{"title":"The comprehensive role of dual-energy CT in gout as an advanced diagnostic innovation.","authors":"Takeshi Fukuda, Manickam Subramanian, Kentaro Noda, Shohei Kumeta, Haruki Mori, Naoki Ikeda, Hiroya Ojiri","doi":"10.1007/s00256-024-04856-4","DOIUrl":"10.1007/s00256-024-04856-4","url":null,"abstract":"<p><p>Gout is a common and growing health concern globally, marked by the deposition of monosodium urate (MSU) crystals in joints and soft tissues. While diagnosis relies on synovial fluid analysis, it is limited by technical difficulties and a notable rate of false negatives. Over the past decade, dual-energy computed tomography (DECT) has emerged as a highly sensitive and less-invasive modality for detecting MSU crystals. DECT offers several advantages, including the ability to visualize both intra- and extra-articular MSU deposits and to monitor crystal burden over time. It also aids in treatment planning by accurately assessing the therapeutic response. However, sensitivity of DECT can be lower in early-stage gout, and artifacts can occasionally result in false positives. Recent studies have highlighted new values of using DECT, such as predicting future flares in gout patients. In this review, we focus on the comprehensive clinical utility of DECT and its potential pitfalls in the diagnosis and management of gout.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2253-2263"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847607","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 clues for the diagnosis of various pathogenic causes of infectious spondylitis.","authors":"Pornrujee Hirunpat, Theeraphol Panyaping, Wannisa Wongpipathpong, Siriporn Hirunpat","doi":"10.1007/s00256-025-04943-0","DOIUrl":"10.1007/s00256-025-04943-0","url":null,"abstract":"<p><p>Infectious spondylitis is not a common disease; however, its incidence has increased recently due to the increasing number of older patients with chronic diseases and immunocompromised status globally. The clinical presentation of infectious spondylitis may be non-specific, causing delays in diagnosis and treatment, and leading to significant sequelae. Imaging usually plays a crucial role in characterizing the presence and extent of the disease, leading to proper management, reduced mortality, and long-term neurological morbidity. Many studies have proposed imaging features to distinguish between the common causes of infectious spondylitis, pyogenic or tuberculous infections, while the less common infections, including those caused by fungi or other bacterial organisms such as brucellosis, melioidosis, and actinomycosis, are believed to lack specific imaging characteristics. In this review, we highlight the characteristic imaging findings of both common and uncommon pathogens, which can serve as key clues for accurately diagnosing various pathogenic causes of infectious spondylitis.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2411-2424"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080133","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":"B-mode artefacts relevant in rheumatological musculoskeletal ultrasound-impact on image interpretation and their diagnostic value.","authors":"Lene Terslev, Emilio Filippucci, Søren Torp-Pedersen","doi":"10.1007/s00256-025-04928-z","DOIUrl":"10.1007/s00256-025-04928-z","url":null,"abstract":"<p><p>When performing ultrasound examinations, artefacts are a frequent challenge and cannot be eliminated completely. Understanding and recognizing artefacts are of utmost importance. This paper describes and explains the most commonly encountered B-mode artefacts in rheumatologically applied musculoskeletal (MSK) and vascular ultrasound particularly those which may have additional diagnostic value or often lead to misdiagnosis. Knowledge and understanding of artefacts provide more precise and uniform interpretations of the ultrasound examinations minimizing variability in findings and ensuring generalizability of research results.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2373-2383"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037842","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":"Reactive arthritis: a comprehensive journey through diagnostic findings.","authors":"Chiara Giraudo, Davide Astorri, Monique Reijnierse","doi":"10.1007/s00256-025-04965-8","DOIUrl":"10.1007/s00256-025-04965-8","url":null,"abstract":"<p><p>Reactive arthritis, initially described at the beginning of the twentieth century, is characterized by a sterile articular inflammation occurring several days to weeks after a bacterial gastrointestinal or urogenital infection. The most common agents include Chlamydia trachomatis, Ureaplasma urealyticum, and Neisseria gonorrhea for the venereal