Skeletal Radiology最新文献

{"title":"A comprehensive review of ultrasonographic imaging in athletic elbow injuries: a compartment-based approach.","authors":"Dong Rak Kwon, EunKuk Kim","doi":"10.1007/s00256-026-05241-z","DOIUrl":"https://doi.org/10.1007/s00256-026-05241-z","url":null,"abstract":"<p><p>Elbow injury rates are markedly higher among collegiate athletes than in the general population; however, this elevated incidence is largely driven by overhead throwing sports and does not represent a uniform risk across all athletes. Elbow disorders represent a significant diagnostic challenge in sports medicine due to the intricate anatomy of the joint. High-resolution ultrasonography has become an indispensable first-line imaging modality, offering superior spatial resolution for superficial structures and the unique capability for real-time dynamic assessment. This review illustrates the ultrasonographic spectrum of common elbow injuries in athletes, including epicondylopathy, ulnar collateral ligament insufficiency, and nerve entrapment syndromes. By employing a systematic, compartment-based approach categorizing findings into anterior, medial, lateral, and posterior zones, radiologists can ensure a comprehensive evaluation. Particular emphasis is placed on dynamic maneuvers such as valgus stress for ulnar collateral ligament stability and flexion-extension for ulnar nerve subluxation, which provide functional insights that are often unavailable on static magnetic resonance imaging. Furthermore, emerging adjunctive techniques, such as sonoelastography, may provide complementary information on tissue stiffness and integrity, potentially improving lesion characterization in specific athletic elbow conditions. Understanding these imaging patterns is crucial for accurate diagnosis and optimized management in athletes.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842541","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":"Comparison of radiomics-based models for detection of Modic type 1 changes in photon-counting detector CT images of the lumbar spine.","authors":"Adrian A Marth, Benjamin Fritz, Reto Sutter","doi":"10.1007/s00256-026-05247-7","DOIUrl":"https://doi.org/10.1007/s00256-026-05247-7","url":null,"abstract":"<p><strong>Objective: </strong>To compare diagnostic performance of four radiomics-based machine learning models for detecting Modic type 1-changes of the lumbar spine in photon-counting detector (PCD)-CT images, using MRI as the reference standard.</p><p><strong>Materials and methods: </strong>In this retrospective single-center study, 60 patients who underwent lumbar spine PCD-CT and MRI within a one-week interval showing Modic type 1-changes were analyzed. A total of 105 radiomic features were extracted from 360 segmented vertebrae, of which 348 were included in the final analysis after quality control. Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest, Extreme Gradient Boosting (XGBoost), and support vector machines (SVM) were trained and evaluated using nested cross-validation. Discriminatory performance of the models was evaluated by area under the receiver operating characteristic curve (AUC). AUC values were compared using the DeLong Test with Benjamini-Hochberg correction to adjust for multiple testing. Diagnostic accuracy was assessed by calculating sensitivity, specificity and F1-score for each model.</p><p><strong>Results: </strong>LASSO achieved the highest AUC (0.842, 95% CI 0.793-0.891), pairwise comparisons did not show significant differences across the models (p ≥ 0.337). Sensitivity was highest for LASSO (0.756, 95% CI 0.662-0.846), whereas specificity was highest for SVM (0.929, 95% CI 0.896-0.958). The highest F1-score was observed for LASSO (0.605, 95% CI 0.521-0.679).</p><p><strong>Conclusion: </strong>Four radiomics-based machine learning models demonstrated similar high discriminatory performance but differing diagnostic accuracy for detecting Modic type 1-changes on PCD-CT images. These results support the feasibility of radiomics for evaluation of pathologies beyond visual inspection, although further validation is required to determine clinical applicability.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842490","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":"Common weightlifting injuries of the upper extremity.","authors":"Sarah M Yu, Joseph S Yu","doi":"10.1007/s00256-026-05240-0","DOIUrl":"https://doi.org/10.1007/s00256-026-05240-0","url":null,"abstract":"<p><p>The popularity of weightlifting continues to increase as both a form of exercise and as a method of competition. The recognized benefits of resistance training on muscle and bone health are recognized in all age groups. Weightlifting promotes strength and balance in youth but is also an important way to combat the effects of aging. However, injuries to muscles, tendons, and bone may occur, particularly when executing lifts that push tensile and compressive forces to an extreme. In this article, we will discuss five common upper extremity injuries that are associated with weightlifting, their mechanisms of injury, and their imaging findings with an emphasis on MR imaging.