Seminars in Musculoskeletal Radiology最新文献

Injury patterns in children differ from those in adults because of the physiology of the immature skeleton. A tailored imaging approach and in-depth knowledge of the physiology and pathology of the immature musculoskeletal system are essential for diagnosis, guiding the clinician to the right treatment plan and preventing long-term complications. This review provides a comprehensive overview of pediatric sports injuries, structured by tissue type and anatomical region. We pay special attention to the physiology of the immature musculoskeletal system, epidemiology of pediatric sport injuries, advanced imaging techniques, differentiation between normal developmental variants and pathology, and recognition of conditions that may mimic sports injuries. By integrating anatomical insight with clinical relevance, this review offers a modern multidisciplinary guide to the challenges of pediatric sports imaging.

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.

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.

Traumatic and overuse injuries of bones and tendons of the wrist represent a significant proportion of the musculoskeletal disorders encountered in both athletic and occupational settings. Conventional radiography remains the first-line imaging modality for osseous trauma, but it can miss up to a third of scaphoid and hamate fractures. Computed tomography is superior for characterizing occult or nondisplaced fractures. Magnetic resonance imaging provides important information on occult fractures, overuse injuries of osseous structures, and tendinous abnormalities.A comprehensive understanding of wrist injuries is essential to ensure accurate and timely diagnosis, in turn facilitating the selection of appropriate patient-specific treatment strategies. By minimizing diagnostic delays, clinicians can reduce the risk of adverse sequelae such as chronic instability, degenerative joint changes, and functional impairment. The implementation of optimized diagnostic and therapeutic pathways not only lessens the long-term burden of disability for patients, but it also plays a crucial role in enabling a safe and efficient return to both occupational duties and sporting activities.

Magnetic resonance imaging is a vital tool in sports medicine for evaluating ankle and foot injuries in athletes, offering detailed insights into bone, cartilage, ligament, and tendon pathology. However, the findings in athletes, especially those who are asymptomatic, can present pitfalls that may lead to misdiagnosis and unnecessary treatment. Common findings such as bone marrow edema, joint effusions, and tendon sheath fluid are frequently observed in athletes without symptoms and may represent physiologic adaptations rather than pathology.This article emphasizes the importance of correlating magnetic resonance imaging results with clinical evaluation and physical examination to avoid overinterpretation. Radiologists should be familiar with normal variants and nonspecific findings in athletes to ensure accurate reporting. Radiology reports must clearly describe findings and focus conclusions on those most likely to be clinically significant.Effective communication between clinicians, radiologists, and athletes is essential to prevent unnecessary interventions and economic consequences. A comprehensive approach, combining clinical assessment with advanced imaging, ultimately ensures accurate diagnosis and optimal management of ankle and foot injuries in athletes, minimizing the risk of overtreatment and supporting safe return to play.

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.

Cystic soft tissue lesions of the hand often pose a diagnostic challenge due to their broad range of differential diagnoses that include benign ganglion cysts as well as inflammatory and malignant conditions. Although most lesions are benign, atypical clinical or imaging features may suggest rare but significant pathologies that require timely recognition. This article provides a structured case-based overview of cystic and cystic-appearing soft tissue lesions of the hand, integrating each case with a brief review of relevant pathophysiology, imaging characteristics, and therapeutic considerations. The cases illustrate the spectrum of cystic lesions categorized as true cysts, tumors or tumor-like lesions with cystic features, and infectious and inflammatory entities. Special emphasis is placed on identifying imaging red flags in lesions that may mimic benign cysts, such as synovial sarcoma, and on the role of magnetic resonance imaging as the key imaging modality in ambiguous cases.

Intravascular lipomas are rare benign tumors composed of adipose tissue that originate from the walls of blood vessels. They most commonly arise from veins, are typically asymptomatic, and rarely occur in the lower extremities. When large, these tumors can cause symptoms related to venous obstruction, such as swelling and pain. We report a case of a 75-year-old man with an intravascular lipoma in the right common femoral vein, identified during evaluation of lower extremity swelling and poorly healing ulcers. Surgical resection was ultimately required. This case contributes to the few published reports of pathologically proven symptomatic intravascular lipomas involving the lower extremity veins. Comprehensive preoperative imaging played a critical role in characterizing the lesion. The case facilitates a discussion of key differential diagnoses, such as atypical lipomatous tumors/well-differentiated liposarcoma and leiomyosarcoma. · Intravascular lipomas are rare and generally asymptomatic masses that most often arise in the veins of the upper extremity and thorax.. · The differential diagnosis for a fatty intravascular mass includes benign lipoma, atypical lipomatous tumor (ALT)/well-differentiated liposarcoma, and leiomyosarcoma.. · Benign lipomas usually demonstrate homogeneous fat signal with thin fibrous septa and minimal nonadipose components.. · Imaging features suggestive of ALT/well-differentiated liposarcoma are reduced and/or heterogeneous fat composition, thickened septa, and nodular nonadipose tissue..

Cystic bone lesions of the hand encompass a heterogeneous group of entities presenting as mostly well-defined lytic areas on imaging. The most common entities are ganglion cysts and degenerative geodes, typically arising adjacent to joints in adults. Primary masses include simple (unicameral) and aneurysmatic bone cysts. Also, other benign tumors like enchondroma, epidermoid inclusion cyst, giant cell tumor, fibrous dysplasia, tenosynovial giant cell tumor, and brown tumor can appear as expansile lucent lesions. Inflammatory processes such as rheumatoid arthritis or gout often produce focal osteolytic defects resembling cystic cavities. Multimodal imaging is often necessary. Magnetic resonance imaging is useful to detect cystic defects and assess adjacent soft tissues; computed tomography can depict cortical integrity. Radiography is especially helpful to assess aggressiveness of growth and for follow-up. Management depends on symptoms and etiology. Most true cystic lesions are usually treated conservatively. Other symptomatic or aggressive lesions may require curettage, bone grafting, or targeted therapy.

A swollen finger may be caused by a variety of lesions of different etiologies, such as infection, inflammation, degenerative disorders, crystal diseases, congenital diseases, trauma, and tumors or tumorlike disorders of bone and soft tissues. Following a case presentation of a rare case presenting with a swollen finger, this article reviews the imaging features of the most common etiologies of swelling of the digits.