Skeletal Radiology最新文献

{"title":"Test yourself: question-longstanding medial thigh mass.","authors":"Usman Goga, Luqman Wali, Ramanan Rajakulasingam","doi":"10.1007/s00256-025-05046-6","DOIUrl":"https://doi.org/10.1007/s00256-025-05046-6","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281174","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 simple linear alternative to necrotic volume for predicting collapse in osteonecrosis of the femoral head.","authors":"Keiji Otaka, Yusuke Osawa, Yasuhiko Takegami, Hiroto Funahashi, Hiroaki Ido, Takamune Asamoto, Shinya Tanaka, Shiro Imagama","doi":"10.1007/s00256-025-05056-4","DOIUrl":"https://doi.org/10.1007/s00256-025-05056-4","url":null,"abstract":"<p><strong>Objective: </strong>The clinical use of magnetic resonance imaging-based volumetric measurement for osteonecrosis of the femoral head (ONFH) is restricted by its complexity. This study aimed to identify a practical computed tomography-based imaging parameter as a reliable alternative to necrotic volume and to evaluate its ability to predict femoral head collapse.</p><p><strong>Materials and methods: </strong>This retrospective study included 125 hips from 90 patients with ONFH and initial collapse of < 3 mm. Four-dimensional ratios were examined for their association with necrotic volume using generalized estimating equation models. The parameter showing the strongest association was determined by comparing models with the Quasi-likelihood Information Criterion (QIC). Receiver operating characteristic curve analysis was then used to establish a cutoff value for predicting a necrotic volume of ≥ 30%, the threshold defined as severe in the Steinberg classification. This prognostic value of this cutoff for collapse (> 3 mm) was tested with a robust Cox proportional hazards model.</p><p><strong>Results: </strong>The coronal vertical diameter ratio (CVDR) showed the strongest association with necrotic volume, yielding the lowest QIC. A CVDR cutoff of 51% predicted a large necrotic volume (AUC 0.931). Hips with a CVDR ≥ 51% had a significantly higher risk of collapse compared with those with a CVDR < 51% (HR, 6.07; 95% CI, 3.25-11.34; P < 0.001). This predictive value was consistent across all Japanese Investigation Committee type subgroups.</p><p><strong>Conclusion: </strong>The CVDR represents a simple and reliable alternative to volumetric assessment. A cutoff of approximately 51% provides clinically useful risk stratification, and incorporating lesion location may further enhance predictive accuracy.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275685","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 proposed radiological model for preoperative chemotherapy response prediction in patients with skeletal Ewing sarcoma.","authors":"Hisaki Aiba, Paolo Spinnato, Ayano Aso, Alberto Righi, Marco Gambarotti, Shuji Ando, Matteo Traversari, Ahmed Atherley, Konstantina Solou, Hiroaki Kimura, Federica Zuccheri, Barbara Dozza, Giorgio Frega, Davide Maria Donati, Costantino Errani","doi":"10.1007/s00256-025-05054-6","DOIUrl":"https://doi.org/10.1007/s00256-025-05054-6","url":null,"abstract":"<p><strong>Objective: </strong>To develop a predictive model for estimating the histological response to preoperative chemotherapy based on imaging data in patients with Ewing sarcoma.</p><p><strong>Materials and methods: </strong>We included 133 patients with Enneking stage IIB or IIIB Ewing sarcoma who underwent chemotherapy and definitive surgery between 2003 and 2020. We analyzed various radiological parameters before and after preoperative chemotherapy. The necrotic area was evaluated using gadolinium-contrasted magnetic resonance imaging (radiological necrotic grade). Patients were classified as good histological responders if > 95% of their resected specimens showed necrosis; otherwise, they were classified as poor responders. Radiological parameters were assessed using the least absolute shrinkage and selection operator (LASSO) with cross-validation. Optimal regularization parameters were identified as those minimizing cross-validation error. The area under the curve (AUC) was calculated based on the predictive model with the selected parameters for training and test data using receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>LASSO models identified key parameters including volume change, radiological necrotic grade, complete regression of the extraskeletal component, and the disappearance of peritumoral gadolinium-enhancement after preoperative chemotherapy. ROC curve analysis showed that the predictive model achieved measurable discrimination ability on both training and test datasets (AUC = 0.89 [95% confidence interval (95%CI); 0.83-0.95] on training data, 0.77 [95%CI; 0.58-0.95] on test data).