Skeletal Radiology最新文献

{"title":"CT measurement of Segond fracture fragment distance to the Gerdy tubercle predicts combined anterolateral ligament and iliotibial band capsulo-osseous layer involvement on MRI.","authors":"Aonan Wang, Ming Ni, Kun Yang, Qiang Zhao, Ying Liu, Huishu Yuan","doi":"10.1007/s00256-026-05346-5","DOIUrl":"10.1007/s00256-026-05346-5","url":null,"abstract":"<p><strong>Objective: </strong>Segond fractures are avulsion fractures of the anterolateral tibial plateau, but the ligamentous structures involved remain debated. This study aimed to determine whether CT-measured fragment distance to the Gerdy tubercle predicts combined involvement of the anterolateral ligament (ALL) and the capsulo-osseous layer of the iliotibial band (ITB) as defined by MRI.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 86 patients (58 male, 28 female; mean age 30.9 ± 11.4 years) with acute Segond fractures on CT and MRI. CT measured fragment dimensions and distance to the Gerdy tubercle. MRI assessed the ALL, ITB, and its capsulo-osseous layer, classifying patients into ALL-only (n = 48) vs combined ALL + ITB involvement (n = 38). ROC analysis evaluated CT parameters.</p><p><strong>Results: </strong>Anterior cruciate ligament(ACL) injury occurred in all 86 patients (100%). MRI showed ALL attachment in 100% and combined involvement in 44.2%. Fragment dimensions did not differ between groups (all p > 0.05). CT distance to Gerdy tubercle was shorter in the combined group (9.2 ± 1.6 mm vs 11.2 ± 3.1 mm, p = 0.029). A cutoff < 10 mm predicted combined involvement (sensitivity 78.9%, specificity 62.5%; AUC = 0.72, 95% CI 0.60-0.84).</p><p><strong>Conclusion: </strong>Segond fractures consistently involve the ALL. Combined involvement of the capsulo-osseous layer adjacent to the ITB occurs in a substantial subset and is associated with a fragment distance of < 10 mm from the Gerdy tubercle on preoperative CT, as identified on MRI. This simple, reproducible CT marker may assist in surgical planning for anterolateral complex injuries when interpreted alongside MRI findings.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3207-3215"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797913","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":"Dual-energy CT-generated bone marrow edema maps improve reader confidence without changing fracture detection rates in bony pelvis trauma.","authors":"Boniface Yarabe, William R Walter, Shana G Neumann, Hyung G Park, Meghan Jardon","doi":"10.1007/s00256-026-05358-1","DOIUrl":"10.1007/s00256-026-05358-1","url":null,"abstract":"<p><strong>Objective: </strong>To retrospectively evaluate the diagnostic utility of dual-energy computed tomography (DECT) virtual non-calcium bone marrow edema (BME) maps in the assessment of osseous pelvic trauma compared to conventional CT. In addition to fracture detection rates, we sought to determine the DECT effect on reader diagnostic confidence and follow-up recommendations.</p><p><strong>Materials and methods: </strong>Three radiologists performed independent retrospective reviews of 92 consecutive pelvic CTs for the presence of fractures, without the use of DECT-generated BME maps. Following a washout period of ≥ 4 weeks, the cases were re-reviewed with the addition of DECT BME maps. Comparison of fracture detection rates, frequency of \"indeterminate\" reads, reader confidence ratings, and follow-up imaging recommendations were performed using McNemar's test and mixed-effects logistic regressions. Mixed-effect models were utilized to assess the effect of DEXA-derived patient bone mineral density, when available, on fracture detection rates.</p><p><strong>Results: </strong>The use of DECT BME maps resulted in higher pooled reader diagnostic confidence, with a mean 0.19 increase on a 5-point Likert scale (p < 0.001). There was, however, no statistically significant difference in fracture detection rates for readers utilizing DECT versus conventional CT alone, with similar rates of \"indeterminate\" interpretations between the groups. For patients with recent DEXAs (n = 27), DECT was not associated with change in fracture detection rates among patients with osteoporosis or osteopenia. Readers recommended follow-up imaging more frequently in cases interpreted with DECT, but this effect was not significant (p = 0.266).</p><p><strong>Conclusion: </strong>When interpreting pelvic CT for trauma, DECT-generated BME maps increased diagnostic confidence without changing detection rates.