Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-01-21DOI: 10.1007/s00256-025-04871-z
Jae Ho Lee, Sae Rom Chung, Jung Hwan Baek, Dong Eun Song, Won Gu Kim, Tae Yong Kim, Tae-Yon Sung, Ki-Wook Chung, Jeong Hyun Lee
{"title":"Role of radiofrequency ablation in the treatment of symptomatic distant metastasis of thyroid cancer.","authors":"Jae Ho Lee, Sae Rom Chung, Jung Hwan Baek, Dong Eun Song, Won Gu Kim, Tae Yong Kim, Tae-Yon Sung, Ki-Wook Chung, Jeong Hyun Lee","doi":"10.1007/s00256-025-04871-z","DOIUrl":"10.1007/s00256-025-04871-z","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness and safety of radiofrequency ablation (RFA) for the treatment of symptomatic distant metastasis of differentiated thyroid carcinoma.</p><p><strong>Materials and methods: </strong>The medical records of 12 patients who underwent RFA for the palliative treatment of 18 symptomatic distant metastases from thyroid cancer between January 2008 and December 2020 were analyzed. All patients were assessed for their degree of discomfort and underwent periodical evaluations as outpatients, including clinical examination, imaging, and serologic markers.</p><p><strong>Results: </strong>Among the 18 tumors treated, nine were soft tissue, and nine were bone metastases. The mean size of the treated tumors was 5.3 cm (range, 1.7-10.7 cm). All patients complained of pain, discomfort and/or bulging of the metastatic mass before RFA. After RFA, 11 out of the 18 patients with metastatic tumors (61.1%) reported a subjective improvement in symptoms. Nine out of 18 tumors decreased in size, with a mean size reduction ratio of 43% ± 22%. Although symptom improvement was achieved in 61.1% of the tumors, after a mean follow-up duration of 37.4 months, five patients experienced progression of the tumor, four patients had a stable tumor status, and three patients died from pneumonia. There were no major adverse events related to RFA during the treatment or follow-up period.</p><p><strong>Conclusion: </strong>RFA can be used as palliative therapy to relieve the symptoms caused by metastatic tumors; however, it has a limited role in improving the overall prognosis in patients with distant metastasis from thyroid cancer.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1673-1680"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-01-18DOI: 10.1007/s00256-025-04867-9
Sophia S Goller, Anna L Falkowski, Rainer J Egli, Georg C Feuerriegel, Samy Bouaicha, Reto Sutter
{"title":"CT imaging findings in symptomatic patients with and without revision surgery after reverse shoulder arthroplasty.","authors":"Sophia S Goller, Anna L Falkowski, Rainer J Egli, Georg C Feuerriegel, Samy Bouaicha, Reto Sutter","doi":"10.1007/s00256-025-04867-9","DOIUrl":"10.1007/s00256-025-04867-9","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate CT imaging findings in symptomatic patients with and without revision surgery (RS) after reverse shoulder arthroplasty (RSA).</p><p><strong>Materials and methods: </strong>In this retrospective study, two radiologists assessed CT imaging findings in symptomatic patients with RSA over 5 years, including material fracture and loosening of the peg, baseplate, screws, and humeral stem, screw positioning, prosthesis dislocation, glenoid notching, fractures, and deltoid muscle quality. The primary outcome parameter was RS. Patients were assigned Group 1 (RS) or Group 2 (No RS).</p><p><strong>Results: </strong>Ninety-nine patients (mean age 70.4 ± 10.3 years, 61 females) met the inclusion criteria. Fifty-two patients (29 females) received RS after 34.0 ± 38.3 months. The only CT imaging finding significantly associated with RS was prosthesis dislocation (P = .007, odds ratio (OR) 10.95, 95% CI 1.34-89.24). All other evaluated CT imaging findings were not associated with RS. Yet, loosening of the peg (30% vs. 16%), baseplate (15% vs. 6%), and superior screw (18% vs. 7%) and periprosthetic humeral fractures (29% vs. 13%)-as common reasons for RS-were more frequent in patients with RS than in those without, however not reaching significance (P ≥ .11). The large majority of patients had glenoid notching (79% vs. 94%), irrespective of RS.</p><p><strong>Conclusion: </strong>In this cohort of symptomatic patients after RSA, prosthesis dislocation was the only CT imaging finding associated with RS. Besides, there was a trend with higher numbers of loosening of the peg, baseplate, and superior screw, as well as periprosthetic humeral fractures in patients with RS, though not reaching significance.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1661-1672"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-01-17DOI: 10.1007/s00256-025-04872-y
