Skeletal Radiology最新文献

{"title":"Association of intra-operative findings with MRI observations in patients with peroneal tendon pathology: a blinded retrospective case-control observational study.","authors":"Zachary Elijah Stewart, Samir Ghandour, Ronald W Mercer, William E Palmer, Lorena Bejarano-Pineda","doi":"10.1007/s00256-025-04915-4","DOIUrl":"10.1007/s00256-025-04915-4","url":null,"abstract":"<p><strong>Objective: </strong>Assess the accuracy of MRI for peroneal tendon tears, evaluate inter/intra-rater reliability among musculoskeletal radiologists, and identify MRI findings that may be associated with tendon tears.</p><p><strong>Materials and methods: </strong>Preoperative MRIs of patients who underwent surgical debridement of peroneal tendon tears were paired with MRIs of a matched control group with medial ankle pain. Randomized MRIs were reviewed by three musculoskeletal radiologists, recording the presence of structural abnormalities of the peroneal tendons and associated morphological abnormalities. Consensus MRI findings were analyzed for associations with surgical diagnoses. Weighted Cohen's and Fleiss' kappa coefficients were used to describe inter/intra-rater agreement.</p><p><strong>Results: </strong>For peroneus brevis tear, individual sensitivities ranged from 58 to 87%, specificities ranged from 78 to 97%, and accuracies ranged from 79 to 87%, while consensus showed 84% sensitivity, 92% specificity, and 88% accuracy. For peroneus longus tear, individual sensitivities ranged from 14 to 57%, specificities ranged from 76 to 94%, and accuracies ranged from 72 to 79%, while consensus showed 36% sensitivity, 91% specificity, and 79% accuracy. Associations were detected between peroneal tendon tears and numerous secondary MR findings. Tearing of the superior peroneal retinaculum was most diagnostically powerful, present in 55.9% of cases and in none of the controls.</p><p><strong>Conclusion: </strong>MRI is a valuable tool for assessing for peroneus brevis tears but may be less sensitive for detecting peroneus longus tears. Diagnostic accuracy is similar between radiologists, but there is variability in sensitivity/specificity. No individual radiologist achieved a higher accuracy than that obtained through consensus. This may imply value in additional opinions from multiple radiologists when there is diagnostic uncertainty.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2035-2043"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693188","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":"Reliability of pre-operative symptoms, radiographs, and MRI for the assessment of cartilage loss in patients with femoroacetabular impingement syndrome with intra-operative correlation.","authors":"Meghan Jardon, Christopher Burke, Zachary Li, Charles Lin, Xiaochun Li, Judith D Goldberg, Thomas Youm, Mohammad Samim","doi":"10.1007/s00256-025-04939-w","DOIUrl":"10.1007/s00256-025-04939-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess the correlation of pre-operative symptoms, pre-operative diagnostic imaging for cartilage loss, and intra-operative cartilage findings in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome.</p><p><strong>Materials and methods: </strong>Three radiologists performed retrospective independent reviews of pre-operative MRIs in 96 hips for acetabular/femoral cartilage loss utilizing a simplified \"high-low\" classification and the International Cartilage Repair Society grading system. Severity of supra-foveal central femoral head cartilage loss was separately noted. Pre-operative radiographs were graded using the Tonnis and Kellgren-Lawrence systems and for central joint space narrowing. Pre-operative patient symptoms were prospectively gathered utilizing the Nonarthritic Hip Score and the modified Harris Hip Score. Intra-operatively, cartilage loss was recorded using the Outerbridge system.