Dramatic change has been seen in the treatment of shoulder girdle neoplasia. Forequarter amputation was once the treatment of choice for aggressive tumors in this area. Today, the great majority are treated with limb-sparing procedures like the Tikhoff-Linberg resection, which involves removal of the scapula, humeral head, outer 1/3 of the clavicle, and surrounding soft tissue. With advancements in surgical and endoprosthetic technology, expectations of surgeons and patients have increased and limb preservation without reasonable function is no longer acceptable. Accordingly, the goal of modern skeletal reconstructions is to maintain near normal hand and elbow function by stabilizing the shoulder. The most recent techniques also attempt to restore some shoulder function. Published reports documenting these notoriously difficult procedures and their post-operative imaging findings are scarce.
Describe the key anatomic or physiologic issues, imaging findings or imaging technique the proposed exhibit will address:
Limb-sparing resection for shoulder girdle malignancies can leave a flail upper extremity. Endoprosthetic replacement of the scapula is a novel strategy used to maintain normal function in the unaffected part of the upper extremity, and to restore some shoulder range of motion. This exhibit will highlight pre-operative indications and contraindications seen on plain films, CT, and MR imaging. Moreover, it will demonstrate normal imaging findings and common complications on post-operative imaging including, for example, endoprosthetic dislocation or loosening, and tumor recurrence.
Describe the format (didactic, quiz, interactive, etc.) and organizational structure (by pathology, by imaging technique, etc.) of the proposed exhibit:
This will be a website containing didactic text and numerous operative photos, plain film, CT, and MR images, as well as patient videos. Viewers will navigate the site using a toolbar located on each page that contains links to pages including: prevalence of shoulder neoplasia, relevant shoulder anatomy, mechanisms of tumor spread, historical therapeutic perspectives, surgical options, surgical indications, operative techniques, methods of reconstruction, implant types, pre and post-operative imaging findings, and patient functionality.