Skeletal Radiology最新文献

{"title":"Recent evolution in imaging techniques for assessment of synovitis in osteoarthritis.","authors":"Daichi Hayashi, Kevin Tu, Frank W Roemer, Ali Guermazi","doi":"10.1007/s00256-025-04908-3","DOIUrl":"10.1007/s00256-025-04908-3","url":null,"abstract":"<p><p>Synovitis remains an important marker of osteoarthritis (OA) disease incidence and progression, and is best assessed using imaging. In general, MRI with intravenous contrast is considered the gold standard method for assessing synovitis because it can effectively differentiate inflamed synovium and adjacent joint effusion and other surrounding structures. However, administration of intravenous gadolinium is not always desirable. Several emerging methods are being explored for the visualization of synovitis using non-contrast-enhanced MRI (NCE-MRI) but currently underestimate the amount of inflammation. Ultrasound is another approach that is able to measure and quantify synovitis; however, as with other applications of ultrasound, it is observer-dependent, which may affect reproducibility. Radiography does not play a role in synovitis assessment due to its inability to differentiate intraarticular soft tissues. CT, when contrast enhanced, has been shown to effectively detect synovitis and may be a viable alternative to MRI when MRI is contraindicated or not available. Nuclear medicine techniques such as PET-CT, PET-MRI, and SPECT-CT are not routinely used due to high cost, radiation exposure, and image acquisition times. However, novel radiotracers/biomarkers are being investigated. AI approaches have been investigated for their ability to predict clinical and structural outcomes and for automated detection and quantification including features such as effusion-synovitis.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2329-2338"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693195","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}

{"title":"Recent developments in pharmacologic therapy of synovitis in osteoarthritis.","authors":"Francis Berenbaum","doi":"10.1007/s00256-025-04976-5","DOIUrl":"10.1007/s00256-025-04976-5","url":null,"abstract":"<p><p>Osteoarthritis (OA) is now considered an inflammatory disease in which synovitis has an active role in the generation of pain and structural progression. Despite attempts to reposition treatments for rheumatoid arthritis without conclusive success, synovitis remains a viable therapeutic target to slow progression and enhance the quality of life of OA patients. This review highlights the main targets explored today at the clinical and preclinical levels with the goal to not only relieve the symptoms but also to provide real disease modifying treatments that can prevent further joint damage and improve joint function by treating synovitis.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2481-2488"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336842","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}

