|Learn basic principles of arthrography, including aspiration or injection of the hip and total joint prostheses. |

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|Skill Objectives: |

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|Continue to build on the skills objectives gain in rotation 1. |

|Perform arthrography for conventional arthrogram or MR arthrogram with supervision. |

|Learn how to perform basic MSK US of tendons and muscles. |

|Provide concise, accurate reports on all studies, including MSK MR and CT. |

|Kate Stevens’ suggested MSK MRI templates can be found at . |

| |

|Behavior and Attitude Objectives: |

| |

|Work with the health care team in a professional manner to provide patient-centered care. |

|Notify referring clinician for urgent, emergent, or unexpected findings, and document in dictation. |

| |

| |

|Medical Knowledge |

| |

|Goal: |

| |

|Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as |

|the application of this knowledge to patient care. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Continue to build on the knowledge objectives of rotation 1. |

|Learn detailed anatomy of the knee and shoulder joints through MRI interpretation. |

|Learn about common musculoskeletal neoplasms, including benign and malignant primary tumors and metastatic lesions. |

|Understand applications of MR arthrography, including shoulder, hip, and knee. |

|Understand the MR imaging appearance of tumor, infection, and arthritis. |

|Learn the pathophysiology and manifestations of the least one half of the disease entities listed in appendix B. |

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|Skill Objectives: |

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|Continue to build on the skills objectives of rotation 1. |

|Define findings in most musculoskeletal abnormalities, including soft tissue masses, as well as benign and malignant bone tumors. |

|Learn basic interpretation of MRI of the knee and shoulder. |

|Be able to accurately interpret radiographic studies for arthritis, including degenerative, inflammatory, and crystal-induced diseases. |

| |

|Behavior and Attitude Objectives: |

| |

|Recognize limitations of personal competency and ask for guidance when appropriate. |

| |

| |

|Practice-Based Learning and Improvement |

| |

|Goal: |

| |

|Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to |

|continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to |

|be able to: |

| |

|Knowledge Objectives: |

|Assess radiographs, CT and MR for quality and suggest methods of improvement. |

|Skill Objectives: |

| |

|Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet. |

|Facilitate the learning of students and other health care professionals. |

| |

|Behavior and Attitude Objectives: |

| |

|Incorporate formative feedback into daily practice, positively responding to constructive criticism. |

|Follow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents. |

| |

| |

|Systems Based Practice |

| |

|Goal: |

| |

|Residents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call |

|effectively on other resources in the system to provide optimal health care. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Understand how their image interpretation affects patient care. |

| |

|Skill Objectives: |

| |

|Provide accurate and timely interpretations to decrease length of hospital and emergency department stay. |

|Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted. |

|Practice using cost effective use of time and support personnel. |

| |

|Behavior and Attitude Objectives: |

| |

|Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues. |

| |

| |

|Professionalism |

| |

|Goal: |

| |

|Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are |

|expected to demonstrate: |

| |

|Knowledge Objectives: |

| |

|Understanding of the need for respect for patient privacy and autonomy. |

|Understanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning|

|to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. |

|If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate |

|faculty and/or fellow. |

| |

|Skill Objectives: |

| |

|Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, |

|disabilities, and sexual orientation. |

| |

|Behavior and Attitude Objectives: |

| |

|Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest. |

| |

| |

|Interpersonal and Communication Skills |

| |

|Goal: |

| |

|Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, |

|their families, and professional associates. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Know the importance of accurate, timely, and professional communication. |

| |

|Skill Objectives: |

| |

|Produce concise and accurate reports on most examinations. |

|Communicate effectively with physicians, other health professionals. |

| |

|Behavior and Attitude Objectives: |

| |

|Work effectively as a member of the patient care team. |

| |

| |

| |

|MSK-3rd year VA/SMOC-third rotation |

| |

|By the end of this rotation, residents should have become expert in their understanding of MSK radiographs. Although radiographs will be |

|interpreted at SMOC, residents will gain further experience in MSK MRI and CT, as well as more advanced MSK procedures. |

| |

| |

|Patient Care |

| |

|Goal: |

| |

|Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the |

|promotion of health. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Continue to build on the knowledge objectives of Rotations 1 and 2 |

|Understand the indications for all musculoskeletal imaging, including more complex cases. |

|Be facile with MSK imaging protocols, including spine and extremities. |

|Learn to protocol and monitor MSK MRI studies. |

|Understand common indications for musculoskeletal ultrasound. |

|Learn basic principles of arthrography, including aspiration or injection of the hip and total joint prostheses, and injection of the glenohumeral |

|joint. |

|Learn principles of advanced MSK procedures, including tenography and US-guided procedures. |

| |

|Skill Objectives: |

| |

|Continue to build on the skills gained in rotations 1 and 2. |

|Perform arthrography for conventional arthrogram or MR arthrogram with supervision. |

|Learn how to perform basic MSK US of tendons and muscles. |

|Provide concise, accurate reports on all studies. |

| |

|Behavior and Attitude Objectives: |

| |

|Work with the health care team in a professional manner to provide patient-centered care. |

|Notify referring clinicians for urgent, emergent, or unexpected findings, and document in dictation. |

| |

| |

|Medical Knowledge |

| |

|Goal: |

| |

|Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as |

|the application of this knowledge to patient care. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Continue to build on the skills gained in rotations 1 and 2. |

|Describe imaging findings of more complex osseous pathology. |

|Understand applications of MR arthrography, including shoulder, hip, and knee. |

|Become familiar with basic principles of metabolic bone diseases, including osteoporosis, osteomalacia and hyperparathyroidism. |

|Learn the pathophysiology and manifestations of the least one half of the disease entities listed in the appendix of this document. |

|Understand the MR imaging appearance of tumor, infection, and arthritis. |

|Recognize pertinent musculoskeletal anatomy, particularly knee, hip, and shoulder, and identify common abnormalities of these regions. |

