Skeletal Radiology最新文献

{"title":"Association of ligamentum teres thickness on MRI with femoral head extrusion in Legg-Calvé-Perthes disease.","authors":"Felipe Bortoloni Pires Correa, Leonor Garbin Savarese, Marcello Henrique Nogueira-Barbosa","doi":"10.1007/s00256-026-05349-2","DOIUrl":"10.1007/s00256-026-05349-2","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between ligamentum teres thickness measured on hip MRI and lateral femoral head extrusion in patients with Legg-Calvé-Perthes disease and to assess the intra- and interobserver reproducibility of these measurements.</p><p><strong>Materials and methods: </strong>This retrospective study included pelvic radiographs and hip MRI examinations of patients with Legg-Calvé-Perthes disease. Femoral head extrusion was assessed on anteroposterior pelvic radiographs using the Reimers migration index, which served as the reference standard. Two musculoskeletal radiologists independently measured ligamentum teres thickness on MRI in the mediolateral and anteroposterior planes and performed qualitative assessment of ligament morphology. Intra- and interobserver agreement was evaluated using intraclass correlation coefficients and kappa statistics.</p><p><strong>Results: </strong>Sixty-four hips from 58 patients (mean age, 13.4 years) were included; femoral head extrusion was present in 24 hips (37.5%). Mediolateral ligamentum teres thickness showed excellent intraobserver and good interobserver reproducibility and was significantly greater in hips with extrusion than in those without extrusion (mean, 5.03 mm vs 3.80 mm; p = 0.008). Mediolateral thickness correlated positively with the migration index (ρ = 0.30, p = 0.016). Age was not significantly associated with ligamentum teres thickness or migration index values, and the association between mediolateral thickness and extrusion remained significant after adjustment for age (OR = 1.61; 95% CI, 1.14-2.28; p = 0.007). No significant associations were observed for anteroposterior thickness or qualitative ligament morphology.</p><p><strong>Conclusion: </strong>In Legg-Calvé-Perthes disease, increased mediolateral ligamentum teres thickness on MRI is associated with lateral femoral head extrusion and may represent a reproducible imaging parameter.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3251-3261"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814143","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":"Genicular artery embolization as a minimally invasive treatment for knee osteoarthritis: systematic review and meta-analysis.","authors":"Lucas Habiro Alves, Davi Barbosa, Maria Clara Merighi, Rafaela Correia Maciel, Guilherme Franceschini Machado, Atul Kumar Taneja, Bernard Giancristoforo","doi":"10.1007/s00256-026-05340-x","DOIUrl":"10.1007/s00256-026-05340-x","url":null,"abstract":"<p><strong>Objectives: </strong>Genicular artery embolization (GAE) has emerged as a novel intervention targeting the inflammatory cycle of knee osteoarthritis (KOA). While previous meta-analyses established efficacy, they were limited by small samples and embolic protocols. This systematic review incorporates recent trials and techniques, emphasizing on longitudinal improvement and durability of response.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, EMBASE, and Cochrane Central was conducted from inception through October 2025. Studies reporting patient-reported outcomes (VAS, WOMAC, KOOS) were included. Data were pooled using random-effects models to quantify changes from baseline. Heterogeneity was assessed using I², τ², and 95% prediction intervals, and sensitivity analyses performed to evaluate robustness of estimates.</p><p><strong>Results: </strong>A total of 18 studies comprising 534 patients demonstrated significant and sustained pain reduction, with mean VAS decreases of 3.96 (95% CI - 4.64 to - 3.27), 4.17 (95% CI - 4.81 to - 3.54), 4.36 (95% CI - 5.09 to - 3.63), and 4.53 (95% CI - 5.47 to - 3.60) points at 1, 3, 6, and 12 months, respectively. WOMAC and KOOS outcomes followed similar trajectories with improvements at 1 month and maintained through 12-month follow-up. Magnitude of VAS improvement exceeded commonly accepted clinically thresholds across all time points. Substantial heterogeneity (I² > 80%) was observed, reflecting differences in agents, selection criteria, and techniques.</p><p><strong>Conclusions: </strong>GAE provides meaningful and durable symptom relief for KOA refractory to conservative management. However, substantial heterogeneity and recent sham-controlled data indicate that the magnitude of treatment effect remains uncertain. These findings support standardization of protocols, selection criteria, and outcome reporting in future studies.