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842543","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":"Incremental diagnostic value of multiregional single-slice CT muscle areas over L3 for sarcopenia: a deep learning-based segmentation study.","authors":"Hong-Seon Lee, Doyoung Kim, Chung Hwan Choi, Sungjun Kim, Jung Hyun Park","doi":"10.1007/s00256-026-05237-9","DOIUrl":"https://doi.org/10.1007/s00256-026-05237-9","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic performance of multiregional CT-based muscle assessment with conventional single-level (L3) evaluation.</p><p><strong>Materials and methods: </strong>This retrospective study included 83 adults who underwent multiregional non-contrast CT and completed sarcopenia assessments based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Skeletal muscle areas at six anatomical levels (T4, L3, ASIS, femoral head, midthigh, and proximal calf) were automatically quantified using a deep learning-based segmentation software (DeepCatch). The diagnostic performance of single-slice muscle areas was evaluated using the area under the receiver operating characteristic curve (AUC). Pearson's or Spearman's correlation coefficients were analyzed to assess the relationship between CT-derived muscle metrics and functional status.</p><p><strong>Results: </strong>Multiregional muscle assessment demonstrated the highest diagnostic performance. In a clinical prediction model, models incorporating three-site and six-site muscle areas improved discrimination compared with the clinical base model (ΔAUC 0.123 and 0.136, respectively), and these improvements remained significant after BH-FDR adjustment (both q = 0.034). In contrast, the addition of the midthigh muscle area showed a modest improvement (ΔAUC 0.089; p = 0.029), which did not remain significant after FDR adjustment (q = 0.064), and L3 muscle area provided limited incremental value.</p><p><strong>Conclusion: </strong>Multiregional CT-based muscle assessment provides improved diagnostic performance for sarcopenia compared with single-level evaluation. Lower-extremity muscle measurements, particularly at the midthigh, contribute to this improvement, whereas reliance on L3 alone may be insufficient.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842463","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":"Tumour-to-tumour metastasis: head and neck squamous cell carcinoma to enchondroma.","authors":"Robert Henderson, Daniel Wong, Richard Carey-Smith, Rajesh Botchu","doi":"10.1007/s00256-026-05225-z","DOIUrl":"https://doi.org/10.1007/s00256-026-05225-z","url":null,"abstract":"<p><p>Metastatic disease is a common occurrence in malignancy with certain cancers recognised to have a high incidence of metastases, particularly the liver, lungs, and bones. Tumour-to-tumour metastases are an exceptionally rare occurrence, where a distant malignancy metastasises to a secondary distinct tumour. Breast and lung carcinomas are the more commonly reported origin sites, whilst renal cell carcinomas and meningiomas are the most reported recipient malignant and benign tumours respectively. In this article, we describe an unusual case of a metastatic head and neck squamous cell carcinoma (HNSCC) complicated by tumour-to-tumour metastasis to a benign intramedullary cartilage lesion in the distal femur.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842451","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 findings of foot and ankle injuries in dancers.","authors":"Philip G Colucci, Madeleine A Gao, Kathleen L Davenport, Matthew S Conti, Carolyn M Sofka","doi":"10.1007/s00256-026-05229-9","DOIUrl":"https://doi.org/10.1007/s00256-026-05229-9","url":null,"abstract":"<p><p>Dancers are performing artists and elite athletes with unique physiological and psychological demands. Many dance styles, especially classical ballet, require extraordinary flexibility and strength throughout the foot and ankle with remarkable pain tolerance. Injuries arising from biomechanical and metabolic stresses negatively impact career progression with resultant chronic pain, permanently impaired function, and financial loss. Therefore, dancers rarely seek medical attention except for genuine problems. The unique demands of dance can result in specific injuries and distinctive radiological patterns on imaging. Early and accurate recognition of these dance-specific findings is essential in diagnosing the dancer's foot and ankle. Given the dancer's unique needs and high risk of injury, this manuscript will discuss essential radiologic considerations specific to foot and ankle imaging in the dancer. Key points include the need for weightbearing radiographs, applications for weightbearing computed tomography, indications for ultrasound when magnetic resonance imaging is generally the gold standard, and the value of dancer-specific imaging techniques. An emphasis is placed on recognizing pathology that is genuinely unique to this patient cohort such as flexor hallucis longus tendinopathy, low-risk stress fractures at the second metatarsal base, and spiral fractures at the fifth metatarsal diaphysis. Understanding the degree of correlation between imaging findings with symptoms and clinical diagnoses is essential. Identifying common and uncommon injury patterns in dancers coupled with a knowledge of the implications of these injuries can facilitate improved communication with referring providers, which may help radiologists contribute to providing optimal patient care for a vulnerable patient population.