Seminars in Musculoskeletal Radiology最新文献

Musculoskeletal injuries, particularly rotator cuff tears, are common in sport and can significantly impact athletes' performance and recovery. The rotator cuff stabilizes the glenohumeral joint, with the supraspinatus muscle the most susceptible to injury due to its central role in abduction and stabilization. Rotator cuff tears in athletes are in general the result of chronic microtrauma in an overused shoulder, but they can result after direct acute trauma. Sports-specific movements, such as overhead throwing, repetitive abduction, or heavy lifting, predispose athletes to different injury patterns. Magnetic resonance imaging plays a central role in the diagnosis and management of rotator cuff tears, providing detailed insight into tendon integrity, muscle changes, and associated labral or bone pathology. Return-to-play decisions depend on the severity of the injury, the management approach, and complex multidisciplinary considerations. Rehabilitation protocols are critical, with most athletes returning to sport, often at preinjury levels.

Sports-related injuries of the hip joint and surrounding structures are frequently encountered in athletes, encompassing a wide spectrum of osseous, intra-articular, and extra-articular pathologies. Early and accurate detection of typical injury patterns across various sports can expedite recovery. Delayed diagnosis often leads to prolonged return to play and progression of low grade to more severe injuries. These injuries, caused by repetitive stress or acute trauma, include fractures, hip dislocations, and intra-articular abnormalities, such as femoroacetabular impingement, labral tears, cartilage defects, and ligamentum teres tears. Extra-articular pathologies include apophyseal injuries, muscle strains, athletic pubalgia, greater trochanteric pain syndrome, or snapping hip syndrome, all of which can substantially impair athletic performance. Familiarity with hip anatomy and biomechanics, as well as the strengths of different imaging modalities, with magnetic resonance imaging often the preferred choice for many injuries, is essential for an efficient diagnostic work-up of the painful hip and reducing long-term complications.

The European Diploma in Musculoskeletal Radiology (EDiMSK) is a recognized European qualification of excellence for musculoskeletal (MSK) radiologists. The EDiMSK confirms proof of knowledge of MSK radiology, in addition to any national qualifications certifying competency. The examination is conducted in English and consists of both a written and an oral part. This article guides candidates taking the EDiMSK examination on how to prepare for the written exam that consists of 40 multiple-choice questions (MCQs). Information is provided on how the questions are structured and the candidate is scored. Ten MCQs representative of the written section of the EDiMSK are also presented.

Traumatic finger injuries in athletes are widespread and vary widely, from minor sprains to complex fractures or tendon damage, with occurrences differing by sport due to distinct biomechanical demands. Imaging plays a pivotal role in assessing these injuries. Radiography serves as the primary diagnostic tool, crucial for detecting bone-related abnormalities; ultrasound and magnetic resonance imaging are essential for evaluating soft tissue injuries. Prompt and accurate diagnosis is key to ensuring effective treatment and preventing long-term complications, thereby facilitating a quick and safe return to sports activities.

The European Diploma in Musculoskeletal Radiology (EDiMSK) is a recognized European qualification of excellence for musculoskeletal (MSK) radiologists. Webinars have become a vital component of electronic learning. This article introduces European Society of Musculoskeletal Radiology members to its webinar program that offers an additional source of direct interactive learning from renowned MSK radiologists. These webinars contribute to Continuing Medical Education and assist in preparing for the EDiMSK exam. We discuss the concept, history, and organization of the webinars.

Ultrasound (US) is a valuable tool in the evaluation of arthritis both for diagnosis and treatment response. Pertinent findings such as joint effusions, synovitis, bursitis, bone erosions, tenosynovitis, and enthesitis can all be readily evaluated sonographically. In this article, we describe specific considerations in the US evaluation of rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis, crystalline arthritis (gout, calcium pyrophosphate deposition disease, and hydroxyapatite deposition disease), septic arthritis, and osteoarthritis with attention to certain differentiating features. The potential role of US in the diagnosis of specific arthritides is discussed, together with an overview of newer technologies and future directions.

Rheumatoid arthritis is a common chronic inflammatory arthritis, primarily characterized by proliferative synovitis of the small joints of the appendicular skeleton. Rapidly evolving treatment regimens for rheumatoid arthritis patients, including conventional and biologic disease-modifying antirheumatic drugs, promise improved quality of life and prognosis. These treatments necessitate earlier clinical detection of rheumatoid arthritis, a goal that has forever changed the role of imaging in this pursuit. This review discusses the dominant imaging modalities in state-of-the-art rheumatoid arthritis management: radiography, magnetic resonance imaging, and ultrasound. It focuses on hand and wrist evaluation, with key relevant findings detected by each modality and recent evidence supporting them. Emerging techniques are also described in this discussion to understand likely future radiologic contributions to rheumatoid arthritis diagnosis and management.

Gout is a common inflammatory arthritis with well-described imaging characteristics. Radiography depicts erosive change and in advanced cases, tophus deposition near joints and in association with tendons or bursae. Computed tomography demonstrates the same features but may also use dual-energy or photon-counting techniques that allow for tissue composition analysis and the specific identification of monosodium urate deposition. Magnetic resonance imaging (MRI) is useful in identifying tophi and the damage associated with gout, such as bone erosion and cartilage loss in advanced cases. MRI also helps differentiate gout from other types of inflammatory arthritis, infection, or tumor that may have a similar clinical presentation. Ultrasound is widely used in the diagnosis of gout and also useful in procedural guidance of joint aspiration or soft tissue biopsy.

This case report concerns a 16-year-old boy who developed pain in his right thigh after a soccer game. Imaging studies revealed a pathologic transtrochanteric fracture of the right femur, accompanied by a large expansive intramuscular lesion centered in the deep planes of the adductor musculature. Main imaging findings included intense enhancement and vascularization of the lesion, along with peripheral and central flow voids, the latter described as characteristic of this subtype of soft tissue sarcoma. Alveolar soft part sarcoma is a rare and distinctive sarcoma with an indolent clinical course that typically occurs in young patients and predominantly affects the deep tissues of the lower limbs. · Soft tissue sarcomas are a rare group of malignancies, often found in the extremities. Suspicious features include larger size, deeper location, heterogeneous enhancement, and progressive growth.. · Alveolar soft part sarcoma (ASPS), a rare subtype primarily seen in children, is characterized by high T1 signal intensity, intense contrast enhancement, and more than five central and peripheral flow voids that are highly indicative of this condition.. · Magnetic resonance imaging (MRI) is the preferred modality for evaluating these lesions. Advanced MRI techniques, such as diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), enhance diagnostic confidence, particularly in postoperative evaluations..

Sacroiliac joint pathology presents a complex diagnostic challenge due to the diverse range of conditions, both mechanical and inflammatory, that can affect the joint. Although axial spondyloarthritis-related sacroiliitis is often the most recognized pathology, numerous other conditions closely mimic axial spondyloarthritis in both clinical presentation and imaging features. This review describes key anatomical aspects of the sacroiliac joint, including its distinct morphology, ligamentous support, and histologic characteristics, essential for understanding and differentiating various pathologies. It also examines detailed imaging findings from magnetic resonance imaging, computed tomography, and radiography in relation to each pathologic condition. By providing a framework for distinguishing between common and rare sacroiliac joint disorders and axial spondyloarthritis, this article will enhance diagnostic accuracy and offer insights into the anatomical nuances that impact clinical and imaging assessments.