Skeletal Radiology最新文献

{"title":"Development and evaluation of an ultra-high-resolution cone-beam computed tomography system for hand and foot.","authors":"Wakiko Tani, Katsuhiro Ichikawa, Hiroki Kawashima, Kaoru Tada","doi":"10.1007/s00256-025-05077-z","DOIUrl":"10.1007/s00256-025-05077-z","url":null,"abstract":"<p><strong>Objective: </strong>To develop an experimental ultra-high-resolution cone-beam computed tomography (UHRCBCT) system for imaging the human hand and foot and to evaluate its spatial resolution, image noise, radiation dose, and feasibility through phantom and volunteer studies.</p><p><strong>Materials and methods: </strong>The UHRCBCT system was built based on a 0.5-mm focal spot X-ray tube and a 0.099-mm pixel CMOS detector. A low magnification geometry (magnification: 1.22) was applied to reduce geometry blurring. Images were reconstructed with a voxel size of 0.10 × 0.10 × 0.10 mm³. Radiation dose was quantified by measuring the CT dose index (CTDI) corresponding to the scanning method. Spatial resolution and image noise were quantitatively evaluated using a 0.1-mm copper wire and a water phantom, respectively, in comparison with those of a high-resolution multi-slice CT system (HRMSCT, detector size: 0.25 mm at isocenter) for the matched radiation dose. Scans were also performed on a foot phantom using UHRCBCT and HRMSCT and on carpal bones of healthy volunteers using UHRCBCT under ethical approval.</p><p><strong>Results: </strong>The effective dose estimated from CTDI was 0.024 mSv using a conversion factor of 0.0005 mSv/(mGy cm), which was within the lowest category for healthy volunteers in ICRP publication 103. The 5%MTF-based spatial resolution was 0.10 mm, significantly smaller than 0.23 mm achieved by HRMSCT. Image noise was approximately twice as high in UHRCBCT; however, trabecular bone structures and joint spaces were more distinctly visualized in both phantom and volunteer images.</p><p><strong>Conclusion: </strong>UHRCBCT achieved a high resolution of 0.10-mm in imaging trabecular hand and foot bones with an acceptable radiation dose, indicating potential for clinical application in orthopedic diagnosis.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1385-1392"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507135","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":"Soft tissue reporting and data system (soft tissue-RADS): framework for radiologists specializing in imaging of musculoskeletal tumors and tumor-like lesions.","authors":"Avneesh Chhabra, Mark D Murphey, Mahad Rehman, Majid Chalian, Ty Subhawong, Shivani Ahlawat, Kambiz Motamedi, Jim S Wu, Behrang Amini, Gitanjali Bajaj, Jonathan Samet, Shyam Ramachandran, Madison Havranek, Yin Xi, Julie Fanburg-Smith, Edwin Choy, Carol D Morris, Hillary W Garner","doi":"10.1007/s00256-026-05134-1","DOIUrl":"10.1007/s00256-026-05134-1","url":null,"abstract":"<p><p>Soft tissue-RADS scoring system for musculoskeletal (MSK) tumor and tumor-like lesions is recently published. The system includes diagnostic MRI flowcharts and algorithms for lipomatous masses, cyst-like or high-water content masses, and indeterminate-solid appearing masses with consistent and standardized management recommendations. MSK radiology and cancer imaging training commonly provides the essential skills needed to render appropriate prospective diagnosis for many non-neoplastic tumor-like lesions and various commonly encountered sarcomas. Such trained readers may benefit from additional advanced algorithms to accurately identify and categorize different benign tumors and sarcomas and correctly input them in the soft tissue-RADS scoring system. These algorithms are built from a comprehensive literature search to establish an evidence-based composite and are supported by the expert opinions of the multidisciplinary ACR-soft tissue-RADS team. In this article we provide (1) a literature review of multimodality imaging, immunopathology, and clinical findings of soft tissue tumors and tumor-like lesions, presented in 7 tables (condensed from the 12 tables published in the WHO classification of soft tissue tumors) with respective table summaries; (2) a suggested modality-based lexicon; and (3) advanced diagnostic algorithms for trained readers based on published evidence and expert opinion that feed into the soft tissue-RADS scoring system (categories 1-6). The purpose of this work is to provide comprehensive guidance on soft tissue-RADS scoring to help streamline care for soft tissue tumors and tumor-like lesions and optimize patient outcomes.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1227-1267"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491530","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":"Investigating possible predictors of malignant transformation of osteochondroma: a retrospective cohort study with an illustrative case report.","authors":"Lucy L Hederick, Megan H Goh, Adrián Ibáñez-Navarro, Joseph J Connolly, Shreya R Halur, Aiden R Miller, Blake A Flood, G Petur Nielsen, Connie Y Chang, Santiago A Lozano-Calderón","doi":"10.1007/s00256-026-05162-x","DOIUrl":"10.1007/s00256-026-05162-x","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between cartilage cap thickness, osteochondroma subtype (pedunculated vs. sessile), patient age, and multiple hereditary exostoses (MHE) diagnosis with malignant transformation of osteochondromas.