|Be able to interpret basic MRI of post-operative joints. |

|Learn how to interpret MSK CT in the setting of orthopedic hardware. |

|Learn how to perform multiplanar and 3D rendering of MSK studies. |

|Have a comprehensive approach to differential diagnosis and workup of solitary bone lesions. |

|Gain a basic understanding of various syndromes and developmental and dysplastic syndromes affecting the MSK system. |

|Learn the pathophysiology and manifestations of all of the disease entities listed in the appendix of this document. |

|Learn the pathophysiology and manifestations of the least one half of the disease entities listed in appendix B. |

| |

|Skill Objectives: |

| |

|Continue to build on the skills gained in rotations 1 and 2. |

|Learn basic interpretation of MRI of the hip, ankle, elbow, and wrist. |

|Be able to accurately interpret radiographic studies for arthritis, including degenerative, inflammatory, and crystal-induced diseases. |

| |

|Behavior and Attitude Objectives: |

| |

|Recognize limitations of personal competency and ask for guidance when appropriate. |

| |

| |

|Practice-Based Learning and Improvement |

| |

|Goal: |

| |

|Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to |

|continuously improve patient care based on constant self-evaluation and lifelong learning. Residents are expected to develop skills and habits to |

|be able to: |

| |

|Knowledge Objectives: |

| |

|Assess radiographs, CT and MR for quality and suggest methods of improvement. |

| |

|Skill Objectives: |

| |

|Demonstrate independent self-study using various resources including texts, journals, teaching files, and other resources on the internet. |

|Facilitate the learning of students and other health care professionals. |

| |

|Behavior and Attitude Objectives: |

| |

|Incorporate formative feedback into daily practice. |

|Follow-up interesting or difficult cases without prompting and share this information with appropriate faculty and fellow residents. |

| |

| |

|Systems Based Practice |

| |

|Goal: |

| |

|Residents must demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call |

|effectively on other resources in the system to provide optimal health care. Residents are expected to: |

|Knowledge Objectives: |

| |

|Understand how their image interpretation affects patient care. |

| |

|Skill Objectives: |

| |

|Provide accurate and timely interpretations. |

|Appropriately notify the referring clinician if there are urgent or unexpected findings and document such without being prompted. |

|Practice using cost effective use of time and support personnel. |

| |

|Behavior and Attitude Objectives: |

| |

|Advocate for quality patient care in a professional manner, particularly concerning imaging utilization issues. |

| |

| |

| |

| |

| |

|Professionalism |

| |

|Goal: |

| |

|Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are |

|expected to demonstrate: |

| |

|Knowledge Objectives: |

| |

|Understanding of the need for respect for patient privacy and autonomy. |

|Understanding of their responsibility for the patient and the service, including arriving in the reading room promptly each day, promptly returning|

|to the reading room after conferences, completing the work in a timely fashion, and not leaving at the end of the day until all work is complete. |

|If the resident will be away from a service (for time off, meeting, board review, etc.), this must be arranged in advance with the appropriate |

|faculty and/or fellow. |

| |

|Skill Objectives: |

| |

|Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, |

|disabilities, and sexual orientation. |

| |

|Behavior and Attitude Objectives: |

| |

|Respect, compassion, integrity, and responsiveness to patient care needs that supersede self-interest. |

| |

| |

| |

|Interpersonal and Communication Skills |

| |

|Goal: |

| |

|Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, |

|their families, and professional associates. Residents are expected to: |

| |

|Knowledge Objectives: |

| |

|Know the importance of accurate, timely, and professional communication. |

| |

|Skill Objectives: |

| |

|Produce concise and accurate reports on most examinations. |

|Communicate effectively with physicians and other health professionals. |

| |

|Behavior and Attitude Objectives: |

| |

|Work effectively as a member of the patient care team. |

| |

|MSK written curriculum: posted online at |

|Kate Stevens’ MSK MRI templates: |

| |

|Duties and Workflow: |

|General Guidelines |

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|1. Plain Radiographs: Report to Bone reading room no later than 8:45 AM and begin reviewing plain films. If you cannot arrive by this time, you |

|must page the bone attending. By 9:00 to 9:30 AM, you should be ready to read out with the bone attending. Note that attendings may not arrive |

|until 9:00 AM, but should be available by pager by 8:30 AM. |

| |

|“Wet Reads” are radiographic exams where the referring physician has requested immediate review by a radiologist, and a call or fax back with |

|results. These exams are brought to us throughout the day, and need to be reviewed by a faculty person before the report is called or faxed back. |

|Particularly important are studies performed on Stanford Athletes ("team players"), which require timely reading and attending review. Residents |

|should also prioritize films from the Vaden student healthcare center, to allow prompt referral for fractures. |

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|2. ER/Trauma Coverage: The ER extremity MSK films are periodically read during the day, typically at least twice each morning and afternoon. Wet |

|reads are entered into the PACs throughout the day until 5 PM when the junior resident takes over. Coverage is from 8:30 AM to 5 PM, except during |

|noon conference. A trauma pager is available in the bone room to alert us that a major trauma is arriving. |

| |

|3. MRI Interpretation: MRI readouts now occur at SMOC in Redwood City. During the 2nd and third-year rotations, the resident on service will be |

|expected to drive to SMOC on Monday and Friday after morning conference (Tuesday, Wednesday and Thursday at the VA). Cross sectional imaging |

|studies will be allocated to the MSK fellows and residents, who are expected to preview the case prior to readout with the attending. |

|Teleconferencing is set up at SMOC to enable the resident to participate in the resident conference at noon. MSK ultrasound cases are also done at|

|SMOC, and the resident will be given the opportunity to participate in these. |

| |

|4. Procedures: Up to 5 arthrograms, tenograms and ultrasound-guided interventions are scheduled throughout the day at SMOC, usually commencing at |

|10am, with emergency cases added on as needed. Resident participation in these procedures is on a case-by-case basis, but it is expected that the |

|resident will learn how to perform conventional hip and shoulder arthrograms. Note that we have an agreement that only attending physicians can |

|perform procedures on Stanford and Professional Athletes, though residents and fellows may assist with these cases. |

