Skeletal Radiology最新文献

{"title":"Myopericytoma of the hand.","authors":"Patrick S Sullivan, Lily M Belfi, Roberto A Garcia, Duretti T Fufa, Roger J Bartolotta","doi":"10.1007/s00256-024-04849-3","DOIUrl":"10.1007/s00256-024-04849-3","url":null,"abstract":"<p><p>Myopericytoma is a rare benign smooth-muscle cell neoplasm of the subcutaneous soft tissues that is primarily found in young adults with a male predominance. We present the clinical, radiologic, and histopathologic features of a longstanding myopericytoma of the hand. We emphasize the features that help the radiologist and pathologist to accurately characterize this entity. Radiologic evaluation, particularly MRI, plays a crucial role in differentiating myopericytoma from other soft tissue masses. Characteristic MR features include a well-demarcated lesion with intense post-contrast enhancement, isointensity to muscle on T1-weighted imaging, and hyperintensity on T2-weighted imaging, often with a central vascular pedicle. Histopathologic examination reveals a concentric perivascular growth pattern, which helps to distinguish myopericytoma from other soft tissue tumors. Immunohistochemically, these myoid cell neoplasms stain positive for alpha-smooth muscle actin and h-caldesmon, lack nuclear atypia, and are not highly proliferative (relatively low Ki-67 index and very low mitotic activity). The vast majority stain negative for desmin and CD34. Treatment typically involves complete surgical resection, with excellent prognosis and rare recurrence. Despite its rarity, awareness of this entity is important for clinicians who encounter soft tissue masses of the extremities.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1531-1535"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781001","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":"Conventional radiography for the assessment of focal bone lesions of the appendicular skeleton: fundamental concepts in the modern imaging era.","authors":"George R Matcuk, Leah E Waldman, Brandon K K Fields, Marco Colangeli, Marco Palmas, Alberto Righi, Giacomo Filonzi, Amandine Crombé, Paolo Spinnato","doi":"10.1007/s00256-024-04854-6","DOIUrl":"10.1007/s00256-024-04854-6","url":null,"abstract":"<p><p>Bone lesions of the appendicular skeleton can be caused by primary benign or malignant tumors, metastases, osteomyelitis, or pseudotumors. Conventional radiography plays a crucial role in the initial assessment of osseous lesions and should not be underestimated even in this era of modern complex and advanced imaging technologies. Combined with patient age, clinical symptoms and biology, and lesion features including location, solitary versus multiplicity, density, margin (transitional zone evaluated with Lodwick-Madewell grading score), and, if present, the type of periosteal reaction and matrix mineralization can narrow the differential diagnosis or offer a likely diagnosis. These radiographic features help guide further follow-up or management.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1391-1406"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882891","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":"Test yourself question: 67 year old male with worsening right shoulder pain and restricted range of motion.","authors":"Kevin Quinlan, Scott Evans, Petra Balogh, Mahmoud Etaiwi, Rajesh Botchu","doi":"10.1007/s00256-025-04870-0","DOIUrl":"10.1007/s00256-025-04870-0","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1515-1516"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010414","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":"Direct traction MR imaging of the wrist: practical experience.","authors":"Miaoru Zhang, Stefanie W Y Yip, Su Wu, David K W Yeung, James F Griffith","doi":"10.1007/s00256-024-04842-w","DOIUrl":"10.1007/s00256-024-04842-w","url":null,"abstract":"<p><strong>Objective: </strong>To study the effect of direct wrist traction on patient pain and joint distraction on MRI.</p><p><strong>Materials and methods: </strong>291 patients (109 males, 182 females; mean age, 45.8 years) who underwent wrist MRI between November 2019 and September 2024 were studied (152 patients with traction, 139 patients without traction). All patients completed a questionnaire assessing wrist pain scores before, during, and ten minutes after MRI examination. Joint space width and cartilage visibility of the radiocarpal and intercarpal joints were assessed. For patients with arthroscopy within one year after MRI, diagnostic accuracy of intrinsic ligament and triangular fibrocartilage complex tears was assessed.