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820605","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":"Avascular necrosis of the femoral head following hysteroscopic myomectomy: Evaluation of bone perfusion using dynamic contrast-enhanced MRI and intravoxel incoherent motion.","authors":"Tijen Cankurtaran, Büşra Yavuz Sarsam, İlhami Kuru, Ahmet Muhteşem Ağıldere","doi":"10.1007/s00256-026-05232-0","DOIUrl":"https://doi.org/10.1007/s00256-026-05232-0","url":null,"abstract":"<p><p>Avascular necrosis of the femoral head (ANFH) results from compromised vascular supply, leading to osteonecrosis and progressive structural weakening that may culminate in articular collapse and functional disability. We report a case of a 33-year-old woman who developed avascular necrosis of the right femoral head six weeks after a three-hour hysteroscopic myomectomy. Initial non-contrast magnetic resonance imaging (MRI) demonstrated early-stage osteonecrosis. Two weeks later, a sudden increase in hip pain raised concern for femoral head collapse, prompting a non-contrast computed tomography (CT) scan. CT revealed intraosseous gas within the necrotic region, with subtle evidence of articular collapse at the superior aspect of the femoral head. A contrast-enhanced MRI was subsequently performed to exclude a possible superimposed anaerobic infection and included dynamic contrast-enhanced (DCE-MRI) and intravoxel incoherent motion (IVIM) sequences. Functional MRI techniques allowed in vivo evaluation of perfusion and microvascular diffusion within the affected femoral head, providing valuable insight into areas likely corresponding to necrotic bone, reparative tissue, and preserved marrow. Multimodal imaging integrating morphological and functional findings enabled detailed interpretation of distinct zones representing different stages or characteristics of tissue response to ischemic injury. This case report highlights the potential of functional MRI techniques to enhance understanding of perfusion alterations in avascular necrosis of the femoral head.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820576","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":"Discrepancies in CPAK classification between CT and long-leg radiography: a systematic review and meta-analysis.","authors":"Tao Bian, Yunfeng Zhang, Lei Li, Yixin Zhou","doi":"10.1007/s00256-026-05224-0","DOIUrl":"https://doi.org/10.1007/s00256-026-05224-0","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether substantial differences in coronal plane alignment of the knee phenotype distribution, as well as systematic angular measurement discrepancies, exist between CT and long-leg radiography.</p><p><strong>Materials and methods: </strong>From February 2021 to April 2025, we searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for studies comparing CT- and long-leg radiography-derived coronal plane alignment classifications of the knee in patients with osteoarthritis. The primary outcome was distribution of coronal plane alignment phenotypes. Secondary outcomes included differences in medial proximal tibial angle, lateral distal femoral angle, arithmetic hip-knee-ankle angle, and joint line obliquity.</p><p><strong>Results: </strong>Four studies (1,134 knees) were included. Compared with long-leg radiography-derived classification, CT-derived classification increased type I phenotypes (risk difference: 0.10; 95% confidence interval: 0.01-0.20; P = 0.040) and decreased type III (risk difference: -0.04; 95% confidence interval: -0.07 to -0.01; P = 0.020) and type V phenotypes (risk difference: -0.04; 95% confidence interval: -0.07 to -0.01; P = 0.004). CT yielded significantly lower medial proximal tibial angle (weighted mean difference: - 1.18°; P < 0.001), arithmetic hip-knee-ankle angle (weighted mean difference: - 0.95°; P < 0.001), and joint line obliquity (weighted mean difference: - 1.40°; P < 0.001) than long-leg radiography. Heterogeneity was high for type I phenotype (I² = 81%), lateral distal femoral angle (I² = 70%), and joint line obliquity (I² = 69%).</p><p><strong>Conclusion: </strong>Discrepancies between CT-based software-generated and long-leg radiography-derived measurements substantially affect coronal plane alignment classification and angular parameters. Surgeons should consider these modality-specific variations and employ compensatory verification strategies to ensure optimal alignment.