| |

|4. Teaching Cases: Interesting cases will be added to teaching folders on the PACS system, and the MSK fellows will also document interesting cases|

|for presentation at bone rounds (every Thursday at 5:15 PM in the ballroom). |

| |

|5. MSK Conference: Residents are encouraged to present cases during at least one conference during the month. This requires background reading on |

|the disorders. Bone residents are expected to attend all morning conferences related to musculoskeletal imaging during their rotation, and are |

|encouraged to attend bone rounds on Thursday afternoon at 5.15pm. |

| |

|6. Pathology and other Clinical Consultations. Pathology residents will page you when tumor biopsy cases need radiographic/pathologic correlation. |

|Coordinate time to meet with the pathologist and a bone radiology attending. Many of these cases are excellent additions to the teaching file or |

|for AFIP. |

| |

|7. Clinical conferences. Generally, these are attended by faculty and the fellow but residents are welcome to attend also. Orthopedics Grand |

|Rounds with Radiology/Pathology sessions Wed AM’s at 0730 hrs. Arthroscopy conference, 0700 hrs, one Monday per month at SMOC. Rheumatology case |

|conference, third Tuesday of the month at 1200 hrs, run by Dr. Stevens. |

| |

|Preparing Films |

| |

|Readouts occur on the 2 PACS workstations in the bone room. Cases should be read directly from the SMOC work list. In addition, in the afternoon |

|cases are read out from the MSK 1 work list. At a minimum all films taken before 2 pm on the SMOC work list must be read out on the same day, but |

|obviously if it is a slow day, reading out more films is desirable. Occasionally there can be glitches in the system, and cases inadvertently do |

|not make it to the work list that day, and are then added the subsequent day. The MSK fellow will independently read cases on the MSK 3 work list, |

|time permitting, and if this is not possible the MSK fellow will alert the bone attending accordingly. |

|What to do during readout |

| |

|Case reviewed with attending, resident takes notes and dictates later. There are a number of “canned” dictation examples printed out in the |

|reading room, which can be helpful as a guideline. |

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|Conference Schedule/Format |

|Title |Wednesday |Time |Location |

|MSK resident conference |Wednesday |7:30 AM weekly |Lucas |

|Orthopedics grand rounds |Wednesday |7:30 AM |Medical School (opposite canteen) |

| Bone rounds | Thursday | 5:15 PM weekly | Ballroom |

|Rheumatology cases |Third Tuesday of month |Noon |Bone room |

|Sarcoma tumor board |Friday |7 AM |Cancer center |

| | | | |

|Method of Assessment of Performance: |

|Written evaluation of resident by responsible faculty member monthly |

|Verbal feedback to resident by faculty |

|ACR In-Training Service Exam annually |

|Recommended reading during your 1st yr rotation includes: |

| |

|Helms, C: “Fundamentals of Musculoskeletal Radiology” |

|This is an excellent introductory text for first year residents. |

| |

|Brower, A: “Arthritis in Black and White” |

|Excellent review of features of the main types of arthritis. A book that is very useful to review again before boards. |

| |

|Harris, J: "Radiography of Acute Cervical Spine Trauma". |

| |

|Greenspan, A. “Orthopedic Radiology”. |

| |

| |

|Websites and Electronic Resources: |

| |

|University of Virgina Skeletal Trauma Tutorial |

| |

|MSK MRI Atlas |

| |

|ACR Skeletal Radiology CD-ROM |

|Good resource for cases |

| |

| |

| |

|Suggested supplementary reading : |

| |

|1. Keats, T.: “Atlas of Normal Roentgen Variants” |

|This is a book you need to know how to use, so that you can quickly find the information you are looking for. Particularly useful for ED reads and |

|on-call. If in doubt about a developmental variant eg. accessory ossicles, nutrient channels, weird looking bones → look it up in Keats! |

| |

|2. Rogers, L.: “Radiology of Skeletal Trauma” |

|Describes the common fracture and dislocation patterns in different body parts. Crucial for handling cases in the ER! |

| |

|3. Keats, T.: “Emergency Radiology” |

| |

|This is an excellent and readable text for first year residents prior to taking ER call. |

| |

|4. Kaplan, PA., Helms, C., Dussault, R., Anderson, MW. “ Musculoskeletal MRI” |

|Comprehensive textbook on MRI of the musculoskeletal system. Extremely useful to read this book when you are on the MSK MRI rotation. |

| |

|5. Stoller, D., Tirman, P., Bredella, M. “Diagnostic Imaging: Orthopaedics” |

|Excellent supplementary text for reading up around specific MRI pathology and considering differential diagnoses. Contains easy to understand |

|illustrations and high quality MR images, with bullet points summarizing each condition. |

| |

|6. Resnick, D: “Diagnosis of Bone and Joint Disorders” |

|The musculoskeletal radiology (5 volume) bible! Useful as reference when you want to find out more about a certain topic, but not to be attempted |

|to read from cover to cover unless you are a complete masochist! An "abbreviated (“baby”) Resnick" (1 volume) is also available for residents. |

| |

|Most of these books and a collection of other MSK radiology books are located in the locked cabinets in the bone reading rooms at Stanford and SMOC|

|and can be used by the resident on the MSK and MSK MRI rotations. If you do borrow books for the evening please ensure that books are returned to |

|the bone room. In the past books have been borrowed and not returned. This spoils it for residents subsequently on the rotation, as we cannot |

|afford to keep replacing them. |

| |

Appendix A: knowledge objectives in rotation one in preparation for call.

