Skeletal Radiology最新文献

{"title":"Deep learning-enhanced zero echo time MRI for glenohumeral assessment in shoulder instability: a comparative study with CT.","authors":"Laura Carretero-Gómez, Maggie Fung, Florian Wiesinger, Michael Carl, Graeme McKinnon, José de Arcos, Sagar Mandava, Santiago Arauz, Eugenia Sánchez-Lacalle, Satish Nagrani, Juan Manuel López-Alcorocho, Elena Rodríguez-Íñigo, Norberto Malpica, Mario Padrón","doi":"10.1007/s00256-024-04830-0","DOIUrl":"10.1007/s00256-024-04830-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate image quality and lesion conspicuity of zero echo time (ZTE) MRI reconstructed with deep learning (DL)-based algorithm versus conventional reconstruction and to assess DL ZTE performance against CT for bone loss measurements in shoulder instability.</p><p><strong>Methods: </strong>Forty-four patients (9 females; 33.5 ± 15.65 years) with symptomatic anterior glenohumeral instability and no previous shoulder surgery underwent ZTE MRI and CT on the same day. ZTE images were reconstructed with conventional and DL methods and post-processed for CT-like contrast. Two musculoskeletal radiologists, blinded to the reconstruction method, independently evaluated 20 randomized MR ZTE datasets with and without DL-enhancement for perceived signal-to-noise ratio, resolution, and lesion conspicuity at humerus and glenoid using a 4-point Likert scale. Inter-reader reliability was assessed using weighted Cohen's kappa (K). An ordinal logistic regression model analyzed Likert scores, with the reconstruction method (DL-enhanced vs. conventional) as the predictor. Glenoid track (GT) and Hill-Sachs interval (HSI) measurements were performed by another radiologist on both DL ZTE and CT datasets. Intermodal agreement was assessed through intraclass correlation coefficients (ICCs) and Bland-Altman analysis.</p><p><strong>Results: </strong>DL ZTE MR bone images scored higher than conventional ZTE across all items, with significantly improved perceived resolution (odds ratio (OR) = 7.67, p = 0.01) and glenoid lesion conspicuity (OR = 25.12, p = 0.01), with substantial inter-rater agreement (K = 0.61 (0.38-0.83) to 0.77 (0.58-0.95)). Inter-modality assessment showed almost perfect agreement between DL ZTE MR and CT for all bone measurements (overall ICC = 0.99 (0.97-0.99)), with mean differences of 0.08 (- 0.80 to 0.96) mm for GT and - 0.07 (- 1.24 to 1.10) mm for HSI.</p><p><strong>Conclusion: </strong>DL-based reconstruction enhances ZTE MRI quality for glenohumeral assessment, offering osseous evaluation and quantification equivalent to gold-standard CT, potentially simplifying preoperative workflow, and reducing CT radiation exposure.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1263-1273"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688723","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":"Foreign body giant cell reaction due to Durolane (hyaluronic acid derivative) injection - A case report.","authors":"Jacob R Doddridge, Katherine A Banner, Nathaniel B Hunter, Nicholas M Beckmann","doi":"10.1007/s00256-024-04824-y","DOIUrl":"10.1007/s00256-024-04824-y","url":null,"abstract":"<p><p>Osteoarthritis can be treated with hyaluronic acid derivatives, such as Durolane manufactured by Bioventus (Hill, 2017), particularly when conventional treatments prove ineffective. In osteoarthritic joints, the synovial fluid has a lower concentration of hyaluronic acid compared to healthy joints. Intra-articular therapy with exogenous hyaluronic acid can improve viscoelastic properties, enhance chondrocyte synthesis, reduce cartilage degradation, and alleviate pain associated with osteoarthritis (Migliore and Procopio in Clin Cases Miner Bone Metab. 12:31-3, 2015). This report describes a unique case where a patient, following Durolane administration, presented with an intraosseous foreign body giant cell reaction. A 2.5-cm lesion was identified on MRI, initially raising concerns for metastatic disease or multiple myeloma. Subsequent IR CT-guided biopsy confirmed a diagnosis of \"foreign body giant cell reaction to gel,\" linked to the Durolane injection. This case presents a contribution to the literature due to the scarcity of documented instances where Durolane injection leads to an intraosseous foreign body giant cell reaction resembling metastatic disease. While a solitary intraosseous pseudotumor, reportedly due to viscosupplement injection, has been published, it differs in both location (hip vs. knee) and imaging characteristics from the presented case. The manifestation of a foreign body giant cell reaction after Durolane injection, mimicking malignant osseous lesions, merits attention among practitioners. This case underscores the necessity for further research into potential adverse reactions associated with hyaluronic acid derivatives.