</p><p><strong>Methods: </strong>A single-institution retrospective study of patients who underwent surgical excision of one or more osteochondromas between 1983 and 2025 was conducted. The relationship between cartilage cap thickness, osteochondroma subtype (pedunculated vs. sessile), patient age, and MHE diagnosis with malignant transformation was investigated.</p><p><strong>Results: </strong>Among 1138 pathology-confirmed osteochondromas, 1097 (96.4%) were benign osteochondromas and 41 (3.60%) underwent malignant transformation. In tumors with a pathology-measured cartilage cap (n = 411), benign tumors (n = 397) had a smaller median cap size than malignant lesions (0.3 cm [IQR: 0.2-0.6 cm] vs. 3.15 cm [IQR: 1.93-4.78 cm]; p < .0001). Among 27 malignant cases with preoperative imaging, 63% were sessile and 37% pedunculated. Patients with benign tumors were younger than those with malignant transformations (27.1 ± 15.9 vs. 37.8 ± 12.2 years; p < .0001). Patients with MHE had a greater incidence of malignant transformation compared to patients without (17% vs. 1.98%) (p < .0001). 137 MRIs and 37 CTs were compared to pathology measurements, yielding a concordance correlation coefficient of 0.80 and 0.92, respectively. The sensitivities and specificities were 29% and 91% for MRI and 67% and 94% for CT, respectively.</p><p><strong>Conclusion: </strong>A thicker cartilage cap, older age, and confirmed MHE diagnosis were each significantly associated with a higher rate of malignant transformation. Multidisciplinary teams should factor in a patient's clinical presentation and past medical history in addition to the tumor characteristics in deciding the proper course of treatment.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1309-1319"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158403","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: 38-year-old female with left hip pain.","authors":"Ruhaid Khurram, Amar Nitin Kanani, Mohammed Saif Sait, Khamaeel Khaleel Al Lami, Ramanan Rajakulasingam","doi":"10.1007/s00256-026-05145-y","DOIUrl":"10.1007/s00256-026-05145-y","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1429-1432"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107199","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":"Intradural extraosseous Ewing sarcoma.","authors":"Leonor Garbin Savarese, Mateus de Andrade Hernandes, Daniel Olivatto Zanutto, Joel Del Bel Pádua, Marcello Henrique Nogueira-Barbosa","doi":"10.1007/s00256-026-05165-8","DOIUrl":"10.1007/s00256-026-05165-8","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1433-1435"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202307","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":"MRI features of joint capsule-originating hamartomas in a pediatric patient with tuberous sclerosis: a novel case report.","authors":"Yusuf Yahsi, Rodi Ertogrul, Hayri Ogul","doi":"10.1007/s00256-025-05122-x","DOIUrl":"10.1007/s00256-025-05122-x","url":null,"abstract":"<p><p>Hamartomas are well-recognized benign growths associated with tuberous sclerosis complex (TSC), occurring frequently in the skin, central nervous system, and kidneys. Although musculoskeletal manifestations have been documented, intra-articular hamartomas originating specifically from the joint capsule have not been previously reported to the best of our knowledge. We present a unique case involving a 9-year-old female with genetically confirmed TSC who exhibited multiple intra-articular hamartomatous lesions originating from the joint capsules of the hip and knee. These lesions were distinctly visible on magnetic resonance imaging (MRI), displaying signal characteristics consistent with hamartomas, and they were confirmed by histopathological analysis. This underscores the importance of considering capsular hamartomas in the differential diagnosis of intra-articular masses in TSC and highlights the diagnostic value of MRI in identifying such rare manifestations.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1403-1407"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966991","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":"Guide to lower extremity radiologic measurements: part 2 knee.","authors":"Allison M Crone, Imran M Omar, Allison M Bronson, Lucas T Buchler, Ryan S Selley, Jennifer S Weaver, Andrea S Klauser, Mihra S Taljanovic","doi":"10.1007/s00256-026-05187-2","DOIUrl":"10.1007/s00256-026-05187-2","url":null,"abstract":"<p><p>Although most imaging assessments are made qualitatively, quantitative measurements in orthopedic imaging are becoming more important in detecting subtle findings and assessing degrees of abnormality, which can help direct surgical management. In the knee, patellofemoral maltracking is a common cause of anterior pain, particularly in younger patients. Failure to recognize this pathophysiology may result in accelerated chondral loss and osteoarthritis (OA), and the imaging findings may be subtle. As a result, clinicians and radiologists have developed numerous measurements to detect and quantify patellofemoral alignment. Additional entities, such as femorotibial subluxation or angular abnormalities, may only be detected by using standardized measurements and can help detect ligamentous insufficiency or developmental malalignment, which can lead to instability and OA in the medial and lateral femorotibial compartments. Finally, the proper positioning and hardware selection for knee arthroplasty are critical to preventing early hardware failure and postsurgical pain. This review, which focuses on the knee, is the second in a three-part series discussing the appropriate imaging modalities on which to obtain specific lower extremity measurements as well as proper measurement techniques, grouped by pathology. Furthermore, the normal value or range of values according to current literature is reported, along with the significance of abnormal measurements.