Skeletal Radiology最新文献

{"title":"Shear wave elastography in elastofibroma dorsi: lesion-based associations with pain severity and anatomical localization.","authors":"Osman Kamer Eryilmaz, İbrahim Feyyaz Naldemir","doi":"10.1007/s00256-026-05260-w","DOIUrl":"10.1007/s00256-026-05260-w","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to evaluate lesion-based associations between pain severity and intrinsic tissue stiffness measured by shear wave elastography in elastofibroma dorsi.</p><p><strong>Methods: </strong>This single-center study included 58 patients, in whom 110 elastofibroma dorsi lesions were incidentally detected on thoracic computed tomography. All underwent shear wave elastography. Pain was graded per lesion using the Chronic Pain Grade scale. Lesion volume, computed tomography attenuation, inferior ectopy, and concomitant superior elastofibroma dorsi were recorded. Painful vs. painless lesions were compared using correlation and multivariable regression.</p><p><strong>Results: </strong>Mean age was 62.1 ± 9.4 years; 91.4% were female. Stiffness was higher in painful lesions than in painless lesions (3.12 vs. 2.59 m/s; p < 0.001) and correlated with pain severity (ρ = 0.45, p < 0.001). Shear wave elastography independently predicted pain (odds ratio = 1.80 per 1 m/s; 95% confidence interval 1.21-2.68; p < 0.01). Inferior ectopy (84.6% vs. 72.2%, p = 0.041) and concomitant superior elastofibroma dorsi (91.7% vs. 68.6%, p = 0.048) were associated with higher pain prevalence but did not influence stiffness. In multivariable analysis, shear wave elastography and concomitant superior elastofibroma dorsi remained independently associated with pain (odds ratio = 5.08; p = 0.037), while inferior ectopy did not. Lesion volume and computed tomography attenuation were not associated with pain.</p><p><strong>Conclusions: </strong>Increased stiffness independently predicts pain in elastofibroma dorsi. Inferior ectopy may contribute through extrinsic factors; superior lesions independently predict pain. Shear wave elastography may aid identification of symptomatic lesions.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2769-2778"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423610","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 performance of zero-echo time (ZTE) MRI for preoperative evaluation of cervical OPLL complicated with dural ossification (DO): a retrospective study.","authors":"Baiyang Jiang, Qianxi Jin, Dongqing Zhu, Xin Zhang, Weijin Zhang, Jiayi Zhang, Guangwen Duan, Meiling Xu, Xuegao Wu, Wenwen Wang, Song Jiang, Fukai Li, Xiang Wang, Tiefeng Li, Yi Xiao, Shiyuan Liu","doi":"10.1007/s00256-026-05324-x","DOIUrl":"10.1007/s00256-026-05324-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic efficacy of zero-echo time (ZTE) magnetic resonance imaging (MRI) for cervical ossification of the posterior longitudinal ligament (OPLL) complicated by dural ossification (DO), compared with T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI).</p><p><strong>Materials and methods: </strong>This retrospective single-center study included 73 consecutive OPLL patients (52 males, 21 females; mean age 55.5 ± 10.6 years) admitted between April 2025 and October 2025. All underwent 1-mm thin-slice computed tomography (CT) (gold standard) and 3.0T MRI (T1WI, T2WI, and ZTE). Two senior radiologists blindly assessed DO presence. Sensitivity, specificity, diagnostic accuracy, area under the curve (AUC), and Cohen's κ interobserver agreement coefficient were calculated, with McNemar's and DeLong's tests applied for interreader and pairwise AUC statistical comparisons, respectively.</p><p><strong>Results: </strong>CT confirmed 46 cases (63.0%) of cervical OPLL complicated with DO. For the ZTE sequence, the diagnostic sensitivity of the two readers was 93.5% and 95.7%, specificity was 96.3% and 88.9%, accuracy was 94.5% and 93.2%, and AUC was 0.949 and 0.923, respectively. These metrics were significantly superior to those of T1WI imaging (AUC 0.522-0.536) and T2WI imaging (AUC 0.550-0.572). DeLong's test confirmed that the AUC of ZTE was significantly higher than that of T1WI (P < 0.001) and T2WI (p < 0.001), while there was no significant difference between T1WI and T2WI (p > 0.05). Regarding interobserver consistency: the Cohen's κ value for ZTE was 0.854, while those for T1WI and T2WI were -0.043 and 0.466, respectively.