{"title":"Optimizing contrast timing in photon-counting detector CT for the assessment of peripheral arthritis.","authors":"Akos Horvath, Rita Csercsik, Janos Norbert Gyebnar, Daniel Sandor Veres, Pal Maurovich-Horvat, Akos Menyhart, Viktoria Gyergyoi, Peter Vince Balint, Nikolett Marton","doi":"10.1007/s00256-025-04993-4","DOIUrl":"10.1007/s00256-025-04993-4","url":null,"abstract":"<p><strong>Objective: </strong>Photon-counting detector CT (PCD-CT) allows for iodine mapping of inflamed tissues in peripheral immune-mediated arthritis, supporting diagnosis and disease activity assessment. This study aims to identify the optimal timing for image acquisition after intravenous iodinated contrast administration to maximize enhancement and contrast with surrounding tissues.</p><p><strong>Methods: </strong>High-resolution PCD-CT scans of bilateral wrist-hand regions were obtained from 26 patients with peripheral arthritis, both native and post-contrast (1 ml/kg intravenous iodinated contrast at 2.5 ml/sec flow) at 120-, 180-, and 240-s delay phases. Iodine maps were constructed from spectral data. Phases were compared based on densities and iodine concentrations measured in synovial, tenosynovial, and periungual tissues, with muscle, fat, and vessels as controls. We used descriptive statistics and mixed-effects linear regression inferential models for the comparisons. Synovitis and tenosynovitis were verified by ultrasound measurements.</p><p><strong>Results: </strong>No significant differences (p > 0.05) were found in iodine concentration or density across the 120-, 180-, and 240-s post-contrast phases in inflamed synovial, tenosynovial, and periungual soft tissues. Inflamed tissues showed significant and consistent differences in iodine concentration from muscle and fat (p < 0.0001) across all phases, while the greatest differentiation from vessels was in the 120-s phase. The effective dose was identical across all post-contrast phases (0.028 ± 0.0035 mSv).</p><p><strong>Conclusion: </strong>Iodine uptake in inflamed tissues was identical across all three post-contrast phases. However, the 120-s phase offered the highest contrast between inflammation and surrounding vascular structures while minimizing scan time, supporting its use for standardized follow-up imaging.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2565-2578"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800177","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":"Whole-body MRI in arthritis.","authors":"Fabio Zecca, Denise Dejua, Winston J Rennie, Luca Saba","doi":"10.1007/s00256-025-04998-z","DOIUrl":"10.1007/s00256-025-04998-z","url":null,"abstract":"<p><p>Whole-body MRI (wbMRI) is an advanced scan modality which provides high-contrast resolution images of the entire body for screening, diagnosis, staging, and surveillance purposes. Thanks to recent technological advancements, wbMRI has gained increasing attention as a valuable tool for diagnosing and monitoring systemic arthritides by virtue of its comprehensive coverage. This technology is particularly beneficial for inflammatory conditions like rheumatoid arthritis, seronegative spondyloarthropathy, juvenile idiopathic arthritis, and chronic aseptic osteitis, all characterized by multifocal involvement of both skeletal and extra-skeletal sites. Unlike conventional MRI targeting symptomatic areas, wbMRI enables concurrent early detection also of subclinical disease foci, providing a more accurate assessment of the total disease burden. Compared to plain radiography, conventional ultrasound, and targeted MRI, wbMRI offers better sensitivity and reproducibility, particularly for intraosseous findings and axial involvement. In addition, wbMRI can be tailored to specific clinical needs through customizable scan protocols, and the lack of ionizing radiation makes it ideal for monitoring autoimmune diseases also in sensitive cohorts. Although wbMRI holds great potential for improving diagnostic accuracy and patient outcomes in inflammatory arthritis, further research is needed to validate standard scan protocols, to confirm their cost-effectiveness, and to integrate them into routine clinical practice. The present article aims to overview the current wbMRI technology and discuss it in the context of inflammatory arthritis. A general wbMRI protocol for non-oncologic musculoskeletal application is also provided.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2517-2539"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967812","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":"Imaging in clinical trials for psoriatic arthritis: a scoping review.","authors":"Andrew Xiao, Ainge Roy, Liz Dennett, Elaine Yacyshyn, Matthew D Li","doi":"10.1007/s00256-025-04884-8","DOIUrl":"10.1007/s00256-025-04884-8","url":null,"abstract":"<p><p>Psoriatic arthritis (PsA) is a chronic inflammatory condition principally affecting the skin and musculoskeletal system, associated with comorbidities and decreased quality of life. Imaging is crucial for diagnosis, monitoring progression, and evaluating treatment efficacy; therefore, it plays an important role in PsA clinical trials. In this review, we aimed to characterize how imaging modalities and advances in imaging techniques are being used specifically in the PsA clinical trial literature. Following the Arksey and O'Malley framework for scoping reviews, we conducted a comprehensive search of multiple literature databases, from January 1, 2000, to June 27, 2024. We captured 1961 articles and after deduplication, title and abstract screening, and full-text review, 53 studies were included. Radiographs were the most used imaging modality (n = 32/53, 60%), and radiographic progression was frequently measured using the PsA-modified Sharp/van der Heijde score. MRI (n = 16/53, 30%) was used in evaluating peripheral and axial disease, with more recent adoption of validated scoring systems (PsAMRIS and SPARCC). Ultrasound (n = 11/53, 21%), including power Doppler, was used to assess soft tissue inflammation. Standardized scoring systems (e.g. GLOESS) were used in a minority of ultrasound-based studies. Multimodality imaging (n = 7/53, 13%) and CT (n = 2/53, 4%) was uncommon. The development of PsA-specific scoring systems for radiographs and MRI has been instrumental in advancing imaging assessment in PsA. However, their application remains limited, particularly in ultrasound, where further standardization is needed. Future clinical trials should focus on increasing the adoption of PsA-specific scoring systems, exploring advanced techniques (e.g. DCE-MRI), and multi-modal imaging to improve PsA disease monitoring.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2275-2289"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256516","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}

{"title":"Musculoskeletal manifestations of systemic lupus erythematosus.","authors":"Erica M Lanser, Iwona Sudol-Szopinska, Jennifer S Weaver, Matthew Vickery, Mihra S Taljanovic","doi":"10.1007/s00256-025-04896-4","DOIUrl":"10.1007/s00256-025-04896-4","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease affecting nearly every organ system in the body. The musculoskeletal (MSK) system is frequently affected and often the earliest site of disease presentation. Tendon, tendon sheath, bone, muscle, and soft tissue involvement is assessed through a multimodality approach. Radiology has an evolving role in the diagnosis and management of SLE. In this article, the authors discuss the epidemiology, pathophysiology, and typical imaging findings, as well as review the role of imaging in the management of SLE.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2305-2314"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459431","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}

{"title":"Imaging evaluation of rheumatologic musculoskeletal disorders in children.","authors":"Atsuhiko Handa, Sofia B Restrepo, Ricardo Restrepo, Terri Williams-Weekes, Edward Y Lee","doi":"10.1007/s00256-025-04910-9","DOIUrl":"10.1007/s00256-025-04910-9","url":null,"abstract":"<p><p>Imaging plays a vital role in the diagnosis and management of pediatric inflammatory musculoskeletal disorders. Currently, various imaging modalities are utilized in a stepwise approach, each providing complementary information. This article explores the advantages and limitations of currently available imaging techniques, including plain radiography, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), in the assessment of pediatric inflammatory musculoskeletal disorders. Additionally, characteristic imaging features of major pediatric inflammatory conditions are reviewed, including juvenile idiopathic arthritis, chronic nonbacterial osteomyelitis, Caffey disease, and juvenile idiopathic inflammatory myopathies.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2357-2371"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743665","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}