</p><p><strong>Results: </strong>A moderate-to-strong positive correlation between pre-operative radiographic and MR cartilage loss was observed (0.21 <math><mo>≤</mo></math> Τ <math><mo>≤</mo></math> 0.53, T = Kendall's tau) for all readers/scales. Weak-to-moderate positive correlation was found between intra-operative cartilage grading and radiographic grading (0.10 <math><mo>≤</mo></math> Τ <math><mo>≤</mo></math> 0.30). Weak-to-moderate positive correlation between MRI and intra-operative cartilage grading was found for all readers/grading systems (0.17 <math><mo>≤</mo></math> Τ <math><mo>≤</mo></math> 0.43). Cartilage defects were slightly under-reported on MRI, reaching statistical significance at the femoral head. There was moderate-to-strong positive correlation between radiographic central joint narrowing and MRI central femoral head cartilage loss (0.35 <math><mo>≤</mo></math> Τ <math><mo>≤</mo></math> 0.55) for all readers. Inter-reader reliability was fair-to-moderate for radiographs, but poor for MRI. Clinical scores demonstrated very weak negative to no correlation with radiographic/MR cartilage findings and weak positive correlation with intra-operative cartilage findings.</p><p><strong>Conclusion: </strong>Despite MRI underestimation of cartilage loss, the very weak-to-weak correlation of clinical symptoms with pre-operative imaging and intra-operative findings emphasizes the importance of MRI in pre-operative evaluation.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2117-2126"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038750","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 rare case of atypical ossifying fibromyxoid tumor: multiple recurrences and metastasis.","authors":"Zichun Huang, Guohong Liu","doi":"10.1007/s00256-025-04929-y","DOIUrl":"10.1007/s00256-025-04929-y","url":null,"abstract":"<p><p>Ossifying fibromyxoid tumor is a rare soft tissue mesenchymal neoplasm of unclear lineage and intermediate malignant potential, primarily arising in subcutaneous tissues of the limbs, head and neck, or trunk. Ossifying fibromyxoid tumors can be classified as typical, atypical, or malignant. While, most ossifying fibromyxoid tumors exhibit benign behavior, a subset demonstrates malignant tendencies, with a potential for local recurrence and distant metastasis. We report a case of an atypical ossifying fibromyxoid tumor in the soft tissue of the right elbow, characterized by multiple local recurrences and pulmonary metastases. This report details the clinical presentation, radiological findings, histopathological features, and therapeutic interventions, highlighting the challenges in managing this aggressive variant.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2193-2198"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061793","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":"Osteoblastoma involving the sphenoid bone diagnosed with percutaneous biopsy.","authors":"Victoria Kim, Stephanie Cajigas-Loyola, Hamza Alizai, Caitlin Alexander, Bryan Pukenas, Michael Acord","doi":"10.1007/s00256-025-04948-9","DOIUrl":"10.1007/s00256-025-04948-9","url":null,"abstract":"<p><p>Osteoblastomas are rare, benign, bone-forming tumors, most commonly appearing in the axial skeleton. Osteoblastomas arising in the skull are even rarer and tend to originate in the temporal and frontal bones, with involvement of the sphenoid bone being one of the least common sites described. This report discusses a case of an aggressive appearing osteoblastoma of the sphenoid bone that was diagnosed via percutaneous biopsy. A short review of pediatric skull lesions is also presented.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2215-2218"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136497","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":"Question: Chronic neck pain.","authors":"Hideya Tanaka, Takashi Kakiuchi, Takashi Fujishiro, Yuki Yamamoto, Sachio Hayama, Ichiro Baba, Masashi Neo, Shuhei Otsuki","doi":"10.1007/s00256-025-04949-8","DOIUrl":"10.1007/s00256-025-04949-8","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2191-2192"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111868","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":"Radiographic findings in patients suspected of subacromial impingement syndrome in relation to shoulder pain and disability.","authors":"Linda Christie Andrea, Susanne Wulff Svendsen, Poul Frost, Kate Smidt, John Gelineck, David Høyrup Christiansen, Søren Rasmussen Deutch, Torben Bæk Hansen, Annett Dalbøge","doi":"10.1007/s00256-025-04916-3","DOIUrl":"10.1007/s00256-025-04916-3","url":null,"abstract":"<p><strong>Objective: </strong>The aim was to study the association between specific radiographic findings and patient reported shoulder pain and disability in patients suspected of subacromial impingement syndrome (SIS).