</p><p><strong>Conclusion: </strong>The developed model may facilitate accurate monitoring of the efficacy of preoperative chemotherapy in patients with Ewing sarcoma. Identifying patients with a poor histological response to preoperative chemotherapy can aid in the planning of secure surgical margins and effective treatment strategies.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275690","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 and magnetic resonance imaging features of soft tissue extraskeletal myxoid chondrosarcoma: A retrospective observational cohort study.","authors":"Graham Ashburner, Shahd S Almohsen, Elizabeth G Demicco, Kim M Tsoi, Jay S Wunder, Peter C Ferguson, Anthony M Griffin, Ali Naraghi, Lawrence M White","doi":"10.1007/s00256-025-05050-w","DOIUrl":"https://doi.org/10.1007/s00256-025-05050-w","url":null,"abstract":"<p><strong>Objectives: </strong>To review the MRI, histological, and clinical features of extraskeletal myxoid chondrosarcoma (EMC).</p><p><strong>Methods: </strong>Retrospective review of pre-treatment MRIs in 44 patients with pathologically proven EMC. Patient demographics, tumor MR-imaging features, histology and gene rearrangements, clinical management, and follow-up were reviewed. MRI features assessed included lesion size, location, morphology, signal characteristics, and relation to adjacent structures. Correlative analysis was performed to assess associations between demographic, clinical, molecular, and MRI variables with metastatic disease.</p><p><strong>Results: </strong>EMCs were predominantly located in the lower extremity (38/44, 86%) and deep-to-fascia (36/44, 82%). All lesions (44/44) demonstrated well-circumscribed margins. Mean maximal dimension was 8.8 cm (range 1.7-36 cm); 93% (41/44) of lesions were hyperintense on fat-suppressed T2-weighted/ STIR imaging. Post-contrast enhancement was \"solid\" (> 80% enhancement) in 18%, \"mixed\" (20-80% enhancement) in 53%, and \"sparse\" (< 20% enhancement) in 29%. Nodal metastases were detected on preoperative imaging in four patients (9%), and pulmonary metastases in three cases preoperatively, and five cases postoperatively (range 14-128 months). EWSR1::NR4A3 fusion rearrangements were documented in 25 tumors (57%), and non-EWSR1 NR4A3 fusions in six cases (14%). The only variable demonstrating a significant correlation with metastatic disease was \"solid\" pattern of lesional enhancement (p = 0.035).</p><p><strong>Conclusions: </strong>EMC is most commonly a deep lesion of the extremities demonstrating hyperintense T2-weighted signal, internal septations, and variable patterns of enhancement on MRI. Nodal disease is relatively frequent, and prolonged surveillance is recommended as metastases may develop years after diagnosis. Although analysis is limited by small case numbers, a \"solid\" (> 80%) pattern of enhancement was significantly associated with metastatic disease.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275646","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":"Nerve sheath myxoma in the upper extremity: a rare case report.","authors":"Carlos Henrique Maia Ferreira Alencar, Francisco Andrade Neto, Matheus Martins Cavalcante, Cleto Dantas Nogueira, Thiago Santana Feitosa, Sarah Barreira Cavalcante de Azevedo, Júlia Guedelha Araujo, Ilana Terezinha Souza de Freitas, Raquel Silveira Dantas Viana, Cláudio Régis Sampaio Silveira","doi":"10.1007/s00256-025-05045-7","DOIUrl":"https://doi.org/10.1007/s00256-025-05045-7","url":null,"abstract":"<p><p>Nerve sheath myxoma (NSM) is a rare benign tumor originating from peripheral nerves. We present a case of NSM in the upper extremity. A 67-year-old female presented with painful nodular bulging in the elbow. Magnetic resonance imaging and ultrasonography revealed diagnostic features. Surgical excision was performed and histopathological examination confirmed the diagnosis. Our case contributes to the understanding of NSM's clinical presentation, imaging characteristics, and management strategies of NSM.