Seminars in Musculoskeletal Radiology最新文献

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.

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.

Spinal lesions in athletes can be classified into overuse and acute injuries. Overuse injuries can be found after repetitive spinal load during sport activity; acute trauma injuries of the spine are common in contact sports. We present an overview of the wide spectrum of spinal injuries related to sport activity and review their imaging findings. Concerning overuse injuries, we focus on degenerative spine disease, spondylolysis, pedicle fractures, apophyseal ring injuries, Schmorl's nodes, and Scheuermann's disease. Acute spinal injuries are relatively frequently reported in athletes and may be the reason for severe morbidity. Similar to the general population, the type of acute spine fracture in athletes depends on the specific trauma mechanism.

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.

Modic changes, particularly type 1, represent a significant clinical and radiologic challenge in chronic low back pain. This review evaluates the infectious hypothesis, suggesting that the colonization of the intervertebral disk by low-virulence pathogens (primarily Cutibacterium acnes) may contribute to the pathogenesis of these lesions. The evolution of this concept is analyzed through the results of pivotal clinical trials, highlighting the landmark perspectives provided by the Modic Antibiotic Spine Therapy study while considering the methodological nuances and divergent findings introduced by the Antibiotics in Modic Changes study. The article also examines the evidence from disk biopsy studies, addressing the technical difficulties in distinguishing true microbial colonization from potential sample contamination. Finally, we propose an integrative model where mechanical and infectious factors interact, suggesting that bone marrow inflammation may reflect a localized immune response to intradiskal bacterial presence. This balanced approach calls for the standardization of future research protocols to clarify the role of targeted therapeutic interventions.

Zero echo time magnetic resonance imaging is an ultrashort echo time technique that enables computed tomography-like visualization of cortical and trabecular bone while preserving the ionizing radiation-free, multiplanar, and soft tissue advantages of conventional magnetic resonance imaging. This narrative review outlines the technical foundations of spinal zero echo time imaging, such as sequence design, key optimization parameters, advanced deep learning-based reconstruction strategies, and common interpretive pitfalls like gas mimicking calcification, metal-related artifacts, and limited spatial resolution. Clinical applications are detailed across traumatic, degenerative, inflammatory, neoplastic, infectious, and developmental spinal conditions, emphasizing how zero echo time complements standard magnetic resonance imaging sequences and often approaches computed tomography in depicting cortical disruption, osteophytes, erosions, sclerosis, and heterotopic ossification.I also highlight emerging roles for zero echo time in pediatric and fetal spine assessment and in magnetic resonance imaging-only surgical planning workflows, where accurate computed tomography-like bone contrast is required but ionizing radiation avoidance is paramount. Collectively, current evidence positions zero echo time as a versatile adjunct that can streamline imaging algorithms, reduce dependence on computed tomography, and support ionizing radiation-sparing magnetic resonance imaging focused pathways for diagnosis, treatment planning, and follow-up in spine disease.

This history page is dedicated to the British Society of Skeletal Radiology, established in 1985, the first national society to promote musculoskeletal radiology. Initially called the Skeletal Radiology Group, the current name was adopted in 1995. From humble beginnings with only 14 members, the society now counts 681 members in its ranks. It has promoted the subspecialty of skeletal radiology in the United Kingdom and continuing education in skills and knowledge in the field. The society organizes meetings each year for its members and a refresher course every 2 years. It helps other national organizations and the government to develop policies and guidelines related to musculoskeletal radiology.

In spine magnetic resonance imaging (MRI), incidental abnormalities are difficult to distinguish from actual pain generators (the cause of symptoms). Spine specialists see patients face to face and take clinical histories to learn symptoms. They use this symptom information to focus on only the most relevant MRI abnormalities, diagnose pain generators, and make treatment decisions. In the absence of symptom information, radiologists seek to identify all MRI abnormalities and list them in dictated reports without ranking their relative importance.Like spine specialists, radiologists can match symptoms with MRI findings to improve diagnostic accuracy and confidence. Symptom-MRI correlation requires radiologists to have access to high-quality clinical information and understand the causal relationships between symptoms and pain generators. This article covers symptom-MRI correlation and pitfalls related to spine MRI interpretation.

Inflammatory conditions of the anterior chest wall are clinically relevant but remain underrecognized and inconsistently assessed in imaging protocols. The anterior chest wall may be affected by systemic and localized diseases, such as spondyloarthritis, chronic nonbacterial osteitis, rheumatoid arthritis, crystal arthropathies, and osteoarthritis. In spondyloarthritis, anterior chest wall involvement is common yet frequently subclinical. Magnetic resonance imaging enables early detection of enthesitis, synovitis, and osteitis, as well as structural lesions, such as erosions, fatty metaplasia, sclerosis, ankylosis, and hyperostosis. Rheumatoid arthritis typically presents with synovitis, inflammatory cysts, and erosions. Pediatric chronic nonbacterial osteitis manifests as multifocal bone inflammation, often involving the clavicle, requiring whole-body imaging. Adult chronic nonbacterial osteitis includes variants such as sternocostoclavicular hyperostosis and Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis syndrome.Members of the Arthritis Subcommittee of the European Society of Musculoskeletal Radiology prepared this article. It presents updated information on imaging the anterior chest wall in rheumatic conditions with emphasis on systematic assessment. Guidance is provided on optimal imaging sequences, reporting terminology, and differential diagnoses. Ultrasound is the first-line examination. Magnetic resonance imaging is the modality of choice for detecting active inflammation in bone and soft tissue; computed tomography remains preferred for detailed bone and crystal disease evaluation. Recognizing anterior chest wall inflammation can improve diagnostic accuracy and guide early treatment.

Interest is growing about the opportunistic use of imaging data. We conducted a scoping review to provide an overview and define perspectives and gaps in knowledge for the opportunistic extraction of measurements of skeletal muscle and fat quantity or quality from spinal examinations. A comprehensive search on PubMed was performed with key terms such as "sarcopenia," "obesity," "fat," and "muscle," focusing on spine computed tomography and magnetic resonance imaging. Only articles published in the previous 5 years were included. We identified 29 studies, most of which were classified as level of evidence 3/4 and had significant limitations. The clinical settings were diverse, including spine surgery, osteoporosis, degenerative spine disease, and low back pain. This work highlights that an opportunistic assessment of paravertebral muscles by computed tomography/magnetic resonance imaging is feasible, although more evidence is needed to clarify the relationship between specific pathologic conditions and muscle loss/degeneration (aside from aging and disuse) before clinical implementation.