Seminars in Musculoskeletal Radiology最新文献

The Spanish Society of Musculoskeletal Radiology (Sociedad Española de Radiología Musculoesquelética), founded in 1998, emerged from a shared vision among pioneering radiologists to recognize musculoskeletal radiology as a distinct subspecialty in Spain. Since its first meeting in 1999, it has evolved from informal gatherings into a professionalized and influential society, organizing annual congresses across the country and collaborating with national and international institutions. Key milestones include the introduction of online education, joint courses with other societies, and the launch of a dynamic website with valuable learning tools. The society has actively promoted youth involvement, fostering early-career participation through initiatives like the "Resident Corner" and maintaining low membership fees. With nearly a thousand members today, the Spanish Society of Musculoskeletal Radiology stands out for its contributions to scientific excellence, educational initiatives, and community spirit. Its continued growth reflects both its foundational values and its commitment to shaping the future of musculoskeletal radiology.

A 51-year-old man with a history of ankylosing spondylitis presented with gradually increasing right hip pain. Computed tomography and magnetic resonance imaging demonstrated a large lytic lesion of the right iliac bone. Percutaneous bone biopsy was performed, followed by a diagnosis of an aggressive bone hemangioma. After a multidisciplinary meeting, sequential interventional treatment combining arterial embolization, percutaneous cryoablation, and cementoplasty was proposed and performed under imaging guidance, resulting in a complete resolution of symptoms. The patient presented a local recurrence at 4 years posttreatment, managed successfully with percutaneous cementoplasty under computed tomography guidance. · - Multidisciplinary management approach is warranted to yield optimal outcomes in patients with aggressive bone hemangiomas.. · - Percutaneous cryoablation can be considered as an alternative treatment option for symptomatic bone hemangioma, especially when tumor size reduction is desired.. · - When treating vascular bone tumors with percutaneous cryoablation, preoperative arterial embolization may not only reduce hemorrhagic risks but also improve local tumor control by preventing the so-called cold sink effect..

Tendinopathies are a leading cause of chronic musculoskeletal pain and functional limitation. When conservative measures fail, ultrasound-guided interventions are safe, minimally invasive alternatives to surgery. These procedures include injections of corticosteroids or platelet-rich plasma, percutaneous needle tenotomy, percutaneous irrigation of calcific deposits, and mechanical release techniques. Although some interventions are well established in clinical practice, others are only supported by limited or emerging evidence. Ultrasound plays a central role by enabling precise targeting of pathologic tissues and adjacent structures. This review provides an updated overview of current ultrasound-guided interventional procedures for tendinopathies, focusing on their mechanisms, clinical indications, and evidence base.

Musculoskeletal image-guided interventions are integral to modern radiologic practices, offering precise, minimally invasive solutions for a range of diagnostic and therapeutic needs. Despite their clinical utility, these interventions are often limited by operator dependency, procedural variability, and a lack of workflow standardization. As artificial intelligence technologies continue to evolve, they offer a significant opportunity to enhance the precision, safety, and efficiency of musculoskeletal interventions.This review explores the current and emerging applications of artificial intelligence across the procedural continuum of musculoskeletal image-guided interventions. We examine its role in preprocedural planning-including lesion detection, segmentation, and personalized risk stratification-through to intraprocedural guidance with artificial intelligence-assisted navigation, needle trajectory optimization, and robotics, and finally postprocedural evaluation using radiomics, complication prediction, and natural language processing for structured reporting.We address the critical challenges that limit clinical translation, including the need for external validation, generalizability across diverse patient populations, regulatory clearance, along with ethical considerations such as bias, data governance, and equitable access. We highlight the absence of multicenter trials and open-access datasets tailored to interventional practice. Particular attention is given to the role of artificial intelligence as a decision-support tool rather than a replacement for operator expertise, with emphasis on its potential to enhance training, standardize practice, and expand access to high-quality care.By highlighting both the practical applications and limitations of current technologies and with health care increasingly shaped by digital innovation, radiologists must engage critically with artificial intelligence technologies to ensure safe, effective, and inclusive deployment. This review synthesizes the current state of artificial intelligence in musculoskeletal interventions and outlines future directions, including the need for interventional artificial intelligence registries, foundation model development, and collaborative translational research. By focusing on practical integration, we aim to support radiologists in leveraging artificial intelligence to enhance procedural accuracy, consistency, and patient 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.

Solid soft tissue masses of the hand represent a diverse group of lesions, most of which are benign. Accurate diagnosis is essential to guide management and avoid unnecessary or inappropriate surgical intervention. This review discusses solid soft tissue tumors of the hand in accordance with the 2020 World Health Organization Classification of Soft Tissue Tumors, emphasizing imaging features and clinical presentation, as well as the current European Society of Musculoskeletal Radiology guidelines from 2023 for primary imaging of soft tissue lesions. Characteristic imaging features help diagnose common entities such as lipomas, tenosynovial giant cell tumors, glomus tumors, and nerve sheath tumors. Various pseudolesions (e.g., traumatic neuromas) are also discussed. The importance of referral to specialized sarcoma centers for indeterminant or aggressive lesions is highlighted.