Skeletal Radiology最新文献

Degloving muscle injury was described for the rectus femoris where the inner bipennate component is dissociated from its superficial unipennate component. The semimembranosus muscle displays a distinctive dual morphology, featuring both unipennate and bipennate muscle fibers. Nevertheless, this specific tear pattern has not been previously documented. Conversely, the adductor longus muscle showcases an elongated intramuscular tendon segment, indicating a multipennate morphology. We present two separate cases of previous undescribed degloving injuries of the semimembranosus and the adductor longus in teenage soccer players with MRI and ultrasound diagnosis, ultrasound-guided hematoma aspiration, and recovery timelines for return-to-play.

Soccer is the most popular sport worldwide, and it is associated with high injury rates, with most of these injuries occurring in the lower extremities. Particularly, in youth soccer players with immature skeleton, the physeal plate is two to five times weaker than the surrounding fibrous structures, and therefore more vulnerable to injury. The physeal plate consists of epiphyses and apophyses, with the former serving as tendon attachment sites and being subject to traction forces. There are two types of apophyseal injury: (i) apophyseal avulsion, which consists of an acute separation across the physeal plate; and (ii) apophysitis, an injury caused by chronic and repetitive contraction of musculotendon unit, leading to inflammation of the growth plate cartilage. Apophyses of the hip and pelvis are the most commonly injured in youth soccer players, due to vigorous contractions during sports activities and the fact that they tend to fuse later compared to other epiphyseal centers, making them more susceptible to injury. In this review, we will discuss the anatomy of lower limb apophyses and clinical and imaging findings of apophyseal injuries in youth soccer players, as well as briefly review treatment options and complications.

Imaging of the axial skeleton is a critical component of the diagnosis, management and follow-up of axial spondyloarthritis which may be difficult on clinical grounds and biological data alone. The sacroiliac joints (SIJ) are anatomically complex with high incidence of normal variation and degenerative change and techniques used to image the SIJ vary widely. Interpretation of MRI scans of the axial skeleton is facilitated by employing consistent protocols in which sequences are designed for the sensitive detection of inflammatory lesions, fat metaplasia and bone erosion. Considerable research has been undertaken in recent years to improve the accuracy of detection of these findings in early disease and detection of structural damage changes that would allow improvements in diagnosis and management of SpA patients. This review will examine recent advances in our understanding of axSpA and discuss innovations in MRI and CT, focusing on how to optimize a standard acquisition protocol for MRI of the SIJ, and discussing how to avoid some common technical pitfalls that may be encountered in MRI clinical practice.

Background: Central cartilage tumors are common incidental lesions around knee and shoulder joints. Differentiation of low-grade chondroid lesions, such as enchondroma from atypical cartilaginous tumor (ACT) is often difficult on imaging given pathologic and radiologic similarities. The Birmingham atypical cartilage tumor imaging protocol (BACTIP) provides a guide to initial assessment and imaging follow-up for incidental indeterminate central cartilage tumors.

Objective: This study retrospectively evaluates BACTIP in a United States tertiary care center.

Methods: Indeterminate central cartilage tumors in the proximal humerus, distal femur, and proximal tibia of adults were identified by a keyword search in the health network picture archiving and communications systems (PACS). These were categorized into one of seven BACTIP categories based on criteria including size and degree of endosteal scalloping.

Results: There were 292 cases that met the inclusion criteria. The final diagnosis of enchondroma was 100% for lesion types IA and IB, 66% for IC, and 50% for IIB; ACT was 33% for IC and 50% for IIB. Of the type IIC lesions, 43% were diagnosed as intermediate or high-grade chondrosarcoma. Pathology diagnosis was dedifferentiated chondrosarcoma in 75% of type III lesions. Chart review and follow-up imaging revealed no delay of diagnosis. The malignant transformation rate in this study was 0.3%.

Conclusion: There were no cases where the application of BACTIP would have led to a delayed diagnosis. The BACTIP would serve as a conservative and appropriate imaging follow-up guideline for patients with central cartilage tumors around the shoulder and knee joint.

Objective: To describe and  evaluate the current knowledge of MRI characteristics of osteitis condensans ilii (OCI) in the diagnostics and differentiation of OCI from other conditions.

Materials and methods: The databases PubMed, EMBASE, Scopus, and Web of Science were searched from their inception to March 2024 using the search terms "Magnetic Resonance Imaging" (MESH term in PubMed) and "osteitis condensans ilii" and limited to English language. Two reviewers independently screened titles, abstracts, and full-text eligibility and assessed the risk of bias according to Quality Assessment of Diagnostic Accuracy Studies, QUADAS-2.

Results: The search identified 53 records. Case reports, letters/notes, and conference abstracts were excluded, resulting in 24 reports assessed by full-text, 9 research articles, 14 reviews, and a book chapter. Five retrospective research studies were found eligible for the review. Detailed MRI features of OCI were only described in two studies of patients with pain where they encompassed manifest subchondral iliac sclerosis often accompanied by bone marrow edema (BME) located peripheral to the sclerosis and displaying a continuous distribution and frequently accompanied by sacral BME. Erosions were rare and ankylosis did not occur. Fat deposition in the bone marrow was frequent and similar to BME often located to anterior strain-related joint areas. The QUADAS-2 assessments revealed risks of bias in all studies analyzed, especially regarding general applicability of the MRI features.

Conclusion: There is a lack of valid data describing characteristic MRI features in general groups of OCI patients with and without pain.