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Prepare trainees to be on call for the emergency department with this specialized training series.
Library Memberships
Save 30% for Black FridayOn-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Save 30% for Black FridayPractice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Save 40% for Black FridayUnlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
Who We Serve
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
1 topic, 1 min.
19 topics, 1 hr. 35 min.
Clinical Scenario 1 - Orbital Trauma/Inflammation - Introduction Video
2 m.Case 1 - Anterior Segment Ocular Injury
9 m.Case 1 - Ocular Injury/Globe Anatomy
6 m.Case 2 - Choroidal Detachment, Retinal Detachment, Vitrious Hemorrhage, Orbital Floor Fracture
9 m.Case 2 - Orbit: Foreign Body (Updated)
8 m.Case 2 - Orbit: Non-accidental Trauma (Updated)
3 m.Case 2 - Early Ocular Intervention
6 m.Case 2 - Non-Ocular Orbital Trauma
3 m.Case 2 - Orbital Wall Fracture
8 m.Case 2 - Orbital Medial Wall Fracture
8 m.Case 2 - Orbital Apex and Roof Fracture
5 m.Case 2 - Orbital Blow Out Fractures
6 m.Case 2 - Orbital Trauma
5 m.Case 2 - Indications for Surgery
4 m.Case 3 - Orbital Cellulitis, Periorbital Abscess
6 m.Case 3 - Orbital Inflammation
5 m.Case 4 - Pediatric Subperiosteal Abscess
4 m.Case 4 - Orbital Pseudotumor
7 m.Orbital Trauma/Inflammation Lesson Reinforcement Quiz
29 topics, 1 hr. 34 min.
Clinical Scenario 2 - Facial/Neck Trauma - Video Introduction
6 m.Case 5 - Cominuted Nasal Bone Fracture
2 m.Case 5 - Multiple Fractures in Nasal Bones
3 m.Case 5 - Nasal Bone Fracture Summary
3 m.Case 5 - Mandibular Fractures
6 m.Case 5 - Displaced Mandible Fracture At the Angle
3 m.Case 5 - Midface Butresses
3 m.Case 5 - Naso-orbito-ethmoid Fractures
5 m.Case 5 - NOE Fracture
3 m.Case 5 - Midface NOE Fracture
3 m.Case 5 - Le Fort Fractures
7 m.Case 5 - Bilateral Le Fort 1 & 2 Fractures
4 m.Case 5 - Bilateral Le Fort 1, Unilateral Le Fort 2 & 3
4 m.Case 5 - Le Fort Summary
1 m.Case 5 - Zygomaticomaxillary Complex (Tripod) Fracture
5 m.Case 5 - Tripod Fracture
3 m.Case 5 - ZMC Summary
2 m.Case 5 - Capo de Tutti Fractures
5 m.Case 6 - Bilateral Temporal Bone Fractures
9 m.Case 6 - Temporal Bone Fractures
2 m.Case 7 - Complications of Temporal Bone Injury
3 m.Case 8 - Temporal Bone Fracture Summary
3 m.Case 9 - Transverse Sinus Injury
3 m.Case 10 - Dissection, pseudo aneurysm
5 m.Case 11 - Bilateral Dissection
4 m.Case 12 - Horner's Syndrome, MS, Dissection
5 m.Case 12 - Horner's Syndrome
5 m.Case 12- Airway Injury
4 m.Facial/Neck Trauma Lesson Reinforcement Quiz
12 topics, 46 min.
Clinical Scenario 3 - Sore Throat Pain and Fever - Video Introduction
1 m.Case 13 - Tonsillitis
6 m.Case 13 - Peritonsillar Abscess
5 m.Case 14 - Phlegmon
6 m.Case 15 - Epiglotitis, Super Glotitis, Air Way Compromise
7 m.Case 16 - Periodontal Disease
9 m.Case 16 - Ludwig's Angina
3 m.Case 16 - Summary: Ludwig's Angina
3 m.Case 17 - Ludwig's Angina, Sialadinitis
4 m.Case 17 - Lemierre's Syndrome
2 m.Case 17 - Malignant Otitis Externa
6 m.Sore Throat Pain and Fever Lesson Reinforcement Quiz
12 topics, 42 min.