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3167-3179"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702151","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":"Subcutaneous phaeohyphomycosis: ultrasound findings and histopathologic correlation.","authors":"Alessandro Amorim Aita, Carolina Ávila de Almeida, Marcelo Volpatto Ortiz, Kay-Geert Hermann, Sara Severo Mendes da Paz, Rafael de Deus Moura, Clarissa Canella","doi":"10.1007/s00256-026-05287-z","DOIUrl":"10.1007/s00256-026-05287-z","url":null,"abstract":"<p><p>Subcutaneous phaeohyphomycosis is a rare opportunistic fungal infection caused by dematiaceous fungi and may clinically and radiologically mimic benign cystic or inflammatory soft tissue lesions. Imaging descriptions of this entity remain scarce. We report the case of a 60-year-old woman who presented with a slowly growing subcutaneous nodule. Ultrasound examination demonstrated a well-circumscribed hypoechoic pseudocystic lesion containing heterogeneous internal echoes and peripheral hypervascularity. Based on the imaging findings, the initial differential diagnosis included an epidermoid cyst and an inflammatory collection. Surgical excision followed by histopathological analysis revealed granulomatous inflammation containing pigmented septate fungal hyphae associated with a retained plant fragment (thorn), confirming the diagnosis of subcutaneous phaeohyphomycosis. Although the ultrasound appearance was not specific, it provided valuable characterization of lesion morphology, internal content, and vascularity, facilitating diagnostic assessment and guiding further management. This case is noteworthy because it illustrates the sonographic-pathologic correlation of a rare fungal infection associated with a retained vegetal foreign body and highlights imaging features that may increase awareness of this uncommon entity among radiologists, helping to reduce diagnostic delay and improve recognition of superficial fungal infections.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2989-2993"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353449","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":"Elastofibroma dorsi: imaging-guided minimally invasive treatment using percutaneous CO₂ cryoablation.","authors":"Giovanni Mauri, Pierluigi Glielmo, Francesco Cammarata, Domenico Albano, Luca Maria Sconfienza","doi":"10.1007/s00256-026-05302-3","DOIUrl":"10.1007/s00256-026-05302-3","url":null,"abstract":"<p><strong>Objective: </strong>Elastofibroma dorsi is a benign slow-growing fibroelastic pseudotumoral lesion that typically arises in the infrascapular region of elderly individuals and is usually managed conservatively or by surgical excision when symptomatic. Percutaneous cryoablation has only recently been described for this entity, and experience remains very limited. We report the case of a symptomatic left elastofibroma dorsi treated by percutaneous cryoablation using a CO₂-based system.</p><p><strong>Materials and methods: </strong>A 66-year-old man with non-painful but mechanically symptomatic left elastofibroma dorsi, unwilling to undergo surgery, came to our attention to be treated with minimally invasive approach. Pre-treatment MRI demonstrated a lesion measuring 48 × 18 × 70 mm (31.6 mL) in the typical subscapular location. The lesion was treated by US-CT-guided percutaneous cryoablation using a CO₂-based system (Metrum Cryoflex, Lomianki, Poland) equipped with a 4.5 cm of exposed tip cryoapplicator.</p><p><strong>Results: </strong>The procedure was technically successful and well tolerated, with no immediate or delayed complications and free from immediate and post-treatment pain. At 3-month follow-up, contrast-enhanced MRI showed size reduction to 38 × 12 × 59 mm (14.1 mL, - 55.3% volume reduction), with internal non-enhancing necrotic change consistent with post-ablation effect. Clinically, the patient reported complete resolution of mechanical symptoms.</p><p><strong>Conclusions: </strong>This case suggests that percutaneous CO₂ cryoablation may represent a feasible minimally invasive treatment option for selected patients with symptomatic elastofibroma dorsi. The use of a CO₂-based cryoablation platform may offer practical and economic advantages, although its lower freezing capacity compared with conventional argon-and nitrogen-based systems requires careful procedural planning.