</p><p><strong>Materials and methods: </strong>This cross-sectional study used baseline data from a prospective study. Study population included patients age 18 to 63 years, referred to orthopaedic clinic on suspicion of SIS. Radiographic findings before first visit to a department of orthopaedic surgery comprised subacromial calcifications, acromial morphological characteristics (i.e. acromial type and spur), acromioclavicular osteoarthritis, signs of previous glenohumeral dislocation (Bankart/Hill-Sachs lesions), and architectural measures (i.e. acromial tilt, acromion index, and lateral acromial angle). Shoulder pain and disability were evaluated using the Oxford Shoulder Score (OSS) from patient's response to a questionnaire at first visit to the public department of orthopaedic surgery or before surgery for SIS. A low OSS was defined as having a score < 25. Associations between the radiographic findings and low OSS were analysed using logistic regression.</p><p><strong>Results: </strong>The population comprised 825 patients. Median time between radiographic examination and completion of the questionnaire was 9 days (SD = 27.1). In adjusted analysis, we found a statistically significant association for lateral spur especially birdbeak type (OR = 2.24 (95% CI 1.36-3.71)), Bankart/Hill-Sachs lesion (OR = 2.49 (95% CI 1.38-4.48)), and acromial tilt > 35° (OR = 0.62 (95% CI 0.41-0.94)). Female sex (OR = 2.25 (95% CI 1.59-3.18)) was also associated with low OSS.</p><p><strong>Conclusion: </strong>In terms of associations with patient-reported shoulder pain and disability, lateral spurs, with emphasis on birdbeak type, Bankart/Hill-Sachs lesions, and acromial tilt > 35°, seemed clinically important.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2087-2096"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029337","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":"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":"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":"1997-2005"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361264/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and origin of prominent nutrient channels of the ilium bone on MR-imaging.","authors":"Luca Albanese, Christoph Germann, Chantal Pauli, Dominic Gascho, Reto Sutter","doi":"10.1007/s00256-025-04938-x","DOIUrl":"10.1007/s00256-025-04938-x","url":null,"abstract":"<p><strong>Objective: </strong>Prominent nutrient vessels are commonly seen in the ilium bone, but little is known about their anatomical characteristics. The aim of this study was to investigate the frequency and morphology of these vessels and associated bone-marrow changes of the ilium using MRI.</p><p><strong>Materials and methods: </strong>MRI-examinations of the pelvis in 245 patients were analyzed retrospectively. Prominent nutrient vessels of the ilium were recorded, including vessel origin, anatomical characteristics such as branches, bone-marrow changes, and entry points into the bone.</p><p><strong>Results: </strong>Two hundred forty-five patients (54±16 years, range 18-88, 102 males) were included. Prominent central nutrient vessels were found in virtually all patients on both sides of the ilium. All nutrient vessels arose from the iliolumbar artery, forming a breakthrough-anastomosis to the superior gluteal artery. Two branches were seen in 57.6% on the right and 61.2% on the left side, constituting the most prevalent branching pattern. Three branches were seen in a third for each side. One or four branches were seen in 3-4.5% for both sides. A prominent branching pattern we coined \"central-vessel-convolute\" (CVC) at the central part of the ilium was seen in 75% on either side. Perivascular fatty areas were found in 25% of cases, and in 3.7-2.4% adjacent bone-marrow edema was observed.</p><p><strong>Conclusion: </strong>Prominent nutrient vessels in the ilium are seen in almost all individuals, the majority exhibiting a specific CVC-pattern. These vessels may be surrounded by perivascular fatty areas; adjacent bone-marrow edema is rare. Recognizing the CVCs and the associated imaging findings should facilitate distinguishing normal anatomical structures from pathology.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2127-2135"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174591","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":"Deep learning-based prediction of cervical canal stenosis from mid-sagittal T2-weighted MRI.","authors":"Wounsuk Rhee, Sung Cheol Park, Hyoungmin Kim, Bong-Soon Chang, Sam Yeol Chang","doi":"10.1007/s00256-025-04917-2","DOIUrl":"10.1007/s00256-025-04917-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to establish a large degenerative cervical myelopathy cohort and develop deep learning models for predicting cervical canal stenosis from sagittal T2-weighted MRI.