Zeyad Hossam Atta Khalil, Taha Ali Osman
{"title":"Multifocal osteochondromatous proliferation and paraneoplastic hematologic dyscrasia in the context of latent Epstein-Barr virus reactivation: a case of oncologic and infectious pathophysiology.","authors":"Zeyad Hossam Atta Khalil, Taha Ali Osman","doi":"10.1007/s00256-025-04872-y","DOIUrl":"10.1007/s00256-025-04872-y","url":null,"abstract":"<p><p>This case report describes a 15-year-old male with multifocal osteochondromatous proliferation and paraneoplastic hematologic dyscrasia, linked to latent Epstein-Barr virus reactivation. Radiographic and advanced imaging revealed widespread skeletal lesions consistent with osteochondromatosis. Hematologic evaluation indicated pancytopenia with dysplastic megakaryocytes and marrow infiltration. Immunohistochemical staining confirmed latent Epstein-Barr virus infection, suggesting its role in the pathogenesis of both the osteochondromatous and hematologic abnormalities. This case highlights the correlation between Epstein-Barr virus reactivation, bone proliferation, and paraneoplastic hematologic processes, which we believe has not yet been reported in the literature, emphasizing the need for a comprehensive diagnostic approach.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1753-1759"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-01-16DOI: 10.1007/s00256-025-04874-w
Taro Takeda, Mieko Takasugi, Kotaro Yoshida
{"title":"Paravertebral crystal deposition disease: a retrospective study of clinical presentation, prevalence, and CT imaging findings.","authors":"Taro Takeda, Mieko Takasugi, Kotaro Yoshida","doi":"10.1007/s00256-025-04874-w","DOIUrl":"10.1007/s00256-025-04874-w","url":null,"abstract":"<p><strong>Objectives: </strong>Paravertebral crystal deposition disease, characterized by the deposition of crystals around the vertebral bodies leading to acute inflammation and pain, is a condition that remains largely unrecognized. This study aims to elucidate the prevalence, clinical features, and CT findings associated with this disease.</p><p><strong>Methods: </strong>We retrospectively analyzed 14,839 consecutive patients who underwent chest and/or abdominal CT (September 2017 to September 2024) owing to chest, abdominal, or back pain. Cases demonstrating paravertebral calcification with a surrounding soft tissue density of ≥ 5 mm were identified and further evaluated.</p><p><strong>Results: </strong>Twenty-four cases of paravertebral crystal deposition disease were identified, with a prevalence of 0.16% (95% CI: 0.10, 0.24). The mean age was 46.2 years, with a female predominance (n = 15, 63%). Back pain was the most common presenting symptom (n = 15, 63%). Calcifications were primarily located at the lower thoracic and upper lumbar spine (Th6/7-L1/2) in 18 cases (75%) and in the anterior median to anterior right region of the vertebral body in 21 cases (86%). Mean of maximum CT values of the crystal deposition was approximately 800 HU; in follow-up cases, the depositions either resolved or exhibited morphological changes.</p><p><strong>Conclusions: </strong>This study adds to the current knowledge base by identifying a 0.16% prevalence of paravertebral crystal deposition disease in patients with torso pain-often overlooked in clinical practice, primarily affecting middle-aged women. CT imaging shows calcifications mainly in the lower thoracic and upper lumbar spine. Considering this self-limiting disease in differential diagnoses can improve diagnostic accuracy and patient management.