</p><p><strong>Results: </strong>Fifty-seven (38%) of 152 traction patients had an average increase of 1 point (range, 0 ~ 2) in wrist pain following traction compared to 24 (17%) of 139 non-traction patients (p = 0.085). 44% traction patients and 38% non-traction patients reported non-wrist pain (mainly shoulder, neck), with no inter-group difference in location, prevalence, or pain score (all p values > 0.05). Average joint space width was 0.6 mm wider in the traction group (p < 0.001). On average, eighty-five (60%) of 141 traction patients had 'moderate' or 'good' articular cartilage visibility compared to 22 (17%) of 126 non-traction patients (p < 0.001). Traction tended to increase diagnostic accuracy for intrinsic ligament tear, though it did not reach statistical significance (p = 0.136).</p><p><strong>Conclusion: </strong>Compared to wrist MRI without traction, traction increases joint space width and improves cartilage visibility, though with a slight increase in wrist pain.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1407-1415"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772011","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":"Epithelioid angiosarcoma at a non-functioning arteriovenous fistula site in a renal transplant patient.","authors":"Rahim Akram, Asma Haider, Jawad Naqvi","doi":"10.1007/s00256-024-04848-4","DOIUrl":"10.1007/s00256-024-04848-4","url":null,"abstract":"<p><p>We present a case of biopsy-proven epithelioid angiosarcoma in an arteriovenous fistula (AVF). Angiosarcomas developing in non-functioning AVF in renal transplant recipients are rare clinical entities with poor prognosis. A 59-year-old male adequately immunosuppressed kidney transplant patient presented with pain and swelling at the site of a previously asymptomatic fistula. A duplex scan confirmed the presence of thrombosis present along the length of the AVF; however, in light of worsening pain and skin changes, an MRI scan was requested. This demonstrated a thrombosed brachiocephalic AVF and a more sinister appearing irregular segment infiltrating the underlying anterior compartment musculature with associated muscle oedema and internal irregular enhancement. A staging CT thorax showed indeterminate lymphadenopathy in the left axilla with no pulmonary lesions. Core needle biopsy of the primary lesion at the fistula site and subsequent biopsy of the axillary lymph nodes revealed metastatic angiosarcoma. A multidisciplinary decision was made to perform radical surgery with above-elbow amputation and simultaneous left axillary lymph node clearance. We focus on relevant imaging findings to facilitate early recognition of angiosarcoma, in particular, the importance of requesting urgent imaging of vascular access sites (functioning or not) in post-transplant patients presenting with swelling. Although rare, angiosarcoma is an important entity that should be considered in the differential diagnosis of soft tissue masses arising from a vascular access, especially in immunocompromised patients.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1543-1552"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807951","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":"Test Yourself Answer: Pain in left hip following previous surgery in a 60-year-old male.","authors":"K Howard, C Han, P Balogh, V Kurisunkal, Rajesh Botchu","doi":"10.1007/s00256-024-04838-6","DOIUrl":"10.1007/s00256-024-04838-6","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1565-1571"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755498","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":"Unusual bone abnormalities from therapeutic ultrasound diathermy: a radiological case report.","authors":"Isabela A N Cruz, Júlio B Guimarães, Marco A S Ratti, Thomas M Link, Marcelo A C Nico, Alípio G Ormond Filho","doi":"10.1007/s00256-024-04823-z","DOIUrl":"10.1007/s00256-024-04823-z","url":null,"abstract":"<p><p>This report describes bone marrow abnormalities arising as a consequence of therapeutic ultrasound diathermy, which are an uncommon diagnostic entity. Over the period from 2018 to 2023, 11 patients were identified that showed abnormalities of the bone marrow on MRI, as a direct result of ultrasound diathermy treatment. These abnormalities displayed