Clinical Scenario 4 - Mass in the Neck - Video Introduction
4 m.Case 18 - T Cell Lymphoma, lymphadenopathy
4 m.Case 18 - Retropharyngeal Space
3 m.Case 19 - Retropharyngeal Abscess
4 m.Case 20 - Retropharyngeal Phlegmon
3 m.Case 20 - Retropharyngeal Space Collections
4 m.Case 20 - Afebrile
7 m.Case 21 - 2nd Branchial Cleft Cyst
4 m.Case 22 - Thyroglossal Duct Cyst
5 m.Case 22 - Sarcoma in the Levator Scapuli
2 m.Case 22 - Thyroid Nodules
9 m.Mass in the Neck Lesson Reinforcement Quiz
27 topics, 1 hr. 42 min.
Clinical Scenario 5 - Cervical Spine Trauma - Video Introduction
7 m.Case 23 - Occipital Condyle Fracture
2 m.Case 24 - Anterior Arch C1 Fracture
6 m.Case 25 - Odontoid Fracture
4 m.Case 25 - How to Diagnose Alanto-odontoid Distraction
5 m.Case 25 - Odontoid Fractures: Summary
5 m.Case 26 - Jefferson Fracture, vertebral dissection
4 m.Case 27 - Jefferson Fracture on MRI
7 m.Case 27 - Jefferson's Burst Fracture: Summary
4 m.Case 27 - Fixed Rotatory Subluxation
4 m.Case 28 - Bilateral Jumped Facet
9 m.Case 28 - Unilateral Facet Dislocation, Carotid Dissection
4 m.Case 28 - Hyperextension Injury
4 m.Case 28 - Cervical Spine Flexion Injury
6 m.Case 29 - Transverse process fracture
3 m.Case 30 - Unstable Fracture, Two Column Injury
6 m.Case 30 - Epidural Hematoma Summary
7 m.Case 31 - Facet Fracture, Vertebral Artery Occlusion
4 m.Case 31 - Spinal Cord Injury Without Radiographic Abnormalities
4 m.Case 31 - Thoracolumbar AO Spine Injury Score
2 m.Case 32 - Chance Fracture
2 m.Case 32 - Axial Loading Fractures
5 m.Case 33 - Lumbar Transverse Process Fracture
2 m.Case 33 - Transverse Process Fractures and Visceral Injury
3 m.Case 34 - Compression Fracture
4 m.Case 34 - Compression Fracture & Stress Injury
3 m.Cervical Spine Trauma Lesson Reinforcement Quiz
9 topics, 28 min.
Clinical Scenario 6 - Fever, Back Pain - Video Introduction
2 m.Case 35 - Discitis, Osteomyelitis
5 m.Case 35 - Diskitis: Summary
6 m.Case 36 - Tuberculous Spondylitis with Psoas Abscess
4 m.Case 37 - Spinal Cord Infarct
5 m.Case 38 - Spinal Cord Astrocytoma
2 m.Case 39 - Guillain-Barré Syndrome
2 m.Case 39 - Grisel Syndrome, Calcific Tendonitis of Longus Coli,
6 m.Fever, Back Pain Lesson Reinforcement Quiz
13 topics, 37 min.
Head and Neck Emergencies - Video Introduction
8 m.Case 40 - Fungus Ball
2 m.Case 40 - Fungal Sinusitis
2 m.Case 40 - Allergic Fungal Rhinosinusitis
7 m.Case 41 - Invasive Fungal Sinusitis
4 m.Case 41 - Invasive Fungal Sinusitis Imaging Signs
4 m.Case 42 - Necrotizing Fasciitis
4 m.Case 42 - Necrotizing Fasciitis: Summary
2 m.Case 43 - Allergic Fungal Sinusitis with Mucocele
2 m.Case 43 - Epidural Abscess from Sinusitis
3 m.Case 44 - Otomastoiditis with Bezold abscess
2 m.Case 45 - Frontal Lobe Abscess, Sinusitis
3 m.Head and Neck Emergencies Lesson Reinforcement Quiz
Interactive Transcript
Report
Dr. Yousem has provided the following report as a sample report for your reference. It does not match the case reviewed in the video.