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275618","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":"CT-guided radiofrequency ablation in the treatment of pediatric and adult osteoid osteoma: single center experience and comparative results.","authors":"Ismail Dilek, Mehmet Ozturk, Abdi Gurhan, Nusret Seher, Alaaddin Nayman, Bahattin Kerem Aydın","doi":"10.1007/s00256-025-05052-8","DOIUrl":"https://doi.org/10.1007/s00256-025-05052-8","url":null,"abstract":"<p><strong>Objective: </strong>To report a single-center experience comparing the efficacy and safety of computed tomography (CT)-guided radiofrequency ablation (RFA) in the treatment of osteoid osteoma (OO) in pediatric and adult patients.</p><p><strong>Materials and methods: </strong>The electronic medical records of 97 patients who underwent CT-guided RFA for OO between January 2019 and January 2025 were retrospectively reviewed. Patients were divided into pediatric and adult groups. Demographic data, anatomical location and size of the lesion, procedure duration, pre- and post-procedure visual analog scale (VAS) scores, complications, technical and clinical success rates, and recurrence rates were evaluated.</p><p><strong>Results: </strong>Of the 97 patients, 51 (52.6%) were pediatric and 46 (47.4%) were adults. The mean lesion diameter was 7.98 ± 2.92 mm in the pediatric group and 7.14 ± 3.72 mm in the adult group. The overall technical success rate of CT-guided RFA for OO was 100%, with primary and secondary clinical success rates of 97.9% and 98.9%, respectively. The primary clinical success rate was 98.1% (50/51) in the pediatric group and 97.8% (45/46) in the adult group. No major complications related to the procedure were observed. Minor complications included transient skin burn in one pediatric patient (1.9%, 1/51) and localized muscle pain in one pediatric (1.9%, 1/51) and one adult (2.2%, 1/46) patient.</p><p><strong>Conclusion: </strong>This study demonstrates that percutaneous CT-guided RFA is a highly effective and safe technique with high success and low complication rates for the treatment of OO in both pediatric and adult populations.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275607","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":"Intravascular organizing thrombus in the forearm: a unique imaging presentation.","authors":"Rachel Bass, Priyanka Mitta, Constantine Burgan, John Huffman, Bonnie Moore, Thomas Winokur","doi":"10.1007/s00256-025-05044-8","DOIUrl":"https://doi.org/10.1007/s00256-025-05044-8","url":null,"abstract":"<p><p>Organizing thrombus is a well described histologic finding involving the reorganizing and recanalization of a healing thrombus. However, it is rarely large enough to be described on imaging. When the thrombus becomes sufficiently large, intravascular papillary endothelial hyperplasia (IPEH) must be considered. IPEH or Masson's tumor is a benign, exuberant form of organizing thrombus that typically occurs in the soft tissues of the head, neck, and distal extremities. It can occur within a vessel, hematoma, or vascular mass and can mimic benign processes or malignant lesions such as angiosarcoma. Histopathological characteristics are needed for final diagnosis. The treatment is typically complete surgical resection with excellent prognosis. We report the case of a patient presenting with swelling in his left forearm in the same site as a previously treated left basilic vein thrombus. Ultrasound demonstrated a noncompressible, heterogeneous intravascular mass with internal vascularity. Subsequent MRI showed an enhancing mass centered in the left basilic vein with a flow void with the differential diagnosis of IPEH versus intravascular neoplasm. Percutaneous biopsy was performed with histology consistent with reactive vascular proliferation and organizing thrombus. The papillary architecture diagnostic of IPEH was absent. Regardless of final specific terminology, this case presents exuberant organizing thrombus as a benign cause of an enhancing intravascular mass. This patient was treated conservatively with no further intervention.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258954","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":"Lumbosacral transitional vertebra on whole-spine CT: prevalence and association with rib abnormalities.","authors":"Shuji Nagata, Chihiro Yamada, Miyuki Sawano, Yuki Shouji, Gaku Shioyama, Shinobu Nakamura, Yusuke Uchiyama, Hiroshi Nishimura, Shuichi Tanoue","doi":"10.1007/s00256-025-04952-z","DOIUrl":"10.1007/s00256-025-04952-z","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of lumbosacral transitional vertebrae (LSTV) and rib abnormalities and investigate the association between LSTV subtypes and rib abnormalities using whole-spine CT.