consistent imaging features, characterized by areas of low T1W and high T2W signal intensity with well-demarcated geographic margins and central fatty areas, as can be seen in bone infarction. The imaging findings were localized in the superficial aspect of the bone, near the skin surface, corresponding to the site of ultrasound insonation. The clinical relevance of this report stems from the scarcity of documented cases and the unfamiliarity of this diagnostic entity among radiologists and orthopedic surgeons. The specificity of the imaging findings, their typical location, and the potential for resolution with cessation of the diathermy therapy reinforces the importance of this report. Recognition of this condition enables understanding potential adverse effects of ultrasound diathermy, increasing awareness regarding the importance of adhering to safe techniques and the use of this physical treatment modality in clinical practice. This information is also useful to athletic trainers, physical therapists, physical medicine and rehabilitation clinicians, and anyone who might perform ultrasound diathermy.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1517-1523"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740453","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":"Comparison of patient radiation exposure and procedure time between CT-fluoroscopy and spiral CT for lumbar epidural steroid injections.","authors":"Tina Shiang, Ged G Wieschhoff, Jim S Wu, Jacob C Mandell","doi":"10.1007/s00256-024-04858-2","DOIUrl":"10.1007/s00256-024-04858-2","url":null,"abstract":"<p><strong>Objective: </strong>To compare patient radiation exposure and procedure time for lumbar epidural steroid injections (ESIs) performed under CT-fluoroscopy (CTF) vs spiral CT-guidance.</p><p><strong>Materials and methods: </strong>A retrospective cohort study of 767 consecutive lumbar ESIs performed between 2015-2023 using CTF vs spiral CT-guidance was conducted. Patient characteristics (age, sex, weight), procedural characteristics (injection level, type of ESI, trainee participation), and outcomes (patient radiation exposure, procedure time, pain relief, complications) were compared. Student's t and chi-squared tests were performed for statistical analysis.</p><p><strong>Results: </strong>There were 240 CTF and 527 spiral CT-guided lumbar ESIs. There were no significant differences in patient demographics between groups. Radiation exposure for the CTF group was 37.2 ± 50.5 mGy <math><mo>∙</mo></math> cm, compared to 251.1 ± 178.6 mGy <math><mo>∙</mo></math> cm in the spiral CT group (p < 0.001). Procedure times were shorter in the CTF group (20.1 ± 6.1 vs 29.6 ± 12.9 min, p < 0.001). There was no significant difference in immediate post-procedure pain reduction in CTF vs spiral CT groups (p = 0.12). There were no intrathecal puncture complications in the CTF group and four in the spiral CT group. Subgroup analysis of attending-only and trainee-performed lumbar ESIs comparing CTF vs spiral-CT groups showed similar results as the primary analysis, with significant reductions in patient radiation (attending: 31.6 ± 40.7 vs 144.4 ± 97.4 mGy <math><mo>∙</mo></math> cm; trainee: 40.7 ± 55.5 vs 264.5 ± 182.0 mGy <math><mo>∙</mo></math> cm; both p < 0.001) and procedural time (attending: 18.3 ± 4.2 vs 24.4 ± 7.4 min; trainee: 21.2 ± 6.8 vs 30.2 ± 12.4; both p < 0.001).</p><p><strong>Conclusion: </strong>Image-guided lumbar ESIs using CTF were associated with less patient radiation exposure and shorter procedure times without differences in pain relief when compared with spiral CT technique in our practice.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1491-1501"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877845","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":"A simplified fluid-sensitive MRI protocol for the hands to detect inflammation without contrast administration: a large study of symptom-free subjects from the general population as a reference for normality.","authors":"Anna M P Boeren, Dennis A Ton, Elise van Mulligen, Bianca Boxma-de Klerk, Pascal H P de Jong, Edwin H G Oei, Monique Reijnierse, Annette H M van der Helm-van Mil","doi":"10.1007/s00256-024-04843-9","DOIUrl":"10.1007/s00256-024-04843-9","url":null,"abstract":"<p><strong>Objective: </strong>MRI of the hands is valuable for risk-stratification in patients with arthralgia at-risk for developing rheumatoid arthritis (RA). Contrast-enhanced MRI is considered standard for assessment of RA, but has practical disadvantages. It also shows inflammation-like features in the general population, especially at older age, which should be considered in image interpretation. The modified-Dixon (mDixon) technique is reliable compared to contrast-enhanced sequences. Moreover, this short protocol without contrast-enhancement is patient-friendly. Whether it also shows inflammation-like features in the general population is unknown. We studied this to support accurate use in the clinic.