</p><p><strong>Materials and methods: </strong>Data was collected retrospectively from patients who underwent a cervical spine MRI from January 2007 to December 2022 at a single institution. Ground truth labels for cervical canal stenosis were obtained from sagittal T2-weighted MRI using Kang's grade, a four-level scoring system that classifies stenosis with the degree of subarachnoid space obliteration and cord indentation. ResNet50, VGG16, MobileNetV3, and EfficientNetV2 were trained using threefold cross-validation, and the models exhibiting the largest area under the receiver operating characteristic curve (AUC) were selected to produce the ensemble model. Gradient-weighted class activation mapping was adopted for qualitative assessment. Models that incorporate demographic features were trained, and their corresponding AUCs on the test set were evaluated.</p><p><strong>Results: </strong>Of 8676 patients, 7645 were eligible for developing deep learning models, where 6880 (mean age, 56.0 ± 14.3 years, 3480 men) were used for training while 765 (mean age, 56.5 ± 14.4 years, 386 men) were set aside for testing. The ensemble model exhibited the largest AUC of 0.95 (0.94-0.97). Accuracy was 0.875 (0.851-0.898), sensitivity was 0.885 (0.855-0.915), and specificity was 0.861 (0.824-0.898). Qualitative analyses demonstrated that the models accurately pinpoint radiologic findings suggestive of cervical canal stenosis and myelopathy. Incorporation of demographic features did not result in a gain of AUC.</p><p><strong>Conclusion: </strong>We have developed deep learning models from a large degenerative cervical myelopathy cohort and thoroughly explored their robustness and explainability.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2067-2076"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736210","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":"Localized scleroderma: anatomic MRI findings of morphea with inter-reader analysis.","authors":"Alex Iancau, Sarah Attia, Flavio Duarte Silva, Alireza Eajazi, Elona Malja, Yin Xi, Heidi Jacobe, Avneesh Chhabra","doi":"10.1007/s00256-025-04909-2","DOIUrl":"10.1007/s00256-025-04909-2","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the musculoskeletal lesions in patients with localized scleroderma (morphea) using MRI and examine inter-reader reliability.</p><p><strong>Materials and methods: </strong>This was a retrospective study at a tertiary center with approval from the institutional review board. Forty-nine consecutive patients with final clinical diagnosis of Morphea (37 females, 12 males, mean age 39.04 ± 16.12 years) with different subtypes (20 Linear, 13 Generalized, 5 En coupe de Sabre, 4 Parry Romberg, 3 Eosinophilic Fasciitis 2 Plaque, and 2 Other) underwent MR imaging from 2016-2024. Three musculoskeletal radiologists evaluated different compartment involvements by Morphea- skin, fat, superficial/deep/intermuscular fascia, muscle/nerve, joint/bone, and depth of involvement as superficial or deep. Inter-reader analysis was performed using weighted Conger's Kappa and Intraclass Correlation Coefficient.</p><p><strong>Results: </strong>Among 49 patients with 49 MRI scans, 31 (63%) exhibited superficial lesions, and 18 (37%) had deep lesions. The MRI findings included- skin thickening in 37 (76%) and thinning in 10 (20%); fat atrophy in 35 (71%), and hypertrophy in 1 (2%). Thickening and edema were observed in 34 (69%) superficial fascia and 33 (67%) deep fascia. Muscle edema and bone/joint involvement were present in 11/18 deep lesions (61%) and 2 patients (4%), respectively. The depth of involvement showed good inter-rater agreement (ICC = 0.71 (95% CI: 0.58, 0.82)), with the highest reliability found for intermuscular fascial involvement (Conger's Kappa = 0.79).</p><p><strong>Conclusion: </strong>We demonstrated an efficient MRI protocol for categorizing Morphea variations across tissue compartments, achieving good-fair inter-rater reliability, and identified deep tissue involvement in about one-third of cases.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2055-2065"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711153","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}