|Pre-call | | | | |

| | | |1 |Acetabular Fracture |

| | | |2 |Achilles Tendon Tear & Tendinopathy |

| | | |3 |Acromioclavicular Dislocation |

| | | |4 |Acute Osteomyelitis: Child |

| | | |5 |Anterior Glenohumeral Dislocation |

| | | |6 |Avulsive Injury, Knee |

| | | |7 |Bisphosphonates, Complications |

| | | |8 |Calcaneus Fracture, Intraarticular |

| | | |9 |Carpal Dislocation |

| | | |10 |Charcot (Neuropathic) |

| | | |11 |Child Abuse: The Extremities |

| | | |12 |Chondrosarcoma |

| | | |13 |Finger Fracture and Dislocation |

| | | |14 |Distal Radius Fracture |

| | | |15 |Gout |

| | | |16 |Greater Tuberosity Fracture |

| | | |17 |Hydroxyapatite Deposition Disease |

| | | |18 |Hip Dislocation |

| | | |19 |Hip Implant |

| | | |20 |Insufficiency Fractures, Appendicular |

| | | |21 |Juvenile Distal Forearm Fractures |

| | | |22 |Malleolar Fracture |

| | | |23 |Medial Condylar Fracture, Elbow |

| | | |24 |Metacarpal Fracture and Dislocation |

| | | |25 |Metatarsal Fracture |

| | | |26 |Osteonecrosis, Hip |

| | | |27 |Osteosarcoma, Conventional |

| | | |28 |Osteosarcoma, Parosteal |

| | | |29 |Pathologic Fracture |

| | | |30 |Pelvic Fracture, Unstable |

| | | |31 |Pilon Fracture |

| | | |32 |Pyrophosphate Arthropathy |

| | | |33 |Radial Head/Neck Fracture |

| | | |34 |Salter-Harris Fracture, Ankle |

| | | |35 |Scaphoid Fracture |

| | | |36 |Septic Arthritis |

| | | |37 |Sickle Cell Anemia: MSK Complications |

| | | |38 |Slipped Capital Femoral Epiphysis |

| | | |39 |Stress Fracture, Adult |

| | | |40 |Tibial Plateau Fracture |

| | | |41 |Transcondylar Fracture, Elbow |

Appendix B: knowledge objectives for the remainder of the rotations.

|Musculoskeletal Acute and Chronic Injury |

|  |General/systemic Injury |  |

|  |  |  |42 |Complications of Paraplegia |

|  |Soft tissue, non-specific location, extraarticular |

|  |  |  |43 |Hematoma |

|  |  |  |44 |Myositis Ossificans/Heterotopic Ossification |

|  |Muscle injury, non-specific location |

|  |  |  |45 |Muscle Injury |

|  |Neural injury |  |  |

|  |Periosteum |  |  |

|  |Joint |  |  |  |

|  |Fracture healing |  |  |

|  |Fractures with other contributing etiologies (other than acutely traumatic) |