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3263-3269"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851441","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: a 44-year-old woman with chronic left medial clavicular pain.","authors":"Pranav Rajaram, Kyle D Perry, William R Aibinder, Jon A Jacobson, Steven B Soliman","doi":"10.1007/s00256-026-05270-8","DOIUrl":"10.1007/s00256-026-05270-8","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3403-3407"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144447","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":"Localization and quantitative assessment of inflammation in frozen shoulder: a PET/MRI fusion imaging analysis.","authors":"Rei Kimura, Nobuyuki Yamamoto, Yusuke Koibuchi, Kazuma Sasaki, Atsushi Arino, Jun Kawakami, Kentaro Takanami, Toshimi Aizawa","doi":"10.1007/s00256-026-05332-x","DOIUrl":"10.1007/s00256-026-05332-x","url":null,"abstract":"<p><strong>Background and objective: </strong>Frozen shoulder is a common clinical condition; however, its pathophysiology and precise anatomical localization of inflammatory activity remain unclear. This study was aimed at identifying the localization and intensity of inflammation in patients with frozen shoulder using PET/MRI fusion imaging.</p><p><strong>Patients and methods: </strong>Seven patients with frozen shoulder who underwent 18F-FDG PET/CT were analyzed (2 men, 5 women; mean age, 59 years), all in the freezing phase. PET/CT and MRI datasets were coregistered, and standardized uptake values (SUVs) were obtained. The SUVmax of the asymptomatic contralateral shoulder served as the reference threshold. On T2-weighted oblique sagittal images, nine slices centered on the labrum were evaluated. Area-weighted SUV was calculated as the product of the area above threshold and mean SUV. On the labral slice, SUVmax was measured radially using a clockface-based method. SUVmax values of the rotator interval, coracohumeral ligament, axillary recess, and glenoid labrum were compared.</p><p><strong>Results: </strong>The mean SUVmax of the asymptomatic shoulder was 1.6 ± 0.3. Area-weighted SUV peaked at the glenoid labrum and decreased with distance (ρ = - 0.709, p < 0.0001). SUVmax was highest in the anterosuperior and anteroinferior labrum. FDG uptake was most consistently observed at the glenoid labrum, which showed the highest SUVmax in all patients.</p><p><strong>Discussion: </strong>Inflammation was localized to the anterosuperior and anteroinferior glenoid labrum, suggesting the labrum as a preferential site of inflammatory activity. These findings provide insight into disease mechanisms and support further imaging studies focusing on the labrum.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3361-3370"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679728","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 characteristics of osteitis condensans ilii. A follow-up study.","authors":"Anne Grethe Jurik, Alexander Andrew Matthew Mills, Amalie Birk Niesen, Emma Marie Mills, Rosa Marie Kiil, Anna Zejden, Asta Linauskas","doi":"10.1007/s00256-026-05360-7","DOIUrl":"10.1007/s00256-026-05360-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic ability of combined clinical and MRI findings in a cohort of patients initially diagnosed with axial spondyloarthritis (axSpA) and to detect potential patients with osteitis condensans ilii (OCI) for further analyses.</p><p><strong>Materials and methods: </strong>We conducted a retrospective follow-up study of 129 consecutive patients aged ≥ 18 years (49 women/80 men) diagnosed with axSpA during the period 2012-2023. Uniform baseline MRI of the sacroiliac joints (SIJ) and spine with concomitant radiography and/or CT were reassessed by an experienced radiologist using fulfillment of thresholds for SIJ MRI changes consistent with axSpA and a global assessment of all imaging material. Clinical and biochemical findings at baseline and during follow-up were reevaluated and in combination with imaging findings used as a reference standard for axSpA and OCI changes, respectively. Imaging findings consistent with OCI were confirmed by a second experienced radiologist and OCI imaging characteristics were systematically assessed.