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820589","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":"Morphologic assessment of peritalar compensation in patients with advanced varus ankle osteoarthritis.","authors":"Zachary J Eatough, Rich J Lisonbee, Andrew C Peterson, Shireen Y Elhabian, Megan K Mills, Nicola Krähenbühl, Amy L Lenz","doi":"10.1007/s00256-026-05236-w","DOIUrl":"https://doi.org/10.1007/s00256-026-05236-w","url":null,"abstract":"<p><strong>Objective: </strong>Varus ankle malalignment is observed in most ankle osteoarthritis patients with approximately half of these patients presenting with peritalar compensation, where the subtalar joint is aligned valgus to compensate for a varus tibiotalar joint. This study developed a 3D weight-bearing computed tomography-based multi-bone statistical shape model to quantify morphologic and alignment differences between compensated and non-compensated presentations of advanced varus ankle osteoarthritis.</p><p><strong>Materials and methods: </strong>Our assessment included 70 individuals, 44 diagnosed with advanced varus ankle osteoarthritis, and 26 asymptomatic controls. Each participant underwent weight-bearing computed tomography. Semi-automatic segmentations produced patient-specific 3D bone reconstructions of the distal tibia, distal fibula, talus, calcaneus, navicular, and cuboid. A multi-bone statistical shape model was created using each of the 3D bone reconstructions. Joint space distance, coverage area, and congruence index were measured at equivalent anatomic locations within articular coverage obtained from the statistical shape model.</p><p><strong>Results: </strong>Eleven principal component analysis modes retained 85.8% variance. Significant differences existed in mode 1 (medial malleolus and talar dome morphology, fibular positioning; 26.6% variance, p < 0.001 for all comparisons) and mode 3 (talar head morphology, midtarsal joint orientation; 10.8% variance, p < 0.05). Morphometric analysis showed 67.5% combined shape-alignment differences in non-compensated versus controls, predominantly affecting peritalar structures.</p><p><strong>Conclusion: </strong>Patients with non-compensated varus ankle osteoarthritis demonstrate decreased medial tibiotalar joint space, increased talofibular joint space, and increased peritalar joint coverage compared to compensated and asymptomatic ankles. These differences are driven primarily by alignment variation in non-compensated ankles. Complexity between these two clinical presentations should be taken into consideration with rehabilitation efforts and surgical planning.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820594","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":"What is the utility of whole-body PET/MRI in the staging of myxoid liposarcoma?","authors":"Cong Fan, Eduardo Williams-Medina, Kevin Zhu, Ashlyn Pucky, Hakan Ilaslan, Zachary D Burke, Nathan W Mesko, Lukas M Nystrom","doi":"10.1007/s00256-025-05087-x","DOIUrl":"10.1007/s00256-025-05087-x","url":null,"abstract":"<p><strong>Objective: </strong>Myxoid liposarcoma is a soft tissue sarcoma with a unique predilection for metastasis to atypical sites compared to other soft tissue sarcoma histologic subtypes. Does a whole-body (PET/MRI or PET/CT) staging approach, compared to current National Comprehensive Cancer Network (NCCN) guidelines, improve our ability to identify metastatic disease in myxoid liposarcoma?</p><p><strong>Materials and methods: </strong>A retrospective analysis identified 31 patients diagnosed with myxoid liposarcoma between 2015 and 2022. Ten patients were staged with standard guidelines and 21 with a whole-body PET modality. Patients who did not complete any staging or had their definitive care performed outside our institution were excluded.</p><p><strong>Results: </strong>In the whole-body group, three (14.3%) patients were found to have metastatic disease on initial presentation, while none had metastatic disease in the standard group. During post-treatment surveillance, two patients in the standard group (n = 10) had new metastases discovered by CT chest with/without MRI spine. Three patients in the whole-body group developed new metastases, which were discovered by whole-body PET/MRI in one and MRI spine in two patients. The median SUVmax of the primary tumor site was 2.8 (range 2.3, 3.4), and for metastasis detected on follow-up imaging, the median SUVmax was 3.2 and 2.6 for the whole-body and standard groups, respectively.</p><p><strong>Conclusions: </strong>Whole-body PET modalities for staging myxoid liposarcoma appear to detect initial metastatic disease and new disease during surveillance, at least as well as current NCCN guideline-recommended modalities. Given that the avidity of myxoid liposarcoma is low, the added value of PET imaging may be limited.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1027-1035"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724985","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}