Seminars in Musculoskeletal Radiology最新文献

The shoulder joint, one of the most complex and mobile articulations in the human body, is prone to derangement as a result of acute trauma or repetitive microtraumatic injury in athletes. In contact and collision sports, most shoulder injuries are acromioclavicular joint sprains and dislocations, glenohumeral dislocations, and rotator cuff injuries. In overhead and throwing athletes, rotator cuff and labral pathologies are frequent and typically arise as the result of overuse repetitive microtraumatic injuries of the glenohumeral articulation. This review article summarizes the epidemiology, mechanisms of injury, and characteristic imaging findings of common shoulder injuries in athletes, including acromioclavicular joint injuries, rotator cuff tears and avulsions, pediatric epiphyseal and apophyseal injuries, glenohumeral dislocations, repetitive microtraumatic overuse, and other muscular injuries.

Knee injuries are one of the most common complaints in sports medicine. Magnetic resonance imaging is an essential adjunct to clinical evaluation for many traumatic injuries and overuse conditions. Given the heavy use of knee magnetic resonance imaging, developing faster magnetic resonance imaging acquisition methods and deployment in clinical practice would be valuable. In this article, we illustrate a spectrum of knee abnormalities from our clinical practice, utilizing a recently developed, publicly available sub-5-minute knee magnetic resonance imaging protocol with super-resolution image reconstruction based on deep learning. We review common traumatic injuries and overuse conditions of the knee and illustrate cases with this novel fast knee magnetic resonance imaging protocol.

Elbow injuries resulting from acute trauma or repetitive overuse are a common source of pain and functional limitation in both athletes and the general population. This review presents a radiologic approach to the evaluation and management of these conditions. It describes the roles of key imaging modalities and provides practical guidance for assessing traumatic injuries such as fractures, ligamentous disruptions, and tendon avulsions. Common overuse conditions, such as medial epicondylitis, lateral epicondylitis, and nerve compression syndromes, are reviewed with attention to characteristic imaging features and diagnostic challenges. The article also explores the role of image-guided interventions, particularly ultrasound-guided injections, in both diagnosis and treatment. By consolidating imaging strategies and emphasizing the strengths of each modality, this review will help radiologists and clinicians achieve an accurate diagnosis and manage elbow injuries effectively, ultimately promoting better outcomes and a timely return to activity.

The hip is a complex load-bearing joint susceptible to both acute traumatic and chronic overuse injuries. Traumatic injuries, such as acute fractures, dislocations, apophyseal avulsions, and muscle tears, typically follow high-energy events. In contrast, overuse injuries, for example, femoroacetabular impingement, stress fractures, labral degeneration, and greater trochanteric pain syndrome, arise gradually from repetitive mechanical overload. Early and accurate diagnosis requires a multimodal imaging approach: radiographs for baseline assessment, computed tomography for detailed osseous injury and alignment, magnetic resonance imaging and magnetic resonance arthrography for chondrolabral and soft tissue pathology, and ultrasound for dynamic evaluation of tendinous disorders. Understanding the mechanism, location, and severity of hip injuries is essential to guide prognosis, management, and prevention. This review provides a structured overview of traumatic and overuse hip injuries, highlighting imaging features that enable timely detection, precise characterization, and tailored interventions to optimize functional outcomes.

A 73-year-old woman with long-standing therapy-refractory rheumatoid arthritis presented with a persistent fever. Chest computed tomography revealed a mass at the right sternoclavicular joint, growing from 33 × 15 mm to 48 × 44 mm over 8 months, with osteolysis and clavicular erosions. Differential diagnoses were rheumatoid arthritis, spondyloarthritis, tuberculosis, and malignancy. Initial biopsy suggested lymphoid malignancy but was nondiagnostic due to necrosis. Rebiopsy indicated a benign lesion. Positron emission tomography/computed tomography ruled out cancer. The sternoclavicular joint is a fairly common location for rheumatic disease, but autoimmune-related lymphoproliferations are possible. Lesions with progressive growth, bone damage, and systemic symptoms (fever, weight loss, night sweats) require excluding malignancy. Accurate diagnosis depends on interdisciplinary collaboration and histopathologic confirmation.