|  |Fractures, Pediatric |  |

|  |  |  |46 |Physeal Injury (Salter-Harris) |

|  |  |  |47 |Incomplete Fractures |

|  |Other |  |  |  |

|  |  |  |48 |Lead Poisoning |

|  |  |  |49 |Chronic Repetitive Trauma |

|  |Injury to joint & adjacent osseous structures, shoulder girdle & humerus |

|  |  |Sternoclavicular joint & clavicle |

|  |  |Acromioclavicular joint |

|  |  |  |50 |Os Acromiale |

|  |  |  |51 |Traumatic Osteolysis, Distal Clavicle |

|  |  |Osseous structures, glenohumeral joint & humerus |

|  |  |  |52 |Posterior Glenohumeral Dislocation |

|  |  |  |53 |Humeral Head/Neck Fracture |

|  |  |  |54 |Little Leaguer's Shoulder |

|  |  |  |55 |Osteochondral Injury, Shoulder |

|  |  |Muscle injury, shoulder |

|  |  |  |56 |Parsonage-Turner Syndrome |

|  |  |  |57 |Pectoralis Injury |

|  |  |Rotator Cuff tendons |

|  |  |  |58 |Rotator Cuff Tendinopathy |

|  |  |  |59 |Rotator Cuff Partial Thickness Tear |

|  |  |  |60 |Calcific Rotator Cuff Tendinopathy |

|  |  |  |61 |Subscapularis Tear |

|  |  |  |62 |Rotator Cuff Full Thickness Tear |

|  |  |  |63 |Rotator Interval Tear |

|  |  |Biceps Tendon/anchorLabrum/Capsule |

|  |  |  |64 |Biceps Tendinopathy, Shoulder |

|  |  |  |65 |Normal Labral Variants |

|  |  |  |66 |Biceps Tendon Tear, Intraarticular |

|  |  |  |67 |Biceps Tendon Dislocation |

|  |  |  |68 |Posterior Labral Tear, Shoulder |

|  |  |  |69 |Inferior Glenohumeral Ligament Injury |

|  |  |  |70 |Bankart Lesion |

|  |  |  |71 |Perthes Lesion |

|  |  |  |72 |Multidirectional Instability, Shoulder |

|  |  |  |73 |GLAD/GARD Lesion |

|  |  |  |74 |SLAP Tear |

|  |  |Neural impingement |

|  |  |  |75 |Rotator Cuff Denervation Syndromes |

|  |  |  |76 |Suprascapular and Spinoglenoid Notch Cysts |

|  |Injury to joint & adjacent osseous structures, elbow & forearm |

|  |  |Tendons |  |  |

|  |  |  |77 |Biceps Tendon Injury, Elbow |

|  |  |  |78 |Common Extensor Tendon Injury, Elbow |

|  |  |  |79 |Common Flexor/Pronator Tendon Injury, Elbow |

|  |  |  |80 |Triceps Tendon Injury, Elbow |

|  |  |Ligaments |  |

|  |  |  |81 |Radial Collateral Ligament Injury |

|  |  |  |82 |Ulnar Collateral Ligament Injury |

|  |  |Soft tissue abnormalities, other |

|  |  |  |83 |Bicipioradial Bursitis |

|  |  |  |84 |Olecranon Bursitis |

|  |  |Osseous Trauma |

|  |  |  |85 |Capitellum Fracture |

|  |  |  |86 |Elbow Dislocation |

|  |  |  |87 |Lateral Condylar Fracture, Elbow |

|  |  |  |88 |Monteggia Injury |

|  |  |  |89 |Valgus Stress Mechanism/Little Leaguer's Elbow |

|  |  |  |90 |Forearm Fractures |

|  |  |Neural Impingement |

|  |  |  |91 |Radial Nerve Injury |

|  |  |  |92 |Median Nerve Injury |

|  |Injury to joint & adjacent osseous structures, wrist & hand |

|  |  |Ligaments, +/- carpal instability |

|  |  |  |93 |Intrinsic Ligament Tear, Wrist |

|  |  |  |94 |Carpal Instability |

|  |  |Tendons |  |  |

|  |  |  |95 |Extensor Tendon Injury, Wrist and Fingers |

|  |  |  |96 |Extensor Carpi Ulnaris Tendinitis |

|  |  |  |97 |Tenosynovitis, Wrist & Hand |

|  |  |Soft tissue abnormalities, other |

|  |  |Distal radius & ulna: osseous trauma |

|  |  |  |98 |Trauma-related Osteolysis in Children |

|  |  |Carpus: osseous trauma |

|  |  |  |99 |Carpal Fracture, Other than Scaphoid |

|  |  |  |100 |Carpal Impaction Syndromes |

|  |  |Distal Radioulnar Joint |

|  |  |Triangular Fibrocartilage Complex |

|  |  |  |101 |Triangular Fibrocartilage Complex Injury |

|  |  |Fingers |  |  |

|  |  |  |102 |Collateral Ligament Injury, Fingers and Thumb |

|  |  |  |103 |Flexor Tendon Injury, Wrist and Fingers |

|  |  |  |104 |Carpometacarpal Fractures |

|  |  |Neural impingement |

|  |  |  |105 |Nerve Entrapment Syndromes, Wrist |

|  |Injury to joint & adjacent osseous structures, spine |

|  |  |  |106 |Scheuermann Disease |

|  |Injury to joint & adjacent osseous structures, pelvis |

|  |  |Osseous trauma |

|  |  |  |107 |Pelvic Fracture, Stable |

|  |  |  |108 |Pelvic Stress and Insufficiency Fracture |

|  |  |  |109 |Osteitis Pubis, Nontraumatic Origin |

|  |  |  |110 |Pelvic Avulsion Fracture/Apophysitis |

|  |  |  |111 |Osteitis Pubis, Post-Traumatic |