{"title":"Non-FDG PET/CT imaging of inflammatory arthritis.","authors":"Rodolfo Núñez, Michael Reso, Daichi Hayashi","doi":"10.1007/s00256-025-05006-0","DOIUrl":"10.1007/s00256-025-05006-0","url":null,"abstract":"<p><p>Inflammatory arthritis represents a frequent cause of disability among adults, with a huge worldwide negative societal impact. Although clinical and laboratory evaluation of patients with inflammatory arthritis still constitutes the basis of management for these patients, conventional medical imaging has traditionally provided an important aid in the assessment of these conditions. There is a pressing need to obtain an independent, objective, and reproducible imaging evaluation to support the diagnosis of disorders that are difficult to assess or determine response to an increasing number of frequently expensive treatment modalities. This could provide personalized precision medical care, tailored to the specific clinical needs of each patient. Although there has been an early recognition of the potential role that FDG-PET/CT could play in the evaluation of inflammatory or infectious disorders, its clinical introduction has been very slow, in part because approval for reimbursement did not happen until 2021. Nevertheless, there are many publications demonstrating the clinical benefit of PET imaging with FDG and other PET radiopharmaceuticals in the management of these patients. In this narrative review, we will describe the potential applications of non-FDG PET/CT imaging to assess different aspects of the complex inflammatory cascade present in inflammatory arthritis, as well as new technical developments.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2503-2515"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856225","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}

{"title":"Recent advances and insights into imaging of axial spondyloarthritis.","authors":"Robert G W Lambert, Michael J Tuite","doi":"10.1007/s00256-025-04899-1","DOIUrl":"10.1007/s00256-025-04899-1","url":null,"abstract":"<p><p>Imaging of the axial skeleton is a critical component of the diagnosis, management and follow-up of axial spondyloarthritis which may be difficult on clinical grounds and biological data alone. The sacroiliac joints (SIJ) are anatomically complex with high incidence of normal variation and degenerative change and techniques used to image the SIJ vary widely. Interpretation of MRI scans of the axial skeleton is facilitated by employing consistent protocols in which sequences are designed for the sensitive detection of inflammatory lesions, fat metaplasia and bone erosion. Considerable research has been undertaken in recent years to improve the accuracy of detection of these findings in early disease and detection of structural damage changes that would allow improvements in diagnosis and management of SpA patients. This review will examine recent advances in our understanding of axSpA and discuss innovations in MRI and CT, focusing on how to optimize a standard acquisition protocol for MRI of the SIJ, and discussing how to avoid some common technical pitfalls that may be encountered in MRI clinical practice.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2315-2328"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568077","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}

{"title":"Structural effects of whole body electromyostimulation on knee osteoarthritis: the EMSOAT Study.","authors":"Frank W Roemer, Stephanie Kast, Wolfgang Kemmler, Jamie E Collins, Klaus Engelke, Ali Guermazi, Michael Uder, Simon von Stengel","doi":"10.1007/s00256-025-04984-5","DOIUrl":"10.1007/s00256-025-04984-5","url":null,"abstract":"<p><strong>Objective: </strong>Whole-body electromyostimulation (WB-EMS) might be an alternative option to conventional strength training for patients with knee osteoarthritis (OA). Our aim was to compare structural changes of knee OA between patients treated with WB-EMS and a control group (CG) treated with a standard of care approach.</p><p><strong>Material and methods: </strong>Seventy-two overweight participants with symptomatic knee OA were assigned to either WB-EMS or CG. MRIs were acquired at baseline and 7 months using a 3 T system. MRIs were read according to the MRI Osteoarthritis Knee Score (MOAKS) instrument. Between-group differences in regard to change in cartilage, bone marrow lesions (BMLs), osteophytes, meniscus damage and extrusion, and markers of inflammation were analyzed using Fisher's Exact and Wilcoxon Rank Sum tests.</p><p><strong>Results: </strong>Fewer knees in the WB-EMS groups showed cartilage worsening compared to the CG (18% vs. 40%, p = 0.046). There were fewer knees in the WB-EMS group showing an increase in BML size score of ≥ 1 (30% vs 46%, p = 0.43). Regarding prevalent BMLs that showed improvement, no change, or worsening, no differences were seen (p = 0.56). Little osteophyte and meniscal changes were observed during the observational period. Differences regarding change in inflammatory markers were not significant.</p><p><strong>Conclusion: </strong>While there was a difference with fewer subregions showing worsening cartilage damage in the WB-EMS group, no significant differences were observed for change in BMLs, inflammation, osteophytes, and meniscal parameters. The observed improvement in clinical outcome parameters in favor of the WB-EMS group is likely due to other effects than improvement or less worsening of structural changes.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2579-2588"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691417","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}