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1643-1651"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of thoracic degenerative MRI findings and association with pain and disability: a systematic review.","authors":"Bodil Al-Mashhadi Arnbak, Stine Haugaard Clausen, Mette Jensen Stochkendahl, Rikke Krüger Jensen","doi":"10.1007/s00256-024-04864-4","DOIUrl":"10.1007/s00256-024-04864-4","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically review the literature on the prevalence of degenerative MRI findings in the thoracic spine and their association with pain and disability.</p><p><strong>Materials and methods: </strong>The Medline, EMBASE, CINAHL, and CENTRAL databases were searched. Two independent reviewers screened the articles, extracted the data, and assessed the risk of bias (RoB) using a modified version of the Hoy tool for articles on prevalence and QUADAS-2 for articles on associations.</p><p><strong>Results: </strong>The review included 23 articles describing 20 study populations: 5 general populations, 2 populations of asymptomatic volunteers, and 13 clinical populations. As the articles were highly heterogeneous, especially regarding study populations and the MRI findings assessed, a meta-analysis was not possible, and the results were presented descriptively. Prevalence estimates were reported in 21 articles, and 5 (3 study populations) had low RoB. The most frequently reported prevalence rates concerned the intervertebral discs, vertebral endplates, and the ligamentum flavum. Estimates varied considerably, with the prevalence of thoracic disc degeneration ranging from 0.2%-89% and vertebral endplate signal changes ranging from 0%-82%, depending on MRI definitions, population characteristics, and recruitment settings. Four articles investigated the association between MRI findings and spinal pain, with the RoB mainly considered low or unclear. Only two of these studies specifically examined thoracic spinal pain. None assessed the association with disability.</p><p><strong>Conclusion: </strong>Due to heterogeneity, few high-quality studies and few studies on individual MRI findings, no definitive conclusions could be drawn about the prevalence of thoracic degenerative MRI findings or their association with pain and disability.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1607-1619"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-01-27DOI: 10.1007/s00256-025-04876-8
Anette Nieminen, Janne Nurminen, Anni Aavikko, Jani Puhakka, Jussi Haapala, Hannes Keemu, Juha Kukkonen, Ari Alho, Panu Uusalo, Keijo Mäkelä, Jussi Kosola
{"title":"Platelet-rich plasma does not influence magnetic resonance imaging findings of the gluteus muscles after total hip arthroplasty through the Hardinge approach.","authors":"Anette Nieminen, Janne Nurminen, Anni Aavikko, Jani Puhakka, Jussi Haapala, Hannes Keemu, Juha Kukkonen, Ari Alho, Panu Uusalo, Keijo Mäkelä, Jussi Kosola","doi":"10.1007/s00256-025-04876-8","DOIUrl":"10.1007/s00256-025-04876-8","url":null,"abstract":"<p><strong>Objective: </strong>Total hip arthroplasty through the Hardinge approach damages the hip abductor muscles. MRI can be used to assess adverse postoperative events. In this prospective randomized controlled trial, we evaluated MRI findings and whether platelet-rich plasma affected postoperative healing of the gluteal muscles (gluteus medius and minimus).</p><p><strong>Materials and methods: </strong>Forty patients with hip osteoarthritis requiring treatment with total hip arthroplasty, aged between 60 and 76 years, were included. Patients were randomized into two groups: 19 patients in the platelet-rich plasma group and 21 in the placebo group. Platelet-rich plasma or placebo was injected into the gluteus medius tendon incision line during closure. Postoperative hip MRI and plain radiographs were taken 3 and 12 months after surgery.</p><p><strong>Results: </strong>MRI showed fatty atrophy of the gluteal muscles in all 40 patients (100%), gluteal muscle tear in 11 patients (28%), and atrophy in 16 patients (40%) at both 3 and 12 months postoperatively. Fluid collections related to the operated hip joint were seen in 18 patients (45%) at 3 months and 13 patients (33%) at 12 months, heterotopic ossification formation in nine patients (23%) at 3 months, and 12 patients (31%) at 12 months. There were no significant differences in imaging findings between the two groups.</p><p><strong>Conclusion: </strong>MRI can be a valuable tool for evaluating postoperative healing after total hip arthroplasty. Fatty atrophy of the gluteal muscles was a common finding. Platelet-rich plasma injection into the gluteus medius tendon did not improve healing detected by MRI.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1697-1706"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-01-22DOI: 10.1007/s00256-025-04868-8