</p><p><strong>Results: </strong>axSpA was confirmed in 95 patients. Seven women had OCI and 27 (15 women/12 men) had non-specific SIJ bone marrow edema (BME). None of the OCI women fulfilled radiographic criteria for axSpA, but all fulfilled fat deposition thresholds on MRI consistent with axSpA and five also fulfilled thresholds for BME. The detected OCI MRI characteristics were as follows: sclerosis predominating at the anterior-middle iliac joint areas with BME and fat deposition at the periphery, and subchondral BME and fat deposition predominantly in the sacrum.</p><p><strong>Conclusion: </strong>The location of sclerosis, BME, and fat deposition can be used to diagnose OCI changes on MRI.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3347-3360"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907161","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":"CT-based methods for the assessment of glenoid bone loss.","authors":"Massimo De Filippo, Michele Fischetti, Carlo Felice De Biase, Marcello Zappia, Giorgio Concari, Mario Brunese, Chiara Martini, Ruben Foresti, Lorenzo Bertolotti, Ganiyat Adenike Ralitsa Adebanjo, Giulia Viviano","doi":"10.1007/s00256-026-05357-2","DOIUrl":"10.1007/s00256-026-05357-2","url":null,"abstract":"<p><p>Recurrent anterior shoulder dislocation often causes progressive damage and bone loss of the anteroinferior glenoid rim, which is a key factor in persistent shoulder instability. Correct measurement of bone loss is essential before surgery, as it helps decide whether a soft tissue repair is sufficient or if a bone graft procedure, such as the Latarjet, is required. In the past, arthroscopy was considered the standard method for evaluating glenoid bone loss, using the so-called \"bare spot\" as a reference point. However, this landmark is not always visible and has shown poor reliability, which has reduced its clinical value. For this reason, imaging methods with CT and MRI are now preferred. One of the best-known imaging techniques is the PICO CT method, which calculates bone loss by inscribing the glenoid in a circle. Although widely used, this method has significant limitations because the glenoid surface is not truly circular. As a result, variability between observers is high, and clinical accuracy is reduced. To improve precision, the PARMA method was developed. This technique uses curved multiplanar CT reconstructions (cMPRs) to follow the real concavity of the glenoid surface. Cadaveric studies have shown that PARMA is more accurate and reproducible than traditional CT methods, with good agreement compared to high-precision laser scanning. In addition, Hill-Sachs lesions must also be evaluated. The on-track/off-track concept combines humeral and glenoid bone loss to predict the risk of recurrent dislocation. Off-track lesions have a higher chance of surgical failure if treated with soft tissue repair alone and usually require bone procedures. Overall, modern CT-based techniques and combined lesion assessment improve accuracy and allow more tailored treatment of shoulder instability. The aim of this review is to provide an overview of the CT methods most employed to quantify glenoid bone loss in traumatic shoulder instability, emphasizing their strengths and limitations.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3109-3117"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907189","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":"Multi-reader, multi-model benchmark of large language models for modified Outerbridge cartilage grading from knee MRI reports.","authors":"Anna H Zhao, Elizabeth L Roux, Ged Wieschhoff, Sara Bahouth, Stacy E Smith, Jim S Wu, Jacob C Mandell","doi":"10.1007/s00256-026-05342-9","DOIUrl":"10.1007/s00256-026-05342-9","url":null,"abstract":"<p><strong>Objective: </strong>To describe a reproducible framework for bulk large language model (LLM)-based extraction of structured cartilage-lesion data from knee MRI reports and to benchmark seven LLM configurations against multiple radiologists using the modified Outerbridge classification.</p><p><strong>Materials and methods: </strong>In this IRB-approved retrospective study, 100 non-contrast knee MRI reports (January 2019 to January 2025) were randomly selected from 66,479 eligible examinations and independently graded by five readers (four fellowship-trained musculoskeletal radiologists with 6-21 years of post-fellowship experience and one fourth-year resident) and seven LLM configurations, comprising six Azure OpenAI deployments (GPT-4.1, GPT-5.1-mini, GPT-5.3, GPT-5.4, GPT-5.4-mini, GPT-5.4-nano) and one locally hosted open-weight model (Qwen2.5-32B-Instruct), across a fixed 20-surface anatomic taxonomy. Pairwise Cohen quadratic-weighted κ was computed at compartment and surface levels. Bootstrap 95% confidence intervals (CIs) and p-values on the paired difference between each rater's mean κ and the human-human reference were derived by case-level cluster resampling (B = 1000).