Pocket Atlas of Sectional Anatomy, Volume III Spine,

Extremities, Joints Computed Tomography and Magnetic

Resonance Imaging 2nd Edition

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Pocket Atlas of
Sectional Anatomy
Computed Tomography and
Magnetic Resonance Imaging

Volume III
Spine, Extremities, Joints

Torsten B. Moeller, MD
Department of Radiology
Marienhaus Klinikum
Saarlouis/Dillingen, Germany

Emil Reif, MD
Department of Teleradiology
reif & moeller diagnostic-network
Dillingen, Germany

Second Edition
725 illustrations

Thieme
Stuttgart · New York · Delhi · Rio de Janeiro
IV

Library of Congress Cataloging-in-Publica- Important note: Medicine is an ever-changing

tion Data is available from the publisher. science undergoing continual development. Re-
search and clinical experience are continually ex-
Original translation of 1st edition by Barbara panding our knowledge, in particular our knowl-
Herzberger, MD, Munich, Germany edge of proper treatment and drug therapy. Inso-
far as this book mentions any dosage or applica-
tion, readers may rest assured that the authors,
Illustrator: Barbara Gay, Stuttgart, Germany
editors, and publishers have made every effort to
ensure that such references are in accordance
1st French edition 2008 with the state of knowledge at the time of pro-
1st Greek edition 2014 duction of the book.
1st Hungarian edition 2010 Nevertheless, this does not involve, imply, or ex-
1st Italian edition 2007 press any guarantee or responsibility on the part
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1st Korean edition 2010 tions and forms of applications stated in the book.
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1st Russian edition 2010 and to check, if necessary in consultation with a
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stated by the manufacturers differ from the state-
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© 2007, 2017, Georg Thieme Verlag KG tion is particularly important with drugs that are
either rarely used or have been newly released on
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 V

For my American relatives

Bernie and Arlene, Bryan and Nancy,

Rick, Krista, and Ella Rose, Bill, Kayla,
Abby and Liviana, Shirley, Mike,
Austin and Amanda, Michael and
Kendall, Audrey, Mike and Kristen,
Katelyn and Matt, Claudia and Larry,
Bryan and Stacy, Jamie and Shawn,
Meghan and Jason
 VII

Contents

Upper Extremity ........................................ 1

Arm, Axial ............................................................... 2
Shoulder, Coronal ..................................................... 70
Shoulder, Sagittal ...................................................... 82
Upper Arm, Coronal ................................................... 96
Upper Arm, Sagittal ................................................... 108
Elbow, Coronal ......................................................... 124
Elbow, Sagittal ......................................................... 132
Lower Arm, Sagittal ................................................... 142
Lower Arm, Coronal ................................................... 154
Hand, Coronal .......................................................... 164
Hand, Sagittal .......................................................... 172

Lower Extremity ........................................ 185

Leg, Axial ................................................................ 186
Hip, Coronal ............................................................ 254
Hip, Sagittal ............................................................ 266
Thigh, Coronal ......................................................... 280
Thigh, Sagittal ......................................................... 292
Knee, Coronal .......................................................... 302
Knee, Sagittal .......................................................... 318
Lower Leg, Coronal .................................................... 338
Lower Leg, Sagittal .................................................... 348
Foot, Coronal ........................................................... 358
Foot, Sagittal ........................................................... 382
 Spinal Column ........................................... 395
Spine, Sagittal .......................................................... 396
Cervical Spine, Sagittal ............................................... 398
Cervical Spine, Coronal ............................................... 404
Cervical Spine, Axial ................................................... 408
Thoracic Spine, Sagittal ............................................... 420
Thoracic Spine, Axial .................................................. 426
Lumbar Spine, Sagittal ................................................ 428
Lumbar Spine, Coronal ................................................ 436
Lumbar Spine, Axial .................................................... 442
Sacrum .................................................................. 448

Further Reading ........................................................ 452

Index ..................................................................... 454
 IX

Preface

We have been greatly gratified and much encouraged by the very

positive responses to our volume III of the Pocket Atlas of Sectional
Anatomy, the “Musculoskeletal Atlas,” and by its wide distribution
and the many foreign-language editions. This success was a spur to
further improvements. Accordingly, to the existing images of the
first edition, which focus on the regions in the proximity of the
joints, we have added new images and illustrations of the complete
upper and lower arm and thigh and lower leg in two planes. With
these we bridge and fill the previous gap regarding bone or soft tis-
sue lesions of the diaphysis such as those caused by inflammation or
tumors. The regular structure of the book has been preserved: the
uniform color schemes for the different muscles, vessels, nerves, and
other anatomical structures; and the comparison of high-quality
(3-tesla) magnetic resonance images with the drawings. We thus
hope to achieve precision and clarity and to facilitate locating and
identifying the relevant anatomical structures.
As with the other volumes, the work would not have been possible
without the invaluable support of so many dedicated assistants. We
express our cordial thanks to all of them.
Special thanks go to Carina Engler for her consistent commitment to
obtaining optimal images and to our entire MRI team, as well as to
Nicole Bigga for making the 3-tesla images.
We wish the readers of this book once again as much pleasure and
joy in using it as we had in making the images and the illustrations.