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1359-1364"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627239","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":"Dynamic ultrasound of the hip.","authors":"Steven B Soliman, Matthew J Hartwell, Alex Gornitzky, Ira Zaltz","doi":"10.1007/s00256-025-04902-9","DOIUrl":"10.1007/s00256-025-04902-9","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1301-1302"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543371","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":"Sacroiliac joint dysfunction: anatomy, pathophysiology, differential diagnosis, and treatment approaches.","authors":"Leah E Waldman, Isabela Maluli, Charles N Moon, Matthew Skalski, George R Matcuk","doi":"10.1007/s00256-024-04831-z","DOIUrl":"10.1007/s00256-024-04831-z","url":null,"abstract":"<p><p>The sacroiliac joints (SIJ) play a pivotal role in pelvic stability and load transmission. SIJ-related disorders can pose a diagnostic challenge because of complex anatomy, non-specific imaging findings, and overlapping symptomatology with other lower back conditions. Broadly, SIJ pathology can be divided into the following categories: infectious, inflammatory, degenerative, mechanical, traumatic, and neoplastic. On the spectrum of mechanical disorders is the entity of SIJ dysfunction, defined as pain localized to the SIJ due to non-inflammatory causes. This paper aims to enhance the understanding of SIJ dysfunction by exploring SIJ anatomy, pathophysiology, and differential diagnosis for SIJ pain. Etiologies, associations, and diagnostic physical examination maneuvers for SIJ dysfunction are reviewed. We will discuss the role of diagnostic imaging in SIJ dysfunction and propose imaging findings which may indicate the diagnosis. Finally, we will discuss therapeutic strategies to treat SIJ dysfunction. By delving into the complexities of SIJ anatomy and pathophysiology, this paper provides valuable discernment for the diagnosis and management of SIJ-related disorders.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1195-1213"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648809","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":"https://doi.org/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":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-17","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":"Imaging clues for the diagnosis of various pathogenic causes of infectious spondylitis.","authors":"Pornrujee Hirunpat, Theeraphol Panyaping, Wannisa Wongpipathpong, Siriporn Hirunpat","doi":"10.1007/s00256-025-04943-0","DOIUrl":"https://doi.org/10.1007/s00256-025-04943-0","url":null,"abstract":"<p><p>Infectious spondylitis is not a common disease; however, its incidence has increased recently due to the increasing number of older patients with chronic diseases and immunocompromised status globally. The clinical presentation of infectious spondylitis may be non-specific, causing delays in diagnosis and treatment, and leading to significant sequelae. Imaging usually plays a crucial role in characterizing the presence and extent of the disease, leading to proper management, reduced mortality, and long-term neurological morbidity. Many studies have proposed imaging features to distinguish between the common causes of infectious spondylitis, pyogenic or tuberculous infections, while the less common infections, including those caused by fungi or other bacterial organisms such as brucellosis, melioidosis, and actinomycosis, are believed to lack specific imaging characteristics. In this review, we highlight the characteristic imaging findings of both common and uncommon pathogens, which can serve as key clues for accurately diagnosing various pathogenic causes of infectious spondylitis.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal abscopal effect: a review of the important imaging findings and their clinical relevance.","authors":"Hana Farzaneh, Meghan Jardon, Soterios Gyftopoulos, Mohammad Samim","doi":"10.1007/s00256-025-04944-z","DOIUrl":"https://doi.org/10.1007/s00256-025-04944-z","url":null,"abstract":"<p><p>The abscopal effect is a rare but important phenomenon in which targeted therapy of the primary tumor, mainly radiation therapy, leads to the regression of malignant cells at distant sites from the primary tumor and outside the field of treatment. Radioembolization is a developing area of interventional oncology, typically involving microscopic radioactive spheres loaded with yttrium-90. The abscopal effect on distant bone metastases has been previously reported in patients following palliative radiotherapy; however, it has also been observed with more targeted radiation treatments, such as yttrium-90, primarily outside the musculoskeletal system. Musculoskeletal radiologists should be familiar with the abscopal effect, as the indications for radiation therapy are on the rise, and recent advancements in immune therapy have resulted in the induction of the abscopal effect. Herein, we present a case of the abscopal effect in musculoskeletal metastatic disease following targeted radioembolization. We also review the literature on the abscopal effect involving metastatic bone lesions resulting from different types of cancer therapy. Finally, we present recent advancements in cancer treatment with the aim of utilizing this effect.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080135","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":"Cone beam CT in the imaging of musculoskeletal trauma: a scoping review.","authors":"Jessica R Smith, Balvinder K Bharath, Martine A Mallinson, Kim Mason, Beverly Snaith","doi":"10.1007/s00256-025-04947-w","DOIUrl":"https://doi.org/10.1007/s00256-025-04947-w","url":null,"abstract":"<p><strong>Introduction: </strong>Cone beam computed tomography (CBCT) is an emerging technology in musculoskeletal (MSK) imaging. The objective of this scoping review was to provide an overview of the research surrounding CBCT utility in bony injury assessment as an alternative to other imaging modalities and investigate any gaps in the current evidence base.