</p><p><strong>Results: </strong>Mean human-human κ was 0.94 (95% CI 0.93, 0.95) at the compartment level and 0.80 (95% CI 0.78, 0.83) at the surface level. Three Azure deployments-GPT-5.4 (surface κ = 0.83), GPT-5.3 (κ = 0.80), and GPT-5.1-mini (κ = 0.77)-had 95% CIs on the difference from the human reference that included zero. Four models had CIs entirely below zero, indicating agreement significantly below the human reference: GPT-4.1, GPT-5.4-mini, Qwen2.5-32B, and GPT-5.4-nano (all p ≤ .02).</p><p><strong>Conclusion: </strong>Three flagship OpenAI deployments achieved cartilage grading agreement indistinguishable from human inter-rater variability, while cost-optimized and open-weight variants performed measurably below.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3217-3228"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797873","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":"Distribution of anterior inferior iliac spine morphology in patients with femoroacetabular impingement syndrome, developmental dysplasia of the hip, and asymptomatic controls: a retrospective cohort study.","authors":"Yu-Peng Duan, Rong-Ge Liu, Tian-Yi Han, Hong-Jie Huang, Yan Xu, Xiao-Dong Ju, Jian-Quan Wang","doi":"10.1007/s00256-026-05326-9","DOIUrl":"10.1007/s00256-026-05326-9","url":null,"abstract":"<p><strong>Objective: </strong>To compare the distribution of anterior inferior iliac spine (AIIS) morphology on three-dimensional computed tomography (3D-CT) among hips with femoroacetabular impingement syndrome (FAIS), developmental dysplasia of the hip (DDH), and an asymptomatic control cohort.</p><p><strong>Materials and methods: </strong>In this single-center retrospective cross-sectional study, AIIS morphology was classified on 3D-CT using a four-subtype system. Asymptomatic control hips were selected from individuals undergoing abdominopelvic CT for non-orthopaedic indications, whereas FAIS and DDH hips were identified from patients evaluated for hip-preservation surgery. Lateral center-edge angle (LCEA) was measured on clinical anteroposterior pelvic radiographs or CT-derived anteroposterior digitally reconstructed radiographs, as applicable. AIIS morphology distributions were compared among groups using chi-square testing with post hoc pairwise analyses. Multivariable logistic regression was used to identify independent predictors of Type III morphology after adjustment for diagnostic group, LCEA, age, and sex.</p><p><strong>Results: </strong>A total of 1,420 hips were analyzed, including 800 asymptomatic hips, 500 FAIS hips, and 120 DDH hips. AIIS morphology distribution did not differ significantly between the FAIS and asymptomatic cohorts. Type III morphology was identified in 9.2% and 9.3% of hips in these two groups, respectively. In contrast, the DDH cohort showed a significantly different distribution, with Type III morphology present in 60.0% of hips. On multivariable analysis, DDH remained the strongest independent predictor of Type III morphology (adjusted odds ratio, 7.99; 95% confidence interval, 3.33-19.14; P < 0.001).</p><p><strong>Conclusion: </strong>Static 3D-CT AIIS morphology did not distinguish FAIS hips from asymptomatic hips. In contrast, Type III morphology was markedly more common in DDH, suggesting that AIIS morphology should be interpreted in the context of acetabular coverage and the underlying hip disorder.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3325-3337"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892379","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":"Local anesthetic selection for spine and large joint radiofrequency ablation: a practical review for the musculoskeletal radiologist.","authors":"Felix M Gonzalez, John B Smirniotopoulos","doi":"10.1007/s00256-026-05365-2","DOIUrl":"10.1007/s00256-026-05365-2","url":null,"abstract":"<p><p>Local anesthetic (LA) selection for radiofrequency ablation (RFA) of spinal medial branch nerves, sacroiliac joint lateral branches, and large peripheral joint articular branches has not been addressed by any