</p><p><strong>Materials and methods: </strong>The vertebral levels were counted caudally from the cervical vertebra, based on the eighth being the first thoracic vertebra, the twentieth as the first lumbar vertebra, and the twenty-fifth being the first sacral vertebra using sagittal reconstructed CT. Sacralization is when 23 vertebrae are found, whereas lumbarization is the presence of 25 vertebrae.</p><p><strong>Results: </strong>This retrospective study included 551 patients (407 females and 144 males). There is no evidence of a difference in age and sex that was observed between the LSTV and no LSTV groups (95% CIs; - 0.34, 3.08; p = 0.12 and p = 0.24, respectively). LSTV were reported in 16.3% of participants, consisting of 12.3% of sacralization and 4.0% of lumbarization. The incidence rate of lumbarization was significantly high in male participants (p = 0.031). Rib abnormalities were reported in 14.0% of participants, consisting of 12.6% of twelfth hypoplastic rib and 1.5% of lumbar rib. In patients with LSTV, all twelfth hypoplastic ribs were found in the sacralization group and all lumbar ribs were found in the lumbarization group (p < 0.001). The types based on the Castellvi classification demonstrated a significant difference between the sacralization and lumbarization groups (p = 0.007).</p><p><strong>Conclusion: </strong>The findings of our study suggest that patients with sacralization and lumbarization are predisposed to having twelfth hypoplastic ribs and lumbar ribs, respectively.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2169-2177"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086525","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":"Expanding on MRI characteristics of neuromuscular choristoma: a single center retrospective review.","authors":"Tomas Marek, B Matthew Howe, Robert J Spinner","doi":"10.1007/s00256-025-04932-3","DOIUrl":"10.1007/s00256-025-04932-3","url":null,"abstract":"<p><strong>Objective: </strong>Neuromuscular choristoma (NMC) is a rare condition affecting peripheral nerves, most commonly the proximal sciatic nerve. It is characterized by the presence of muscle tissue within the nerve. Patients typically present with neuropathic symptoms. NMC is associated with the development of NMC-associated desmoid-type fibromatosis (NMC-DTF). In this study, we report findings of qualitative and quantitative MRI signal intensities to further expand on known MRI imaging features of NMC.</p><p><strong>Methods and materials: </strong>Retrospective analysis of NMC cases of the sciatic nerve from our institution was conducted. The sciatic nerve was selected as a model example due to its common involvement. Inclusion criteria were a confirmed NMC diagnosis and available MR exams. MRI signal intensities from the affected nerves and normal contralateral nerves were compared, normalized to muscle signal intensity for consistency across different MRI sequences.</p><p><strong>Results: </strong>Fourteen patients (8 men, 6 women) met the inclusion criteria. No significant differences in T1 or T2 signal intensities were found between NMC and unaffected nerves. However, NMC demonstrated significantly higher post-contrast signal intensities (p = 0.003) compared to unaffected nerves. These findings were consistent across the proximal and distal segments of the affected nerve.</p><p><strong>Conclusion: </strong>Our study expands the understanding of MRI features in NMC. The increased post-contrast enhancement in NMC may serve as a useful diagnostic tool and could potentially play a role in detecting areas at risk for future DTF development. This highlights the importance of comprehensive imaging, including post-contrast sequences and ideally imaging of the entire course of the affected nerve.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2107-2115"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053114","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: Chronic neck pain.","authors":"Hideya Tanaka, Takashi Kakiuchi, Takashi Fujishiro, Yuki Yamamoto, Sachio Hayama, Ichiro Baba, Masashi Neo, Shuhei Otsuki","doi":"10.1007/s00256-025-04950-1","DOIUrl":"10.1007/s00256-025-04950-1","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2219-2222"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136493","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}