Procedure: MRI LUMBAR SPINE WITHOUT AND WITH CONTRAST
INDICATION: History of polysubstance abuse, hepatitis C, L4-L5 osteomyelitis discitis, wheelchair dependence, presenting with 2 day history of worsening back pain. Concern for osteomyelitis.
COMPARISON: CRISP MRI lumbar spine report from 6/6/2020-images not available. Lumbar spine radiograph from 5/5/2014.
TECHNIQUE/PROTOCOL: Standard protocol lumbar spine pre and post contrast MRI performed.
CONTRAST: 8 mL Gadavist IV administered without acute adverse event. IV contrast was administered to improve disease detection and further define anatomy.
LUMBAR SPINE FINDINGS:
Alignment: Mild retrolisthesis L4 over L5 secondary to destructive intervertebral disc changes.
Spinal Cord and Cauda Equina: Crowding of the cauda equina nerve roots related to sever stenosis at L4-L5 as detailed below. Severe spinal canal stenosis at L4-L5 secondary to L4 retrolisthesis, and anterior epidural phlegmonous changes, and prominent posterior vertebral fat.
Conus: The conus terminates at approximately L1-L2.
Marrow Signal: Decreased T1 signal and increased T2/STIR signal within L4-L5 vertebral bodies with also note of associated enhancement on the postcontrast images.
Enhancement: Abnormal enhancement noted within the intervertebral disc space, prevertebral soft tissues, and the anterior epidural space at the L4-L5 level. Heterogeneous increased T2/STIR signal and enhancement within L5-S1 intervertebral disc.
Multiple nonenhancing areas are seen within the intervertebral disc space, measuring up to 1.3 cm., compatible with small abscess formations
Epidural Space: Enhancing T2/STIR hyperintense anterior epidural soft tissue at the L4-L5 level measuring approximately 0.8 cm in anterior dimension causing effacement of the CSF space with crowding of cauda equina roots. Phlegmonous changes extend into the bilateral lateral recesses causing severe bilateral neuroforaminal narrowing.
Vertebral Body Heights: Destructive erosions of vertebral bodies adjacent to L4-L5 disc space. Mild degenerative disc height loss at L5-S1.
Intervertebral Discs: Aggressive enhancing erosion of L4-L5 disc with severe disc expansion.
Disc Bulge or Herniation: Prominent L4-L5 disc expansion causing severe bilateral neural foraminal narrowing and severe canal stenosis. Moderate disc bulge and ligamentum flavum thickening at L5-S1 causing moderate spinal canal stenosis and moderate bilateral neuroforaminal narrowing. Mild disc bulge and ligamentum flavum thickening at L3-L4 causing mild spinal canal stenosis and mild bilateral neuroforaminal narrowing.
Prevertebral/Paraspinal Soft Tissues: T2/STIR heterogeneous enhancing prevertebral phlegmonous collection extending from L4 through L5-S1 intervertebral space measuring up to 0.8 cm in AP diameter, with mild elevation of the anterior longitudinal ligament, and apparent obliteration of fat planes between bilateral psoas muscles. Moderate edema noted within the paraspinal soft tissues extending from L1 through inferior sacral spine.
Visualized Surrounding Organs and Viscera: Unremarkable.
IMPRESSION:
1. L4-L5 discitis-osteomyelitis with prominent expansion of the intervertebral disc containing multiple nonenhancing loculations/abscesses measuring up to 1.3 cm. Phlegmonous formation with anterior epidural extension and resultant near complete effacement of CSF space, along with prominent posterior epidural fat, contributing to severe spinal canal stenosis at this level. The phlegmonous formation extends into the bilateral lateral recess and contributes to severe neural foraminal stenosis. Of note there is no prior cross-sectional imaging available for comparison.
2. Mild extension of the phlegmonous formation into the medial aspect of the bilateral psoas muscles with no evidence of abscess formation within the muscles.
3. Heterogeneous signal within L5-S1 intervertebral disc is indeterminate and recommend attention on follow-up imaging.
4. Multilevel degenerative disease, most prominent at L5-S1 with moderate bilateral neuroforaminal narrowing.
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