dedicated document. The concentration, class, and sequencing of agents used during needle placement, stimulation testing, and pre-lesioning injection have plausible implications for procedural accuracy and post-procedural analgesia. This review synthesizes pharmacological data and adjacent procedural literature into practice considerations for the musculoskeletal radiologist. No randomized or prospective comparative trial has evaluated LA agents, concentrations, or sequencing within an RFA procedure; every statement therefore rests on indirect evidence, mechanistic reasoning, or the authors' practice, and each is labeled accordingly. Lidocaine 1% is a reasonable default for skin, subcutaneous, and deep track anesthesia. Where sensory and/or motor stimulation testing is performed, there is a mechanistic argument for avoiding lidocaine 2% close to the target nerve, since selectivity between fiber classes falls as concentration rises; that argument derives from epidural quantitative sensory testing and rodent electrophysiology, has not been tested in RFA, and no study has shown that lidocaine 2% impairs stimulation testing or procedural outcome. Bupivacaine 0.25% or ropivacaine 0.2% is a reasonable choice for perineural injection before lesioning. Premixing lidocaine and bupivacaine has no demonstrated advantage: across five randomized trials, all outside interventional pain settings and heterogeneous in design, mixtures did not accelerate onset relative to bupivacaine alone and in several curtailed its duration; two also found same-site sequential injection no better than premixing. Ropivacaine is a reasonable preference in cardiac conduction disease or multi-level procedures. A structured allergy substitution pathway is provided with formal allergist evaluation as the central step. These considerations are offered to inform practice and to prompt the prospective studies the field lacks.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3119-3136"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978014","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 Assessment of the Accessory Anterolateral Talar Facet in Pediatric Patients: Morphometric Features and Associated Subtalar Pathologies.","authors":"Şükriye Yılmaz, Berna Uçan","doi":"10.1007/s00256-026-05379-w","DOIUrl":"10.1007/s00256-026-05379-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess the frequency and morphometric characteristics of AALTF on pediatric ankle MRI, its associations with the Gissane angle and subtalar abnormalities, and the incremental value of zero-echo-time (ZTE) imaging for detecting tarsal coalitions.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed ankle MRI examinations of patients aged 0-18 years performed between September 2022 and January 2026. We randomly selected one ankle from each patient with bilateral examinations. Two pediatric radiologists independently assessed AALTF. For comparative analyses, 129 AALTF-negative controls were selected by simple random sampling from 712 AALTF-negative examinations. We performed age-stratified comparisons and age- and sex-adjusted multivariable regression analysis of the Gissane angle.</p><p><strong>Results: </strong>Among 841 patients, 129 (15.3%) had AALTF. Mean facet length was 6.36 ± 2.20 mm, and cartilage coverage was present in 62.0%. The Gissane angle was lower in patients with AALTF than in controls (109.66° ± 6.74° vs. 117.43° ± 8.21°; p < 0.001). This association remained significant after adjustment for age and sex (B =  - 8.02; 95% CI, - 9.88 to - 6.16; p < 0.001). ROC analysis yielded an AUC of 0.764 and an optimal cutoff of 112.5° (sensitivity, 68.2%; specificity, 70.5%). Bone marrow edema, subtalar degeneration, tarsal coalition, and joint effusion were more frequent in patients with AALTF. Bone marrow edema and joint effusion remained more frequent in both age strata. Conventional MRI detected all coalitions, and ZTE detected no additional lesions. Interobserver agreement and measurement reliability were excellent.</p><p><strong>Conclusion: </strong>AALTF is relatively common on pediatric ankle MRI and is independently associated with a lower Gissane angle and several concomitant abnormalities. A Gissane angle ≤ 112.5° may prompt closer evaluation for AALTF.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3147-3155"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115117","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}