|  |  |Tendons |  |  |

|  |  |Ligaments |  |

|  |  |Neural impingement |

|  |  |Soft tissue abnormalities, other |

|  |  |  |112 |Adductor Insertion Avulsion Syndrome |

|  |  |  |113 |Sports Hernia |

|  |Injury to joint & adjacent osseous structures, hip & femur |

|  |  |Osseous trauma |

|  |  |  |114 |Stress Injury, Leg |

|  |  |  |115 |Femoral Head Fracture |

|  |  |  |116 |Femoral Neck Fracture |

|  |  |  |117 |Subtrochanteric and Femoral Shaft Fracture |

|  |  |  |118 |Trochanteric and Intertrochanteric Fracture |

|  |  |Labroligamentous Pathology |

|  |  |  |119 |Femoral Acetabular Impingement |

|  |  |  |120 |Hip Labral Trauma, Postoperative |

|  |  |  |121 |Acetabular Labral Tear |

|  |  |Musculotendinous Injury |

|  |  |  |122 |Proximal Hamstring Injury |

|  |  |  |123 |Hip Flexor Injury |

|  |  |  |124 |Hip Adductor Injury |

|  |  |  |125 |Hip Internal and External Rotator Injury |

|  |  |Ligaments |  |

|  |  |Neural impingement |

|  |  |Soft tissue abnormalities, other |

|  |  |  |126 |Bursitis, Hip and Pelvis |

|  |Injury to joint & adjacent osseous structures, knee & leg |

|  |  |Osseous trauma |

|  |  |  |127 |Patellar Fracture |

|  |  |  |128 |Subchondral Fracture, Knee |

|  |  |  |129 |Osteochondral Injury, Knee |

|  |  |  |130 |Transient Patellar Dislocation |

|  |  |  |131 |Blount Disease |

|  |  |Menisci |  |  |

|  |  |  |132 |Discoid Meniscus |

|  |  |  |133 |Parameniscal Cyst |

|  |  |  |134 |Meniscal Ossicle |

|  |  |  |135 |Meniscal Radial Tear |

|  |  |  |136 |Other Displaced Meniscal Tears |

|  |  |  |137 |Meniscal Pitfalls and Variants |

|  |  |  |138 |Meniscal Vertical Longitudinal Tear |

|  |  |  |139 |Meniscal Horizontal Tear |

|  |  |  |140 |Meniscal Bucket-Handle Tear |

|  |  |  |141 |Meniscocapsular Separation |

|  |  |Anterior Cruciate ligament |

|  |  |  |142 |Anterior Cruciate Ligament Injury |

|  |  |  |143 |Anterior Cruciate Ligament: Postoperative Imaging |

|  |  |Posterior cruciate ligament |

|  |  |  |144 |Posterior Cruciate Ligament Injury |

|  |  |  |145 |Posterior Cruciate Ligament, Postoperative |

|  |  |Medial supporting structures |

|  |  |  |146 |Medial Collateral Ligament, Knee |

|  |  |  |147 |Posteromedial Corner Injury |

|  |  |  |148 |Pes Anserine Bursitis |

|  |  |Lateral supporting structures |

|  |  |  |149 |Lateral Collateral Ligament Complex, Knee |

|  |  |  |150 |Posterolateral Corner Injury |

|  |  |  |151 |Iliotibial Band Friction Syndrome |

|  |  |Extensor mechanism |

|  |  |  |152 |Patellar Tendon Tears & Tendinosis |

|  |  |  |153 |Osgood-Schlatter Disease |

|  |  |  |154 |Quadriceps Injury |

|  |  |  |155 |Patellar Malalignment |

|  |  |Cartilage |  |  |

|  |  |  |156 |Chondral Injury, Knee |

|  |  |  |157 |Articular Cartilage: Postoperative Imaging |

|  |  |Neural impingement |

|  |  |  |158 |Peroneal Nerve Injury |

|  |  |Muscle injury, leg |

|  |  |  |159 |Gastrocnemius Soleus Strain |

|  |  |Soft tissue abnormalities, other |

|  |  |  |160 |Intercondylar Notch Cyst |

|  |  |  |161 |Prepatellar and Pretibial Bursitis |

|  |  |  |162 |Popliteal Cyst |

|  |  |  |163 |Popliteus Myotendinous Injury |

|  |Injury to joint & adjacent osseous structures, ankle & foot |

|  |  |Tendons |  |  |

|  |  |  |164 |Posterior Tibial Tendon Tear and Tendinopathy |

|  |  |  |165 |Plantaris Tendon Injury |

|  |  |  |166 |Extensor Tendon Tear and Tendinopathy, Ankle |

|  |  |  |167 |Peroneal Tendon Tear and Tendinopathy |

|  |  |  |168 |Tears of Intrinsic Foot Muscles and Plantar Fascia |

|  |  |Ligaments |  |

|  |  |  |169 |Ankle Sprain |

|  |  |  |170 |Syndesmosis Ligament Injury, Ankle |

|  |  |  |171 |Lisfranc Ligament Injury |

|  |  |  |172 |MTP Ligament Injury, Digit 1 |

|  |  |  |173 |Deltoid Ligament Injury |

|  |  |  |174 |Anterior Impingement Syndrome, Ankle |

|  |  |Neural impingement |

|  |  |Soft tissue abnormalities |

|  |  |  |175 |Plantar Fasciitis |

|  |  |  |176 |Superficial Fibromatoses |

|  |  |Overuse syndromes |

|  |  |  |177 |Accessory Ossicles, Ankle and Foot |

|  |  |  |178 |Os Peroneum Syndrome |

|  |  |  |179 |Os Trigonum Syndrome |

|  |  |  |180 |Sesamoid Dysfunction |

