Seminars in Musculoskeletal Radiology最新文献

Glenohumeral instability results from disruptions in dynamic and static stabilizers of the glenohumeral joint, leading to dislocation, subluxation, or chronic apprehension. Although anterior glenohumeral instability is the most common form, posterior instability represents a distinct and often underrecognized condition with unique biomechanical and clinical characteristics. Imaging plays a critical role in evaluating shoulder instability, guiding diagnosis, and informing treatment decisions. Radiographs, computed tomography, and magnetic resonance imaging help assess structural abnormalities, such as labral tears, capsuloligamentous injuries, and osseous defects. Advanced imaging techniques, such as three-dimensional computed tomography and zero echo time magnetic resonance imaging, offer improved assessment of bone loss; magnetic resonance arthrography enhances the detection of soft tissue pathology. This article offers a comprehensive review of the imaging spectrum of glenohumeral instability, covering labral pathology, capsuloligamentous injuries, and bone loss. It highlights the critical role of precise imaging assessment in guiding optimal management strategies for both anterior and posterior instability patterns.

Musculotendinous injuries represent a major concern in sports medicine, with significant implications for athlete recovery and performance. Ultrasound and magnetic resonance imaging, in particular, play a crucial role in diagnosing and monitoring these injuries, guiding treatment strategies, and estimating prognosis. Understanding the anatomy and distribution of connective tissue is fundamental to identifying and classifying musculotendinous injuries accurately. This review focuses on the imaging features of musculotendinous injuries and their evolution, emphasizing the role of connective tissue and the anatomical differences influencing injury patterns. It also examines current grading systems and their prognostic value, highlighting the need for muscle-specific subclassifications to improve accuracy in predicting return to play.

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.

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.

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.