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2967-2971"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449491","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":"Swelling and pain of the left thigh in a young adult.","authors":"Leonor Garbin Savarese, Mateus de Andrade Hernandes, Daniel Olivatto Zanutto, Guilherme Naves de Lima Alves, Marcelo de Almeida Braga Raposo do Amaral, Leticia Wellingta Santos Costa, Marcello Henrique Nogueira-Barbosa","doi":"10.1007/s00256-026-05267-3","DOIUrl":"10.1007/s00256-026-05267-3","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2973-2975"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138959","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":"Intramedullary osteoblastoma of the femur: a case report.","authors":"Ben Thompson, Jonathan Gibson, Hasaam Uldin, Sumathi Vaiyapuri, Rajesh Botchu","doi":"10.1007/s00256-026-05282-4","DOIUrl":"10.1007/s00256-026-05282-4","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoblastoma is a rare primary bone tumour, and the lesions are typically intracortical affecting long-bone metaphysis and the posterior spine. The histological hallmark is characteristic networks of trabeculated woven bone, usually lined by osteoblasts within a vascularised stroma. This case report details an unusual case of an intramedullary osteoblastoma of the femur.</p><p><strong>Case presentation: </strong>A 22-year-old male presented with an eight-month history of right knee pain on a background of a previous distal tibia non-ossifying fibroma. The patient underwent cross-sectional imaging, and a biopsy was obtained confirming a lesion in the distal femoral diametaphysis. MRI showed multiple internal fluid levels and septations with a sclerotic rim and associated marrow oedema, cortical sclerosis, and periosteal soft tissue oedema. Subsequent biopsy provided histological confirmation of osteoblastoma.</p><p><strong>Conclusion: </strong>This case is presented to highlight the rare anatomical location for osteoblastoma: in the medullary canal of the distal femur.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2977-2981"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219438","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":"Answer: Swelling and pain of the left thigh in a young adult.","authors":"Leonor Garbin Savarese, Mateus de Andrade Hernandes, Daniel Olivatto Zanutto, Guilherme Naves de Lima Alves, Marcelo de Almeida Braga Raposo do Amaral, Leticia Wellingta Santos Costa, Marcello Henrique Nogueira-Barbosa","doi":"10.1007/s00256-026-05273-5","DOIUrl":"10.1007/s00256-026-05273-5","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3027-3029"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138987","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":"Clinical feasibility of camera-type X-ray for intraoperative imaging of hip arthroplasty: a pilot study.","authors":"Kyu-Chong Lee, Joo Hui Kim, Seok Ha Hong, Kyung-Sik Ahn, Yongwon Cho, Woo Young Kang, Baek Hyun Kim, Euddeum Shim, Seung Beom Han, Chang Ho Kang","doi":"10.1007/s00256-026-05331-y","DOIUrl":"10.1007/s00256-026-05331-y","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical feasibility of a camera-type X-ray system, compared with conventional portable X-ray, for intraoperative imaging during hip arthroplasty.</p><p><strong>Materials and methods: </strong>Twenty-one patients who underwent hip arthroplasty were prospectively enrolled. Conventional portable and camera-type X-ray images were obtained intraoperatively (n = 42). Three reviewers (two radiologists and one orthopedic surgeon) independently assessed image quality and diagnostic confidence using 4-point Likert scales, as well as the feasibility of assessing leg length discrepancies (LLD), calculated as the difference between the transischial line and the lesser trochanter (TI-LT). Two radiologists also measured the TI-LT interval in both modalities. Image quality and diagnostic confidence were compared using the Wilcoxon rank-sum test. The feasibility of LLD assessment was analyzed using Fisher's exact test. The agreement between camera-type and portable X-ray measurements was evaluated using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>Image quality scores were significantly higher for portable X-rays than for camera-type X-rays (mean ± SD, 3.65 ± 0.44 vs. 2.57 ± 0.89; p < 0.001). Diagnostic confidence was also higher with the portable X-rays (3.86 ± 0.27 vs. 2.95 ± 0.91; p < 0.001). However, the feasibility of the LLD assessment did not differ significantly between the two modalities for any reviewer (all p > 0.1). The TI-LT interval measurements demonstrated good agreement between camera-type and portable X-rays, with an ICC of 0.750 (95% CI 0.454-0.898).</p><p><strong>Conclusions: </strong>Although conventional portable X-rays provided superior image quality and diagnostic confidence, camera-type X-rays demonstrated comparable feasibility for intraoperative evaluation of LLD and good agreement in quantitative measurements. These findings support the clinical feasibility of using camera-type X-rays for intraoperative imaging during hip arthroplasty.