|  |  |Osseous trauma |

|  |  |  |181 |Calcaneus Fracture, Nonarticular |

|  |  |  |182 |Talus Neck and Head Fracture |

|  |  |  |183 |Talus Dislocation |

|  |  |  |184 |Stress and Insufficiency Fracture, Ankle and Foot |

|  |  |  |185 |Chopart Dislocation |

|  |  |  |186 |Talar Body and Process Fracture |

|  |  |  |187 |Ankle Dislocation |

|  |  |  |188 |Osteochondral Injury, Ankle |

|  |  |  |189 |Navicular Fracture and Dislocation |

|  |  |  |190 |Lisfranc Fracture-Dislocation |

|Post-operative Findings |  |  |

|  |  |  |191 |Arthroplasty Loosening & Dislocation |

|  |  |  |192 |Arthroplasty Component Wear/Particle Disease |

|  |  |  |193 |Arthrodesis, Postoperative Appearance |

|  |  |  |194 |Wrist Arthrodesis/Other Postoperative Appearances |

|  |  |  |195 |Cement & Bone Fillers |

|  |  |  |196 |Arthroplasty Implant/Periprosthetic Fx |

|  |  |  |197 |Miscellaneous Hardware |

|  |  |  |198 |Anchoring Devices |

|  |  |  |199 |Revision Arthroplasty |

|  |  |  |200 |Knee Implant |

|  |  |  |201 |Shoulder Implant |

|Infection |  |  |  |  |

|  |  |  |202 |Paget Disease |

|  |  |  |203 |Chronic Recurrent Multifocal Osteomyelitis |

|  |  |  |204 |Necrotizing Fasciitis |

|  |  |  |205 |Brucellosis |

|  |  |  |206 |Soft Tissue Infection |

|  |  |  |207 |Spinal Infections |

|  |  |  |208 |Acute Osteomyelitis, Adult |

|  |  |  |209 |Acute Osteomyelitis, Child |

|  |  |  |210 |Chronic Osteomyelitis |

|  |  |  |211 |Tuberculosis |

|Bone Marrow |  |  |  |

|  |  |  |212 |Focal Marrow Infiltration and Replacement |

|  |  |  |213 |Thalassemia |

|  |  |  |214 |Extramedullary Hematopoiesis |

|  |  |  |215 |Increased or Decreased Marrow Cellularity |

|  |  |  |216 |Myelofibrosis |

|  |  |  |217 |Mucopolysaccharidoses |

|  |  |  |218 |Diffuse Marrow Infiltration and Replacement |

|  |  |  |219 |Gaucher Disease |

|  |  |  |220 |Bone Infarct |

|  |  |  |221 |Transient Bone Marrow Edema |

|  |  |  |222 |Osteonecrosis of Knee |

|  |  |  |223 |Legg-Calvé-Perthes |

|  |  |  |224 |Osteonecrosis of Wrist |

|  |  |  |225 |Osteonecrosis of Shoulder |

|Arthritis |  |  |  |  |

|  |Erosive pattern |  |  |

|  |  |Rheumatoid arthritis |

|  |  |  |226 |Rheumatoid Arthritis of Axial Skeleton |

|  |  |  |227 |Rheumatoid Arthritis of Ankle and Foot |

|  |  |  |228 |Rheumatoid Arthritis of Knee |

|  |  |  |229 |Rheumatoid Arthritis of Shoulder and Elbow |

|  |  |  |230 |Robust Rheumatoid Arthritis |

|  |  |  |231 |Rheumatoid Arthritis of Wrist and Hand |

|  |  |  |232 |Rheumatoid Arthritis of Hip |

|  |  |Non-rheumatoid arthritis, erosive |

|  |  |  |233 |Juvenile Idiopathic Arthritis (JIA) |

|  |Productive pattern |  |  |

|  |  |Osteoarthritis |  |

|  |  |  |234 |Osteoarthritis of Axial Skeleton |

|  |  |  |235 |Osteoarthritis of Shoulder and Elbow |

|  |  |  |236 |Osteoarthritis of Hip |

|  |  |  |237 |Osteoarthritis of Knee |

|  |  |  |238 |Osteoarthritis of Wrist and Hand |

|  |  |Non-joint based |

|  |  |  |239 |DISH |

|  |  |  |240 |OPLL |

|  |Mixed erosive and productive |

|  |  |  |241 |Ankylosing Spondylitis |

|  |  |  |242 |Psoriatic Arthritis |

|  |  |  |243 |Chronic Reactive Arthritis |

|  |  |  |244 |Inflammatory Bowel Disease Arthritis |

|  |Connective tissue disorders |

|  |  |  |245 |Systemic Lupus Erythematosus |

|  |  |  |246 |Progressive Systemic Sclerosis |

|  |  |  |247 |Inflammatory Myopathy |

|  |Arthritis due to biochemical disorders and depositional disease |

|  |  |  |248 |Amyloid Deposition |

|  |Miscellaneous joint disorders |

|  |  |  |249 |Pigmented Villonodular Synovitis (PVNS) |

|  |  |  |250 |Synovial Osteochondromatosis |

|  |  |  |251 |Hypertrophic Osteoarthropathy |

|Metabolic bone disease |  |  |

|  |  |  |252 |Hyperparathyroidism |

|  |  |  |253 |Primary Osteoporosis |

|  |  |  |254 |Disuse Osteoporosis |

|  |  |  |255 |Osteomalacia and Rickets |

|  |  |  |256 |Renal Osteodystrophy |

|  |  |  |257 |Dialysis-Related Disease, Spondyloarthropathy |

|Drug-induced & nutritional MSK conditions |

|  |  |  |258 |Steroids, Complications |

|  |  |  |259 |Scurvy |

|  |  |  |260 |Radiation-Induced Non-neoplastic Marrow & Soft Tissue Abnormalities |