Torsten B. Moeller, MD
Emil Reif, MD
 Color Code: Upper Extremity 1

Arteries Radial Muscles of Lower Arm:

Brachioradialis
Nerves
Extensor carpi radialis longus
Veins and Extensor carpi radialis brevis
Bones Volar Muscles of Lower Arm
(superficial layer):
Fatty tissue
Pronator teres
Cartilage Flexor digitorum superficialis
Tendon Flexor carpi radialis and flexor carpi ulnaris
Palmaris longus and palmaris brevis
Disk, labrum etc.
Volar Muscles of Lower Arm
Fluid (deep layer):
Muscles of Trunk: Flexor digitorum profundus
Serratus anterior Flexor pollicis longus
Omohyoid Pronator quadratus
Trapezius Muscles of Little (Fifth) Finger:
Subclavius Abductor digiti minimi brevis
Intercostal Flexor digiti minimi brevis
Muscles of Shoulder: Opponens digiti minimi
Deltoid Muscles of Thumb:
Infraspinatus Abductor pollicis longus
Pectoralis major and pectoralis minor and abductor pollicis brevis
Subscapularis Opponens pollicis
Coracobrachialis Flexor pollicis brevis
Latissimus dorsi Adductor pollicis
Dorsal Muscles of Lower Arm:
Supinator
Extensor pollicis longus and brevis
Extensor indicis
Muscles of Hand:
Dorsal and palmar interosseous
Lumbrical
Volar Muscles of Upper Arm:
Biceps brachii
Brachialis
Dorsal Muscles of Upper Arm:
Triceps brachii
Anconeus
Dorsal Muscles of Lower Arm
(superficial layer):
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
2 Upper Extremity
 Arm, Axial 3

1 Trapezius muscle 11 Supraspinatus muscle

2 Deltoid muscle (clavicular part) (central tendon)
3 Clavicle 12 Rib
4 Coracoclavicular ligament 13 Deltoid muscle (spinal part)
5 Acromioclavicular joint 14 Serratus anterior muscle
6 Suprascapular artery and vein 15 Supraspinatus muscle
7 Acromion (dorsal ligament)
8 Subclavius muscle 16 Supraspinatus muscle
9 Deltoid muscle (acromial part) (ventral ligament)
10 Omohyoid muscle 17 Spine of scapula
4 Upper Extremity
 Arm, Axial 5

1 Coracohumeral ligament 12 Serratus anterior muscle

2 Deltoid muscle (clavicular part) 13 Superior glenoid labrum
3 Middle glenohumeral ligament 14 Rib
4 Coracoid process 15 Glenoid
5 Supraspinatus muscle (tendon) 16 Internal intercostal muscle
6 Clavicle 17 Deltoid muscle (spinal part)
7 Humerus (greater tubercle) 18 External intercostal muscle
8 Subclavius muscle 19 Infraspinatus muscle
9 Deltoid muscle (acromial part) 20 Supraspinatus muscle
10 Coracoclavicular ligament 21 Spine of scapula
11 Head of humerus
6 Upper Extremity
 Arm, Axial 7

1 Coracohumeral ligament 15 Head of humerus

2 Deltoid muscle (clavicular part) 16 Glenoid
3 Middle glenohumeral ligament 17 Superior glenoid labrum
4 Coracoid process 18 Rib
5 Humerus (lesser tubercle) 19 Infraspinatus muscle
6 Pectoralis major muscle (tendon attachment)
7 Biceps brachii muscle 20 Coracoclavicular ligament
(long head, tendon) 21 Spine of scapula
8 Clavicle 22 Lung
9 Intertubercular sulcus (bicipital 23 Deltoid muscle (spinal part)
groove) 24 Internal and external intercostal
10 Pectoralis minor muscle (tendon) muscles
11 Humerus (greater tubercle) 25 Supraspinatus muscle
12 Subclavius muscle 26 Suprascapular artery, vein and nerve
13 Deltoid muscle (acromial part) 27 Infraspinatus muscle
14 Brachial plexus 28 Serratus anterior muscle