Metabolic bone disease is characterized by impaired bone strength, density, or mineralization, increasingly observed in athletes due to complex nutritional, hormonal, and mechanical factors. The underlying pathophysiology includes dysregulated bone turnover driven by hormonal imbalances, inflammatory cytokines, and microdamage accumulation.Although weight-bearing activity generally promotes bone health, excessive training, inadequate recovery, and nutritional deficiencies, such as low calcium and vitamin D, disrupt bone remodeling, leading to decreased bone mineral density and heightened fracture risk. Female athletes with menstrual irregularities, disordered eating, and energy deficits are particularly susceptible to osteoporosis and osteopenia, components of the female athlete triad; hormonal disturbances like hypogonadism also affect males.Imaging techniques such as magnetic resonance imaging and dual-energy X-ray absorptiometry facilitate early detection of microdamage and bone loss, guiding timely interventions. Prevention strategies are nutritional optimization, balanced training, hormonal regulation, and routine bone mineral density screening. An integrated approach of early diagnosis, lifestyle modifications, and education is vital for maintaining skeletal health and preventing long-term complications in athletes.

This history page in the series "Leaders in MSK Radiology" is dedicated to the achievements of American radiologist Howard L. Steinbach. He was considered one of the leading general as well as musculoskeletal radiologists in the world over the decades from 1950 to 1980. Steinbach's novel observations spanned the gamut from the thickness of the heel pad in acromegaly and the first scientific articles to describe many metabolic bone diseases, arthritides, and musculoskeletal dysplasias to suggesting that the barium enema bag be hung rather than placed below the radiology table to avoid infection. Steinbach dealt with progressive deafness that developed at an early age and became quite profound in his adulthood. Despite that disability, he was achieved great success and recognition from the radiology community.

Bone health remains an underestimated component of athlete care and long-term performance. Many athletes, particularly those involved in endurance or weight-sensitive sports, exhibit reduced bone mineral density or impaired bone microarchitecture due to energy deficiency, hormonal imbalance, or chronic stress. These often underdiagnosed conditions increase the risk of stress fractures, ultimately threatening career longevity. Conventional assessment techniques, such as dual-energy X-ray absorptiometry and quantitative computed tomography, provide valuable diagnostic information but are limited by radiation exposure, high costs, poor accessibility, and low feasibility for routine use in athletic populations.Radiofrequency echographic multi-spectrometry is an ultrasound-based radiation-free technique that estimates bone mineral density and bone quality through the analysis of raw radiofrequency signals. This review examines the role of radiofrequency echographic multi-spectrometry as a supportive diagnostic tool in sports medicine for the prevention, monitoring, and management of bone fragility and stress-related injuries in athletes. We also highlight future directions for research and clinical integration.

Accurate interpretation of muscle injuries requires radiologists trained in anatomy, biomechanics, and clinical context, capable of recognizing their imaging characteristics. Despite advances in imaging techniques, guidance on structured reporting remains limited. Given the growing interest in assessing tissue regeneration, a critical factor in image interpretation and reporting is knowing the time elapsed since injury. We introduce the novel concept of the injury-to-imaging interval to distinguish acute injury from healing-related changes.This article presents a seven-step framework organized into three zones: (1) preparation zone (basic knowledge, clinical context, technical quality), (2) image evaluation zone (systematic review), and (3) report elaboration zone (descriptive report, classification, prognosis, and return-to-play guidance). Five clinical cases illustrate different locations, sports, and stages of healing using ultrasound and magnetic resonance imaging. The guide emphasizes optimization, pattern recognition, and clear communication of imaging findings that influence clinical decisions. Although severity classifications are increasingly muscle specific, detailed descriptive reporting remains essential for clinicians to apply the relevant system.