Seminars in Musculoskeletal Radiology最新文献

Most mistakes relate to either a lesion being missed or when a lesion is seen a wrong diagnosis being made. Clinicians and patients understandably want an accurate diagnosis. An accurate diagnosis, however, is not always possible given the complexities and inherent limitations of imaging. There is an inevitable trade off between committing to trying to provide a definitive diagnosis and occasionally getting it wrong. Better, and more useful, to being occasionally wrong though than habitually noncommittal.

Assessment of internal derangement is a common indication for imaging of the injured knee in athletes. The first line of imaging is conventional radiography, but magnetic resonance imaging is often required. Radiographic features of ligament injury can be subtle, even when the soft tissue injury is devastating, resulting in instability that may require surgery. Magnetic resonance imaging to assess for ligament injury has several potential pitfalls that can lead to interpretation errors. This article describes common errors when imaging knee ligament injuries in the athlete and discusses strategies to reduce inaccuracies in imaging technique and interpretation. Mistakes on magnetic resonance imaging and radiographs typically arise from the timing of imaging (early/acute versus delayed/chronic), technical factors, potential mimics of pathology, and the inherent limitations of radiography.

Musculoskeletal imaging plays a central role in diagnosing and managing a wide range of orthopedic conditions. However, it remains susceptible to both interpretive and noninterpretive errors, amplified by increasing imaging demand and complexity. Artificial intelligence, especially deep learning and large language models, has shown growing potential to reduce these errors at every stage of the imaging workflow. From optimizing exam requests and imaging protocols to reducing artifacts and improving interpretative consistency, artificial intelligence supports radiologists in enhancing diagnostic accuracy, efficiency, and reproducibility. Applications now extend across all modalities, including magnetic resonance, radiography, computed tomography, and ultrasound, and they address common pitfalls such as subjective assessments and measurement variability. Post-interpretation tools using large language models further improve report clarity and patient communication. Although integration into clinical practice remains ongoing, artificial intelligence already offers a transformative opportunity to improve musculoskeletal imaging quality and safety through collaborative human-machine interaction.

Non-neoplastic and noninfectious subchondral bone lesions incorporate several entities: acute traumatic injuries, insufficiency and fatigue fractures, primary or secondary osteonecrosis, osteochondritis dissecans, subchondral abnormalities related to cartilage loss, and marrow changes accompanying disuse or other causes of accelerated bone remodeling. Differentiating these conditions on imaging can be challenging due to overlapping imaging features, technical aspects, and insufficient clinical history. This review discusses how to avoid common mistakes in the imaging diagnosis of subchondral lesions, focusing on descriptive terminology, imaging scenarios, and reporting key imaging features that affect prognosis in these lesions.

Ankle and foot injuries are extremely common among athletes and nonathletes alike. Clinical findings are often nonspecific, and many injuries are difficult to diagnose with imaging, even using advanced techniques, and a delay in diagnosis may have significant adverse long-term consequences. Thus it is important to be familiar with the location and imaging appearances of these injuries. This article addresses several injuries that are commonly missed when imaging the ankle and foot.

This history page is dedicated to the history of the Musculoskeletal Sections of the Belgian Society of Radiology and the Dutch Society of Radiology that take part in the continuing education of musculoskeletal radiology in their respective countries. Since 2008, these societies have worked together and organized a joint annual meeting dedicated to the field of musculoskeletal radiology.

This review covers physiologic changes that occur with normal elbow development, imaging considerations, and common elbow pathologies, subdivided into those involving the medial, lateral, and posterior compartments. At the medial elbow, medial epicondylar apophysitis and avulsion factures are more common among skeletally immature individuals, whereas ulnar collateral ligament injuries are more common among skeletally mature young adults. At the lateral elbow, radial head subluxation, capitellar osteochondritis dissecans, and Panner's disease are more common among skeletally immature individuals. At the posterior elbow, olecranon physeal stress injury is more common among skeletally immature individuals, whereas triceps tendon injury is more common among skeletally mature individuals. We also highlight pathologies in and around the elbow joint, including septic arthritis, juvenile idiopathic arthritis, rheumatoid arthritis, and osteoid osteoma.

Rosai-Dorfman disease is an uncommon proliferation of non-Langerhans cell histiocytosis that mainly affects lymph nodes, although occasionally it can be associated or even present solely with extranodal involvement including skin and subcutaneous fat infiltration.We present a case of cutaneous Rosai-Dorfman disease that occurred at the site of administration of COVID-19 vaccine. The patient was a 13-year-old Bahraini girl who presented with a 1-year history of left upper arm pain and swelling that started after receiving the Pfizer vaccination for COVID-19. Clinically, the mass was medium-sized, tender, and nonmobile. Ultrasound and magnetic resonance imaging were suspicious for sarcoma. Ultrasound-guided biopsy revealed "subcutaneous panniculitis." Excision of the mass revealed a multinodular infiltrate of the subcutaneous fat composed of distinctive large histiocytes, with characteristic emperipolesis, positive for S100, CD68, and OCT-2, consistent with Rosai-Dorfman disease. We present a case of cutaneous Rosai-Dorfman disease as a complication of COVID-19 vaccination that was challenging for the pathologist, radiologist, and clinician.

Groin pain is a common issue in athletes, and an accurate diagnosis is crucial for effective management. The complexity of the groin's anatomy, including the pubic symphysis and adductor muscles, makes diagnosing injuries in this area challenging. Additionally, the maturation of the pubic apophysis, particularly in adolescent athletes, can lead to conditions like apophysitis that are often misdiagnosed as other groin injuries. A major challenge is the inconsistent terminology, with terms like "athletic pubalgia" and "sports hernia" used interchangeably, causing confusion. The 2015 Doha Agreement helped standardize the classification of groin pain into adductor-, iliopsoas-, inguinal-, and pubic-related types. This review highlights common mistakes in imaging interpretation, particularly in diagnosing adductor- and pubic-related groin pain. Magnetic resonance imaging is a key tool, offering superior soft tissue detail that is crucial for accurate diagnosis, but misinterpretation remains common. This review will help clinicians and radiologists improve diagnostic accuracy and thus ultimately enhance patient outcomes.