|  |  |  |261 |AIDS Drug Therapy, Complications |

|  |  |  |262 |Complications of Prostaglandins |

|Venomous-induced conditions |  |

|Radiation induced conditions |  |  |

|  |  |  |263 |Radiation Osteonecrosis |

|  |  |  |264 |Radiation-Induced Osteochondroma |

|  |  |  |265 |Radiation-Induced Sarcoma |

|  |  |  |266 |Radiation-Induced Complications of the Skeleton |

|Osseous tumors |  |  |  |

|  |Bone-forming tumors |  |

|  |  |Benign |  |  |

|  |  |  |267 |Osteoma |

|  |  |  |268 |Osteoid Osteoma |

|  |  |  |269 |Enostosis (Bone Island) |

|  |  |  |270 |Osteoblastoma |

|  |  |Malignant |  |

|  |  |  |271 |Osteosarcoma, Secondary |

|  |  |  |272 |Osteosarcoma, Periosteal |

|  |  |  |273 |Osteosarcoma, Telangiectatic |

|  |Cartilage-forming tumors |

|  |  |Benign |  |  |

|  |  |  |274 |Enchondroma |

|  |  |  |275 |Osteochondroma |

|  |  |  |276 |Multiple Hereditary Exostoses |

|  |  |  |277 |Chondroblastoma |

|  |  |  |278 |Chondromyxoid Fibroma |

|  |  |  |279 |Periosteal Chondroma |

|  |  |Malignant |  |

|  |  |  |280 |Chondrosarcoma, Dedifferentiated |

|  |Fibrous tumors |  |  |

|  |  |Benign |  |  |

|  |  |  |281 |Desmoplastic Fibroma |

|  |  |Malignant |  |

|  |  |  |282 |Fibrosarcoma |

|  |  |  |283 |Malignant Fibrous Histiocytoma of Bone |

|  |Fatty tumors |  |  |

|  |  |  |284 |Intraosseous Lipoma |

|  |Giant Cell tumor |  |  |

|  |  |  |285 |Giant Cell Tumor |

|  |Epithelioid tumor |  |  |

|  |  |  |286 |Adamantinoma |

|  |Vascular tumors |  |  |

|  |  |  |287 |Angiosarcoma, Osseous |

|  |Neural tumors |  |  |

|  |  |  |288 |Chordoma |

|  |Marrow tumors |  |  |

|  |  |Myeloma |  |  |

|  |  |  |289 |Multiple Myeloma |

|  |  |  |290 |POEMS |

|  |  |  |291 |Plasmacytoma |

|  |  |Non-myelomatous marrow tumors |

|  |  |  |292 |Ewing Sarcoma |

|  |  |  |293 |Leukemia: Osseous Manifestations |

|  |  |  |294 |Lymphoma of Bone |

|  |Tumor-like lesions |  |  |

|  |  |  |295 |Langerhans Cell Histiocytosis |

|  |  |  |296 |Fibrous Dysplasia |

|  |  |  |297 |Simple Bone Cyst |

|  |  |  |298 |Aneurysmal Bone Cyst |

|  |  |  |299 |Fibroxanthoma |

|  |  |  |300 |Lower Extremity Variants, Other |

|  |Metastatic tumors |  |  |

|Soft Tissue tumors |  |  |  |

|  |Other |  |  |  |

|  |Adipocytic tumors |  |  |

|  |  |Benign |  |  |

|  |  |  |301 |Lipoma, Soft Tissue |

|  |  |  |302 |Hibernoma |

|  |  |  |303 |Lipomatosis, Nerve |

|  |  |  |304 |Parosteal Lipoma |

|  |  |  |305 |Lipoma Arborescens, Knee |

|  |  |Intermediate (Locally Aggressive) |

|  |  |  |306 |Atypical Lipomatous Tumor |

|  |  |Malignant |  |

|  |  |  |307 |Liposarcoma, Myxoid |

|  |  |  |308 |Liposarcoma, Pleomorphic |

|  |Fibroblastic/Myofibroblastic Tumors |

|  |  |Benign |  |  |

|  |  |  |309 |Elastofibroma |

|  |  |Intermediate (Locally Aggressive) |

|  |  |  |310 |Desmoid-Type Fibromatosis |

|  |  |Intermediate (Rarely Metastasizing) |

|  |  |Malignant |  |

|  |So-called Fibrohistiocytic Tumors |

|  |  |Benign |  |  |

|  |  |  |311 |Giant Cell Tumor Tendon Sheath |

|  |  |  |312 |Xanthoma |

|  |  |Intermediate (Rarely Metastasizing) |

|  |  |Malignant |  |

|  |  |  |313 |Pleomorphic MFH/Undifferentiated Pleomorphic Sarcoma |

|  |  |  |314 |Dermatofibrosarcoma Protuberans |

|  |Smooth Muscle Tumors |  |

|  |  |Benign |  |  |

|  |  |Malignant |  |

|  |Pericytic (Perivascular) Tumors |

|  |  |  |315 |Glomus Tumor |

|  |Skeletal Muscle Tumors |  |

|  |  |Benign |  |  |

|  |  |Malignant |  |

|  |Vascular & lymphatic tumors |

|  |  |Benign |  |  |

|  |  |  |316 |Hemangioma, Soft Tissue |

|  |  |  |317 |Klippel-Trenaunay-Weber Syndrome |

|  |  |Intermediate (Locally Aggressive) |

|  |  |Intermediate (Rarely Metastasizing) |

|  |  |Malignant |  |

|  |  |  |318 |Angiosarcoma of Soft Tissue |

|  |Chondro-Osseous Tumors |

|  |  |  |319 |Extraskeletal Osteosarcoma |

|  |  |  |320 |Intraarticular Chondroma |

|  |Tumors of Uncertain Differentiation |

|  |  |Benign |  |  |

|  |  |  |321 |Intramuscular Myxoma |

|  |  |Intermediate (Rarely Metastasizing) |

|  |  |Malignant |  |

|  |  |  |322 |Synovial Sarcoma |

|  |Peripheral Nerve Sheath Tumors |

|  |  |Non-neoplastic Lesions |

|  |  |  |323 |Morton Neuroma |

|  |  |  |324 |Traumatic Neuroma |

|  |  |Neurofibroma |  |

|  |  |  |325 |Neurofibroma |

|  |  |Schwannoma |  |

|  |  |  |326 |Schwannoma |

|  |  |Nerve Sheath Myxoma |

|  |  |Perineurioma |  |

|  |  |Granular Cell Tumor |

|  |  |Malignant Peripheral Nerve Sheath Tumor (MPNST) |

|  |  |  |327 |Malignant Peripheral Nerve Sheath Tumor |

|  |Skin and Subcutanious Lesions |

|  |  |  |328 |Rheumatoid Nodule |

|Congenital, Familial, & Developmental Conditions |

|  |Generalized |  |  |

|  |  |  |329 |Arthrogryposis |

|  |  |  |330 |Fibrodysplasia Ossificans Progressiva |

|  |  |  |331 |Neurofibromatosis |

|  |  |  |332 |Osteogenesis Imperfecta |

|  |Upper extremity disorders |

|  |  |  |333 |Madelung Deformity |

|  |  |  |334 |Glenoid Hypoplasia |

|  |  |  |335 |Ulnar Variance |

|  |  |  |336 |Carpal Coalition |

|  |Lower extremity disorders |

|  |  |  |337 |Developmental Dysplasia of the Hip |

|  |  |  |338 |Proximal Femoral Focal Deficiency |

|  |Foot deformities |  |  |

|  |  |Contenital foot deformities |

|  |  |  |339 |Club Foot (Talipes Equinovarus) |

|  |  |  |340 |Congenital Vertical Talus (Rocker Bottom Foot) |

|  |  |  |341 |Pes Planus (Flatfoot) |

|  |  |Acquired |  |  |

|  |  |Tarsal coalitions |

|  |  |  |342 |Tarsal Coalition |

|  |Other (Nongeneralized Conditions) |

|Displasias |  |  |  |

|  |Skeletal dysplasias |  |  |

|  |  |Dwarfism |  |  |

|  |  |  |343 |Achondroplasia |

|  |  |  |344 |Spondyloepiphyseal Dysplasia |

|  |  |  |345 |Thanatophoric Dwarfism |

|  |  |Non-dwarfing dysplasias |

|  |  |  |346 |Ollier Disease |

|  |  |  |347 |Cleidocranial Dysplasia |

|  |  |  |348 |Maffucci Syndrome |

|  |  |  |349 |Nail Patella Disease (Fong) |

|  |  |Sclersing dysplasias |

|  |  |  |350 |Melorheostosis |

|  |  |  |351 |Intramedullary Osteosclerosis |

|  |  |  |352 |Pycnodysostosis |

|  |  |  |353 |Osteopoikilosis |

|  |  |  |354 |Progressive Diaphyseal Dysplasia |

|  |  |  |355 |Osteopetrosis |

|Musculolkeletal Complications of Systemic Diseases |

|  |Diabetes |  |  |  |

|  |  |  |356 |Diabetes: MSK Complications |

|  |  |  |357 |Dialysis-Related Disease, Metastatic Calcification |

|  |HIV-AIDS |  |  |  |

|  |  |  |358 |HIV-AIDS |

|  |Hemophilia |  |  |

|  |  |  |359 |Hemophilia: MSK Complications |

|  |Syphilis |  |  |  |

|  |Sarcoidosis |  |  |

|  |  |  |360 |Sarcoidosis, Bone |

|  |Vascular Disease |  |  |

|  |Other |  |  |  |

|  |Polio |  |  |  |

|Anatomic Variants |  |  |  |

|  |Lower Extremity |  |  |

|  |  |  |361 |Dorsal Defect Patella |

|  |  |  |362 |Gastrocnemius Muscle Variant |

|  |  |  |363 |Talar Ridge |

|  |  |  |364 |Accessory Muscles, Ankle and Foot |

|  |Upper Extremity |  |  |

|  |  |  |365 |Buford Complex |

|  |  |  |366 |Sublabral Foramen |

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