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1197-1216"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475168","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":"Clinical impact of adopting an AI-driven opportunistic bone health screening software using routine X-ray.","authors":"Catriona Aileen Syme, Melanie Lopes, Alexander Bilbily, Mark D Cicero","doi":"10.1007/s00256-026-05148-9","DOIUrl":"10.1007/s00256-026-05148-9","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical impact of an artificial intelligence device, Rho, that opportunistically screens X-rays for low bone mineral density (BMD; DXA T-score < -1).</p><p><strong>Materials and methods: </strong>Over 13 months, Rho analyzed X-rays from patients ≥ 50 years at a large independent health facility. Radiologists could opt to include Rho-flagged findings in their X-ray reports. DXAs that occurred within 6 months of an X-ray (from patients in the first 7 months of data collection) were categorized as being prompted by Rho (\"Rho-generated\") or arranged via usual standard-of-care practice (\"pre-planned\"), and their outcomes (diagnoses and 10-year fracture risk scores) were compared.</p><p><strong>Results: </strong>Of 34,162 X-rays, Rho flagged 19,004 (56%) for low BMD, and radiologists included this information in 7726 (41%) reports. From the first 7 months of radiologists reporting Rho findings, initial and surveillance DXAs increased by factors of 1.8 and 1.4, respectively. Of 299 Rho-generated DXAs, 193 had low bone mass (- 2.5 < T-score < - 1) and 65 had osteoporosis. Rho-generated DXAs vs. pre-planned DXAs identified a greater proportion of patients with low BMD (87% vs. 69%; p < 0.001) and similar proportions of patients with elevated fracture risk (34% vs. 40%). The diagnostic yield was particularly marked in patients undergoing their first-ever DXA (84% vs. 60%; p < 0.001), and in males ≥ 65 years (83% vs. 45%; p < 0.001).</p><p><strong>Conclusion: </strong>Incorporating Rho in radiology workflow nearly doubled initial bone health assessments and prompted additional surveillance DXA evaluations. Rho-generated DXAs captured higher rates of true low BMD than standard-of-care practices, particularly in older men.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1321-1327"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158413","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":"Phosphaturic mesenchymal tumour, connective tissue variant: a rare radiological presentation involving the radius mimicking fibrous dysplasia with oncogenic rickets.","authors":"Amar Nitin Kanani, Benjamin Jacobs, Thillainayagam Muthukumar, Ramanan Rajakulasingham, Ruhaid Khurram","doi":"10.1007/s00256-026-05149-8","DOIUrl":"10.1007/s00256-026-05149-8","url":null,"abstract":"<p><p>Phosphaturic mesenchymal tumours (PMTs) are rare neoplasms that secrete fibroblast growth factor-23 (FGF-23), causing tumour-induced osteomalacia (TIO). Histological overlap with juvenile psammomatoid ossifying fibroma (JPOF) can lead to diagnostic difficulty, particularly outside the craniofacial skeleton. A 4-year-old girl presented with a painful forearm swelling. Radiographs demonstrated a fibro-osseous lesion in the radius and biopsy was initially non-diagnostic, leading to a presumptive diagnosis of fibrous dysplasia. Over the next 6 years, the lesion enlarged, and at age 10, the patient developed genu valgum with biochemical evidence of hypophosphataemic rickets (low phosphate, raised alkaline phosphatase, elevated FGF-23). Medical therapy corrected the rickets, though deformity required guided growth surgery. At age 13, a repeat biopsy of the enlarging lesion revealed a fibro-osseous tumour with spindle stroma and psammomatoid ossicles, negative for GNAS mutation, and consistent with a phosphaturic mesenchymal tumour, connective tissue variant. This case highlights a rare radiologic presentation of PMT involving a long bone, with imaging features closely mimicking fibrous dysplasia and histological overlap with JPOF. The rapid progression of imaging findings, discordant metabolic abnormalities and markedly elevated FGF-23 levels poses a diagnostic challenge. As such, fibrous dysplasia-like lesions of the extremities in the setting of hypophosphataemic rickets should prompt consideration of PMT.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1415-1419"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107131","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":"Pathologic fracture following neoadjuvant therapy: a paradoxical radiological sign of effective treatment response.","authors":"Ahmet Onur Çelik, Fethi Emre Ustabaşioğlu, Meltem Ayyildiz Mercan, Savaş Yildirim, Ahmet Küçükarda","doi":"10.1007/s00256-026-05181-8","DOIUrl":"10.1007/s00256-026-05181-8","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1393-1395"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318326","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}