type and Salmonella enteriditis, Shigella flexneri, Yersinia enterocolitica for the post-enteric type. The prevalence of reactive arthritis varies geographically but overall, worldwide, it is estimated as 1/1000 persons. It is more common in young adults (18 to 40 years old) and in terms of gender, there is not a significant difference between men and women for post-enteric infections while the risk of the endemic type is higher in men with a ratio of 9:1. Guidelines and diagnostic algorithms taking into account the identification of the etiological agent and the timing of infection have been proposed in the literature. Typically, it is an asymmetric mono- or oligo-arthritis with a predilection for the lower extremities falling under the spondyloarthritis umbrella having shared clinical features. At imaging, enthesitis is considered a hallmark of the disease although other typical signs of inflammatory joint disease such as synovitis, periostitis, and erosions can be detected taking advantage of the various radiological and hybrid techniques according to the affected areas.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2443-2455"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235097","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 : 2025-11-01Epub Date: 2024-11-25DOI: 10.1007/s00256-024-04834-w
Christian Schmidkonz, Torsten Kuwert, Theresa Ida Götz, Andreas Ramming, Armin Atzinger
{"title":"Recent advances in nuclear medicine and their role in inflammatory arthritis: focus on the emerging role of FAPI PET/CT.","authors":"Christian Schmidkonz, Torsten Kuwert, Theresa Ida Götz, Andreas Ramming, Armin Atzinger","doi":"10.1007/s00256-024-04834-w","DOIUrl":"10.1007/s00256-024-04834-w","url":null,"abstract":"<p><p>Imaging molecular processes associated with inflammatory disease has been revolutionized by hybrid imaging using positron emission tomography/computed tomography (PET/CT). PET/CT visualizes metabolic activity as well as protein expression and provides a comprehensive whole-body evaluation. It has the potential to reveal inflammation prior to detection of structural changes in inflammatory joint diseases. FAP is a type II transmembrane glycoprotein overexpressed not only in the stroma of tumors but also in the fibrotic processes of certain immune-mediated disorders. The recent introduction of fibroblast activation protein inhibitors (FAPI) labeled by positron emitters and thus suitable for PET/CT allows to investigate FAP expression in vivo. This review will focus on the use of FAPI-PET/CT for the diagnosis and evaluation of treatment response in inflammatory joint diseases.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2243-2252"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716952","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 : 2025-11-01Epub Date: 2025-06-03DOI: 10.1007/s00256-025-04958-7
Anthony De Leeuw, Reda Cherkaoui Jaouad, Mohamed Kamoun, Souhir Abidi, Paul Michelin, Anne Cotten
{"title":"When it is not sacroiliitis.","authors":"Anthony De Leeuw, Reda Cherkaoui Jaouad, Mohamed Kamoun, Souhir Abidi, Paul Michelin, Anne Cotten","doi":"10.1007/s00256-025-04958-7","DOIUrl":"10.1007/s00256-025-04958-7","url":null,"abstract":"<p><p>Magnetic resonance imaging of the sacroiliac joints (SIJ) is now frequently performed to detect subchondral inflammatory and structural changes in patients with early axial spondyloarthritis (SpA). However, similar changes can also occur in various other conditions, which may lead to the overdiagnosis of axial SpA. The aim of this article is to review the key imaging features of the most common disorders that may mimic inflammatory sacroiliitis, including mechanical changes and osteoarthritis, osteitis condensans ilii and pregnancy-related changes, other strain related changes, anatomical variants, pediatric SIJs, hyperostosis, infectious sacroiliitis, SAPHO syndrome, hyperparathyroidism, and sacral stress fractures.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2433-2442"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216785","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 : 2025-11-01Epub Date: 2025-01-08DOI: 10.1007/s00256-024-04859-1
Wasim Issa, Ronald Mercer, Janeth Yinh, Ali Guermazi, Mohamed Jarraya