</p><p><strong>Methods: </strong>MEDLINE, CINAHL, and PubMed were searched up to January 2025 for articles including CBCT studies on human participants following trauma. An online literature review tool was used to manage and streamline the review process.</p><p><strong>Results: </strong>The search yielded 23 studies. The image quality and diagnostic accuracy of CBCT were high overall, and a number of studies confirmed the radiation dose to be lower than multislice CT. Studies examined CBCT for extremity trauma, with half the studies focused solely on the wrist. The utility appears greatest in the identification of radiographically occult fractures. Limited cost-effectiveness analysis has been undertaken.</p><p><strong>Conclusions: </strong>Overall, the literature suggests CBCT can be an effective tool in the diagnosis of bony injuries with greater sensitivity than radiography at a lower radiation dose than multi-slice computed tomography. However, evaluation of wider patient and economic impacts of adopting CBCT in MSK trauma pathways is recommended.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080109","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":"Diagnostic value of a coronal STIR sequence in conjoined lumbar nerve root detection: an MRI accuracy study.","authors":"Georg Wilhelm Kajdi, Thomas Marth, Jung-Ah Choi, Mazda Farshad, Reto Sutter","doi":"10.1007/s00256-025-04945-y","DOIUrl":"https://doi.org/10.1007/s00256-025-04945-y","url":null,"abstract":"<p><strong>Objectives: </strong>To assess diagnostic accuracy for conjoined lumbosacral nerve root (CLNR) detection on MRI when adding a coronal STIR sequence to the standard lumbar spine protocol.</p><p><strong>Materials and methods: </strong>In this retrospective study, two radiologists assessed the presence of CLNR and lumbosacral transitional vertebrae (LSTV), using a standard lumbar MRI protocol and an expanded protocol with an additional coronal STIR sequence. Prior radiologist consensus using the expanded protocol served as a reference standard for diagnosis.</p><p><strong>Results: </strong>In 751 patients (mean age 61.2 ± 15.7 years, 435 females), CLNR was found in 38 patients (5.1%) in consensus. Without coronal STIR, 13 CLNR patients were correctly identified, CLNR was missed in 25 patients, and 3 patients were falsely detected as having one (sensitivity of 34.2%, specificity of 99.6%, positive predictive value (PPV) of 81.3%, negative predictive value (NPV) of 96.6%, and accuracy of 96.3%). With coronal STIR, 31 CLNR patients were correctly identified, CLNR were missed in 7 patients, and one patient was falsely detected as having one (sensitivity of 81.6%, specificity of 99.9%, PPV of 96.9%, NPV of 99.0%, and accuracy of 98.9%). Inter-reader agreement improved from moderate without coronal STIR (κ = 0.592; 95% CI 0.38, 0.80) to almost perfect with coronal STIR (κ = 0.915; 95% CI 0.84, 0.99). LSTV had a prevalence of 13.3% among patients without and 26.3% among patients with CLNR (p = 0.025).</p><p><strong>Conclusion: </strong>Coronal STIR greatly improved sensitivity and inter-reader agreement for CLNR detection on MRI while slightly improving the specificity and accuracy. A significant association of CLNR and LSTV was found.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080132","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":"MR neurography findings of brachial plexopathy following total shoulder arthroplasty.","authors":"Yenpo Lin, Marcio Bottene Villa Albers, Jake Fiore, Anna Bryn Williams, Audrey Wimberly, Samuel A Taylor, Lawrence V Gulotta, Ek T Tan, Darryl B Sneag","doi":"10.1007/s00256-025-04946-x","DOIUrl":"10.1007/s00256-025-04946-x","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize nerve injury patterns following total shoulder arthroplasty (TSA).</p><p><strong>Methods: </strong>This retrospective study reviewed brachial plexus MR neurography (MRN) in patients with brachial plexopathy within 180 days post TSA from 2016 to 2023. Patients with pre-existing neurologic symptoms or without available electrodiagnostic testing (EDX) data were excluded. MRN findings were extracted from the original report and independently reviewed by a second, musculoskeletal fellowship trained radiologist.</p><p><strong>Results: </strong>A total of 27 patients (15F/12 M, mean age 67) were included. MRN and EDX-confirmed nerve injury localization matched in 13 patients, with nerve hyperintensity and/or enlargement identified in 7 cases at the plexus proper and 6 cases at the branch nerve level (suprascapular, axillary, radial, median). Nerve impingement by screw (n = 3) or extruded cement (n = 1) and mass effects including soft tissue edema (n = 1), hematoma (n = 2), or joint effusion (n = 2) were identified. MRN detected muscle denervation in 8 of 19 patients with EMG abnormalities, with a median TSA-to-MRN interval of 62.5 days (range, 19-95) versus 3 days (range, 2-155) in those without denervation on MRN (p = 0.003). Inter-rater reliability demonstrated substantial to almost perfect agreement for MRN assessments, except for cord hyperintensity. All patients were clinically followed up: 3 had complete symptomatic resolution and 21/27 reported partial improvement at a mean follow-up time of 25.5 months.</p><p><strong>Conclusions: </strong>MRN findings closely correlated with EDX-confirmed clinical diagnoses in cases with MRN abnormalities. Additionally, MRN identified secondary findings, such as local mass effect on nerve segments, that can guide management.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047686","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}