Merve Sekizkardes Tutuncu, Savas Sencan, Canan Bilekyigit Kurt, Serdar Kokar, Osman Hakan Gunduz
{"title":"The role of facet joint degeneration in the treatment success of transforaminal epidural steroid injection: a retrospective clinical study.","authors":"Merve Sekizkardes Tutuncu, Savas Sencan, Canan Bilekyigit Kurt, Serdar Kokar, Osman Hakan Gunduz","doi":"10.1007/s00256-025-04868-8","DOIUrl":"10.1007/s00256-025-04868-8","url":null,"abstract":"<p><strong>Objective: </strong>Transforaminal epidural steroid injection (TFESI) is highly effective in alleviating radicular back pain. While predictive factors for TFESI treatment outcomes have been previously studied, there is a lack of data on the relationship between facet joint degeneration and TFESI efficacy. This study is aimed at studying the impact of facet joint degeneration on TFESI treatment outcomes for unilateral radicular pain.</p><p><strong>Design: </strong>A retrospective analysis was conducted on patients with unilateral radicular pain who underwent lumbosacral TFESI. Pain severity was assessed using the Numerical Rating Scale (NRS) at baseline, 1 h post-procedure, and 3 weeks post-procedure. Degree of facet joint degeneration was evaluated via MRI. Patients were categorized into two groups: low-grade facet joint degeneration group (group 1) and high-grade facet joint degeneration group (group 2).</p><p><strong>Results: </strong>A total of 147 patients were included in the study. NRS scores were significantly higher in group 2 compared to group 1 at the 3rd week follow-up. Treatment success, defined as a ≥ 50% reduction in NRS scores, was also significantly higher in group 1.</p><p><strong>Conclusion: </strong>Facet joint degeneration adversely impacts the treatment success of TFESI. A comprehensive evaluation of facet joint pathologies prior to procedure planning is imperative for optimizing treatment outcomes.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1689-1696"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-03-14DOI: 10.1007/s00256-025-04906-5
Antoine Moraux, Thomas Le Corroller
{"title":"Ultrasound and magnetic resonance imaging (MRI) assessment of piezogenic papules: A report of three cases.","authors":"Antoine Moraux, Thomas Le Corroller","doi":"10.1007/s00256-025-04906-5","DOIUrl":"10.1007/s00256-025-04906-5","url":null,"abstract":"<p><p>Piezogenic papules (PP) are protrusions of fat that form within the subcutaneous tissue, which are typically found on the heels. We herein describe the ultrasound (US) presentation (topography, echogenicity, shape, dynamic reducibility, and power Doppler activity) and magnetic resonance imaging features (topography, signal, and shape) of PP in three female patients who were referred to our institution for evaluation of soft tissue nodules of the heel. Then, we discuss the anatomy of the heel fat pad and its implication in the pathophysiology of PP. Because PP consist of herniations of subcutaneous fat from deep macrochambers to superficial microchambers through focal defects in the fibroconjunctive capsule of the heel fat pad, dynamic US can demonstrate the reducibility of PP under probe compression and therefore allows easy differentiation from other soft tissue tumors.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1779-1785"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-01-22DOI: 10.1007/s00256-025-04865-x
Sara Haseli, Chankue Park, Arash Azhideh, Gita Karande, Majid Chalian