{"title":"Imaging and management of calcium pyrophosphate deposition disease.","authors":"Wasim Issa, Ronald Mercer, Janeth Yinh, Ali Guermazi, Mohamed Jarraya","doi":"10.1007/s00256-024-04859-1","DOIUrl":"10.1007/s00256-024-04859-1","url":null,"abstract":"<p><p>The radiological manifestations of calcium pyrophosphate deposition (CPPD) revolve around two main axes: the asymptomatic form and CPPD disease. The latter is a consequence of an immune response to calcium phosphate crystals. Chondrocalcinosis is broadly considered the radiographic manifestation of CPPD regardless of whether it is asymptomatic or associated with inflammatory arthritis. CPPD is associated with osteoarthritis although the direction of such association is still unclear. Apart from the detection of CPP crystals in synovial fluid, imaging (mainly conventional radiography and increasingly ultrasound) plays a central role in the diagnosis of CPPD disease. Recently, CT has been added as a diagnostic tool, especially in deep anatomic locations such as crowned dens. To date, no treatment is effective in dissolving CPP crystals. For now, the focus of current treatment strategies remains inflammation control. Our aim is to review the epidemiology, pathogenesis, and clinical and imaging manifestations of asymptomatic and symptomatic CPPD. We will also discuss recent consensus definitions and classifications of CPPD disease.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2265-2274"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954688","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 : 2025-11-01Epub Date: 2025-05-17DOI: 10.1007/s00256-025-04930-5
Stella Chen, Susannah Kay
{"title":"Review of pulmonary manifestations of rheumatoid arthritis.","authors":"Stella Chen, Susannah Kay","doi":"10.1007/s00256-025-04930-5","DOIUrl":"10.1007/s00256-025-04930-5","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a systemic autoinflammatory disorder that primarily affects joints. However, RA can involve extra-articular structures as well, including the lungs, affecting significant morbidity and mortality, though the precise mechanisms of extra-articular RA are still under investigation. Accurate diagnosis of these conditions can be challenging and requires a multidisciplinary approach. This review aims to describe proposed mechanisms of pulmonary RA and characterize common, clinically relevant pulmonary manifestations of RA, including parenchymal disease (interstitial lung disease and multiple pulmonary nodules), small and large airway involvement, and pleural effusions. In particular, CT imaging may reveal developing pulmonary disease before clinical symptoms present, revealing the importance of maintaining a high degree of suspicion for RA-related pulmonary disease.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2425-2432"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094721","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":"The agreement of the OMERACT grey-scale ultrasound scoring system for salivary glands and minor salivary gland biopsy results in a single-center cohort of patients with suspected Sjögren's disease.","authors":"Nanna Surlemont Schmidt, Viktoria Fana, Stylianos Georgiadis, Uffe Møller Døhn, Lene Terslev","doi":"10.1007/s00256-025-04885-7","DOIUrl":"10.1007/s00256-025-04885-7","url":null,"abstract":"<p><strong>Objective: </strong>Salivary gland ultrasound (SGUS) is a non-invasive tool for the evaluation of parenchymal changes related to primary Sjögrens disease (pSjD) with the potential to reduce the need for minor salivary gland biopsies when diagnosing patients with pSjD. The aim was to assess the agreement between SGUS findings and minor salivary gland biopsy results in patients suspected of pSjD.</p><p><strong>Methods: </strong>All patients referred with a suspicion of pSjD and scheduled for a diagnostic minor salivary gland biopsy were included in the period 2017-2021. All underwent SGUS of the parotid and submandibular glands bilaterally, Schirmer's test, unstimulated salivary flow, and blood samples including autoantibody analysis. Changes in the four glands were scored 0-3 using a previously developed ultrasound atlas based on the OMERACT SGUS scoring system for pSjD. All biopsies were scored at the same pathology department and a focus score > 1 was indicative of pSjD.</p><p><strong>Results: </strong>Of 103 patients included, 43 (42%) were diagnosed with pSjD and 40 (39%) fulfilled the 2016 ACR/EULAR classification criteria. Thirty-two (31%) had a positive minor salivary gland biopsy. The sensitivity of SGUS score ≥ 2 in at least 1 gland was 0.59 and the specificity 0.75. The positive predictive and negative predictive values were 0.51 and 0.80, respectively. The agreement slightly improved when combined with an abnormal salivary flow rate or abnormal Schirmer's test.</p><p><strong>Conclusion: </strong>In patients with suspected pSjD, we found good agreement between the OMERACT SGUS scoring system and minor salivary gland biopsy; however, SGUS cannot yet fully replace biopsy in the diagnostic setup of SjD.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2557-2563"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391592","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}