</p><p><strong>Methods: </strong>Two hundred twenty symptom-free volunteers from different age-categories were recruited from the general population and underwent mDixon MRI of both hands. Two readers independently scored MRIs for synovitis, tenosynovitis, and bone marrow edema (BME) in the metacarpophalangeal-joints (MCP) and wrists according to the RAMRIS. Features were considered present if scored by both readers; frequencies > 5% were considered relevant in terms of specificity and determined per age-category (< 40/40- < 60/ ≥ 60-years).</p><p><strong>Results: </strong>Higher age correlated with higher BME-scores (p-value < 0.005), but not with synovitis and tenosynovitis-scores. BME (grade 1) occurred in some bones in people aged ≥ 60, 14% had BME in the lunate, 7% in metacarpal-1, and 6% in the trapezium. Synovitis and tenosynovitis did not occur in > 5%, except for grade-1 synovitis in the right distal radio-ulnar-joint in people aged ≥ 60 (11%).</p><p><strong>Conclusion: </strong>On mDixon MRI, inflammatory features in the hands of the general population are rare. This facilitates image interpretation. To prevent overinterpretation, only several locations should be considered when evaluating people aged ≥ 60-years.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1429-1439"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802233","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":"Assessment of calf muscle constitution in chronic Achilles tendon disease using Dixon-based MRI.","authors":"Sophia S Goller, Georg W Kajdi, Stephan Wirth, Jess G Snedeker, Reto Sutter","doi":"10.1007/s00256-024-04845-7","DOIUrl":"10.1007/s00256-024-04845-7","url":null,"abstract":"<p><strong>Objectives: </strong>To assess calf muscle constitution in chronic Achilles tendon disease (ATD) using two-point Dixon-based MRI (2pt-MRI_DIXON).</p><p><strong>Materials and methods: </strong>This retrospective study analyzed 91 patients (36 females; 57.0 ± 14.4 years) with midportion or insertional chronic ATD who underwent clinical MRI of the Achilles tendon (AT), including 2pt-MRI_DIXON for quantitative assessment of calf muscle fat content (MFC). Additionally, two radiologists qualitatively assessed MFC, AT quality, and co-pathologies. 2pt-MRI_DIXON-derived fat fractions (FF) were related to patients' demographics and qualitative imaging findings.</p><p><strong>Results: </strong>The overall mean FF derived from 2pt-MRI_DIXON of the triceps surae muscle was 11.2 ± 9.3%. Comparing midportion and insertional ATD, there was no significant difference regarding fatty muscle infiltration assessed with 2pt-MRI_DIXON (P ≥ .47) or qualitative grading (P ≥ .059). More severe AT thickening (11 vs.9 mm, P < .001) and complete tears (29 vs. 9%, P = .025) were significantly more common in midportion ATD, while partial tears were significantly more frequent in insertional ATD (55 vs. 31%, P = .027). Soleus muscle edema was more prevalent in midportion than insertional ATD (40 vs. 9%, P = .002). In contrast, insertional ATD more commonly featured bone marrow edema (61 vs. 2%), Haglund's deformity (67 vs. 0%), and retrocalcaneal bursitis (82 vs. 43%) (P ≤ .002). Significant correlations (P ≤ .001) were demonstrated between FF, AT diameter, age (both in midportion and insertional ATD), and body mass index (in midportion ATD only) (ρ range = 0.53-0.61).</p><p><strong>Conclusion: </strong>In chronic ATD, calf MFC was statistically equivalent (approximately 11%), irrespective of the localization of tendon damage. More severe tendon thickening and complete tears were more common in midportion ATD, and, vice versa, partial AT tears were significantly more frequent in insertional ATD.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1457-1468"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807947","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}