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2907-2917"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679807","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":"Visceral adiposity is associated with low trabecular bone score in postmenopausal women with osteopenia.","authors":"Tae Ran Ahn, Hyun Su Kim, Dong Ik Cha, Young Cheol Yoon, Ji Hyun Lee","doi":"10.1007/s00256-026-05299-9","DOIUrl":"10.1007/s00256-026-05299-9","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between computed tomography (CT)-assessed visceral adiposity and impaired bone quality, reflected by a low trabecular bone score, in postmenopausal women with osteopenia.</p><p><strong>Materials and methods: </strong>This retrospective study included postmenopausal women with osteopenia who underwent dual-energy X-ray absorptiometry and abdominopelvic CT on the same day between May 2022 and September 2024. Visceral fat area was measured on CT images obtained at the L3 vertebral level. Trabecular bone score was assessed on lumbar spine dual-energy X-ray absorptiometry at the L1 - L4 levels, with a low trabecular bone score defined as < 1.350. Logistic regression analysis was employed to evaluate the association between visceral fat area and low trabecular bone score.</p><p><strong>Results: </strong>Among the 205 women included (median age, 60 years; interquartile range, 56-66 years), 65 (31.7%) had a low trabecular bone score. A 10-cm² increase in visceral fat area was associated with an increased likelihood of having a low trabecular bone score (odds ratio, 1.08; 95% confidence interval, 1.02-1.15). This association remained significant after adjusting for age, spine bone mineral density, and skeletal muscle area (odds ratio, 1.09; 95% confidence interval, 1.02-1.18).</p><p><strong>Conclusion: </strong>Visceral adiposity was associated with impaired bone quality in postmenopausal women with osteopenia, independent of age, bone mineral density, and skeletal muscle area. These findings suggest that visceral adiposity measured by opportunistic CT may serve as a potential biomarker for identifying postmenopausal women with osteopenia who are at an increased risk of fracture.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2759-2767"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423686","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":"Assessment of vertebral bone quality in women with type 2 diabetes mellitus using digital tomosynthesis.","authors":"Ram N Yadav, Daniel J Oravec, Joshua Drost, Elizabeth Warner, Michael J Flynn, George W Divine, Sudhaker D Rao, Yener N Yeni","doi":"10.1007/s00256-026-05321-0","DOIUrl":"10.1007/s00256-026-05321-0","url":null,"abstract":"<p><strong>Objectives: </strong>Type 2 diabetes mellitus (T2DM) increases vertebral fracture risk. Despite normal (or higher) bone mineral density (BMD), patients with T2DM typically have a lower trabecular bone score (TBS), indicating degraded bone microstructure in T2DM. However, assessment of vertebral microstructure using TBS remains limited because it is based on 2D DXA imaging. Due to high in-plane resolution and 3D imaging capabilities, vertebral microstructure and geometry can be quantified using digital tomosynthesis (DTS) imaging. This study aimed to examine the differences in DTS-derived vertebral parameters between T2DM patients and controls without T2DM (NT2DM).</p><p><strong>Methods: </strong>Fifty postmenopausal women with T2DM and 54 controls were recruited. Lumbar spine BMD and trabecular bone score (TBS) were calculated from DXA images. Microstructural (fractal dimension, lacunarity, scale-dependent lacunarity, anisotropy, and line fraction deviation) and geometrical (vertebral area and width) parameters were calculated from DTS images for T12 and L1 vertebrae. Group differences were examined within the framework of generalized linear models.</p><p><strong>Results: </strong>T2DM and NT2DM were different in race (p < 0.001) but not in age or BMI. T2DM had higher BMD than NT2DM (p < 0.02), but the difference was not present after adjustment for demographic variables (age, BMI, and race) (p > 0.1). T2DM had lower vertebral area (p < 0.002), higher anisotropy (p < 0.03), and marginally lower lacunarity (p = 0.063) as assessed by DTS, even after adjusting for demographic variables.</p><p><strong>Conclusions: </strong>DTS imaging of vertebrae reveals distinct bone size and microstructure characteristics in patients with T2DM, and thus may be clinically useful to explain increased fracture risk in T2DM beyond DXA.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2873-2881"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654240","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}