{"title":"Performance and reliability comparison: original vs. revised bone reporting and data system (Bone-RADS).","authors":"Sara Haseli, Chankue Park, Arash Azhideh, Gita Karande, Majid Chalian","doi":"10.1007/s00256-025-04865-x","DOIUrl":"10.1007/s00256-025-04865-x","url":null,"abstract":"<p><strong>Objective: </strong>To propose a revised bone reporting and data system (Bone-RADS) and evaluate its diagnostic performance and inter-reader reliability compared to the original Bone-RADS for solitary bone lesions on CT.</p><p><strong>Materials and methods: </strong>This retrospective study included 159 adult patients (mean age: 56 ± 19 years; 88 men) who underwent bone biopsy for solitary bone lesions between March 2005 and September 2021. Two radiologists (R1/2) independently categorized the lesions twice, once using the original Bone-RADS and once using the revised version. Lesions were classified as follows: (1, benign; 2, incompletely assessed; 3, indeterminate; 4, malignancy or requiring treatment). The revised Bone-RADS excluded the original criteria for lesion related pain and history of malignancy. Diagnostic performance was assessed using histopathology as the reference standard, and inter-reader reliability was analyzed.</p><p><strong>Results: </strong>The bone lesions included 96 lucent and 63 sclerotic/mixed lesions. Sensitivity showed no significant difference between the original and revised Bone-RADS for both readers across lucent and sclerotic/mixed lesions (all P ≥ .05). However, the specificity of the revised Bone-RADS was significantly higher than that of the original (lucent: 11% vs. 50% [R1], 11% vs. 46% [R2]; sclerotic/mixed: 32% vs. 92% [R1], 32% vs. 86% [R2]). Other performance metrics, including positive/negative predictive value and accuracy, were also higher in the revised Bone-RADS. Inter-reader reliability was higher for the revised Bone-RADS compared to the original (κ = .744 vs .854).</p><p><strong>Conclusion: </strong>The revised Bone-RADS significantly improved specificity while maintaining sensitivity compared to the original version.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1681-1688"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skeletal RadiologyPub Date : 2025-08-01Epub Date: 2025-01-16DOI: 10.1007/s00256-024-04862-6
Mehmet Emin Adin, Graham Woolf, Rahul Hegde, Aladine A Elsamadicy, Ehud Mendel, William B Zucconi, Darko Pucar, Nafi Aygün
{"title":"Sacral tumors: a comprehensive review of imaging, diagnostic challenges, and tumor mimics.","authors":"Mehmet Emin Adin, Graham Woolf, Rahul Hegde, Aladine A Elsamadicy, Ehud Mendel, William B Zucconi, Darko Pucar, Nafi Aygün","doi":"10.1007/s00256-024-04862-6","DOIUrl":"10.1007/s00256-024-04862-6","url":null,"abstract":"<p><p>The sacrum can harbor a diverse group of both benign and malignant tumors, including metastases. Primary tumors of the sacrum can arise from bone, cartilage, marrow, notochordal remnants, or surrounding nerves and vessels. Among a variety of primary tumors of the spine, chordoma, germ cell tumors and Ewing's sarcoma are recognized for their propensity to occur in the sacrum. Imaging is essential in diagnosis, pretreatment evaluation, and assessment of response to treatment. Radiography, CT and MRI are the primary modalities in assessing morphology and tumor extent whereas PET/CT is crucial in the evaluation of systemic disease in the setting of myeloma, lymphoproliferative disease, and metastasis. A definitive diagnosis is not always achievable by imaging as some tumors lack specific imaging features. However, as we detail in this comprehensive review, many entities have characteristic clinical and epidemiological factors as well as typical imaging findings that can help make either a confident diagnosis or offer a narrow list of differentials. We discuss a wide range of benign and malignant, primary, and secondary tumors that can involve the sacrum, highlighting the pertinent clinical details and typical imaging findings of these entities, enabling the reader to develop and apply a systematic approach to evaluating sacral masses on imaging. We also briefly describe non-neoplastic tumor mimics, which include developmental entities, infections, and insufficiency fractures.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1581-1606"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}