Musculoskeletal, Spine, and Extremity Imaging Anatomy — WACS Viva & Clinical Scenarios (Radiological Anatomy and Normal Imaging Variants)

Exam-style musculoskeletal, spine, and extremity imaging anatomy viva scenarios with examiner probes and model answers for Radiology candidates.

Scenarios covered

• SCENARIO 1: Lumbar Spine Neural Foramen and Canal Architecture (Image-Based OSPE Station): Examine the provided multiplanar (axial and sagittal T1- and T2-weighted) magnetic resonance images of the lumbosacral junction. Identify the boundaries of the right L4/L5 neural exit foramen, distinguish the spatial orientation of the exiting versus traversing nerve roots relative to the intervertebral disc, and specify the structural components of the lateral recess and subarticular zone.
• SCENARIO 2: Shoulder Joint and Rotator Cuff Multiplanar Anatomy (Image-Based OSCE / Film Reading Station): Examine the provided coronal oblique, sagittal oblique, and axial T2-weighted fat-suppressed magnetic resonance images and anteroposterior radiograph of the shoulder. Delineate the insertion footprints of the supraspinatus, infraspinatus, teres minor, and subscapularis tendons. Identify the osseous and soft-tissue boundaries of the coracoacromial arch and the structures forming the rotator interval.
• SCENARIO 3: Wrist, Triangular Fibrocartilage Complex, and Carpal Tunnel (Multi-modality Station): Examine the provided coronal T1/proton density-weighted magnetic resonance images and axial wrist CT images. Outline the anatomic components and osseous attachments of the triangular fibrocartilage complex (TFCC). Define the rigid boundaries of the carpal tunnel and Guyon canal, listing the exact contents coursing within each fibro-osseous space.
• SCENARIO 4: Knee Meniscoligamentous and Extrinsic Stabilizing Complexes (OSPE Station): Examine the provided sagittal, coronal, and axial proton density fat-suppressed MR images of the adult knee. Delineate the origins, courses, and tibial/femoral insertion points of the anterior and posterior cruciate ligaments. Contrast the morphology and peripheral capsular attachments of the medial and lateral menisci, identifying the popliteus tendon hiatus and posterolateral corner components.
• SCENARIO 5: Craniovertebral Junction and Cervical Spine Ligamentous Anatomy (Radiographic and Cross-Sectional Station): Examine the provided open-mouth odontoid radiograph, sagittal reconstructions of a non-contrast cervical CT, and mid-sagittal T2-weighted MRI. Describe the precise osseous landmarks of the atlanto-axial and atlanto-occipital joints, and identify the primary stabilizing ligaments securing the dens against the anterior arch of the atlas.