</p><p><strong>Conclusion: </strong>ZTE-MR imaging offers a nonionizing, highly sensitive, and reproducible approach for diagnosing cervical OPLL with DO and serves as a valuable adjunct to conventional sequences for preoperative evaluation.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2941-2951"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685691","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":"Vertebral trabecular attenuation serial changes on chest CT after autologous hematopoietic stem cell transplantation.","authors":"Zeynep Atçeken, Sezer Kula, Taner Tan, Umur Topcu, Çetin Atasoy, Yüksel Peker","doi":"10.1007/s00256-026-05316-x","DOIUrl":"10.1007/s00256-026-05316-x","url":null,"abstract":"<p><strong>Objective: </strong>Transplant-associated bone disease and fragility fractures are recognized complications after hematopoietic stem cell transplantation (HSCT). We aimed to evaluate early and longitudinal changes in vertebral trabecular attenuation on routine chest CT in patients undergoing autologous HSCT.</p><p><strong>Materials and methods: </strong>In this retrospective single-centre study, 98 adult patients who underwent autologous HSCT and had both pre-transplant and early post-transplant (≤ 30 days) non-contrast chest CT were included. Vertebral trabecular attenuation was measured in Hounsfield units (HU) at T10-T12 and vertebral body height was measured in millimeters. Longitudinal changes were additionally evaluated in patients with available late follow-up CT (> 30 days) (n = 61).</p><p><strong>Results: </strong>Vertebral trabecular attenuation decreased significantly from pre-transplant to early post-transplant CT (163.0 ± 57.0 HU vs. 132.7 ± 53.9 HU; p < 0.001). In patients with late follow-up imaging, attenuation remained lower than baseline (157.3 ± 58.7 HU vs. 125.3 ± 56.1 HU; p < 0.001). The proportion of attenuation values within the osteoporosis range (≤ 110 HU) increased from 20.4% at baseline to 39.8% early after transplantation. Among patients with late follow-up imaging, this proportion increased from 27.4% to 45.2% early after transplantation and remained elevated at 48.4% at late follow-up. Vertebral body height remained unchanged during the early post-transplant period but decreased significantly at late follow-up.</p><p><strong>Conclusion: </strong>Vertebral trabecular attenuation on routine chest CT declines within the first month after autologous HSCT and remains reduced on follow-up imaging. Opportunistic CT-based assessment may enable early identification of skeletal vulnerability.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2823-2833"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607574","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":"CT-guided radiofrequency ablation of a tibial osteoid osteoma in pregnancy.","authors":"Prisca C Diala, Ilina Pluym, Nabia Khan, Joe Hong, Aisling Murphy, Varand Ghazikhanian, Simon Dadoun","doi":"10.1007/s00256-026-05304-1","DOIUrl":"10.1007/s00256-026-05304-1","url":null,"abstract":"<p><p>Osteoid osteomas are painful benign bone tumors that primarily affect the long bones and may be managed conservatively with nonsteroidal anti-inflammatory drugs (NSAIDs). When surgical management is required, minimally invasive techniques such as image-guided radiofrequency ablation (RFA) are preferred. Management of osteoid osteomas during pregnancy poses a clinical challenge as NSAIDs are often contraindicated and there are limited reports describing surgical treatment in pregnancy. We present the case of a 32-year-old woman at 34 weeks' gestation who presented with severe right lower extremity pain exacerbated at night. CT imaging of the tibia revealed an 8 mm subperiosteal nidus with focal cortical thickening, periosteal bone formation, and a small central calcification consistent with an osteoid osteoma. The patient had minimal pain relief with acetaminophen and escalating opioid requirements and thus underwent an uncomplicated ultrasound and CT-guided RFA of the lesion with resolution of pain. The total CT dose length product was 81 mGy-cm, well within the acceptable radiation threshold of pregnancy, and minimized by use of ultrasound for localization and needle advancement. The patient subsequently had an uncomplicated term vaginal delivery. In pregnant patients for whom NSAIDs are not a viable treatment option for osteoid osteoma, this case demonstrates that image-guided RFA can be a safe and effective management strategy when performed by a multidisciplinary team comprising of musculoskeletal radiology, maternal-fetal medicine, and anesthesiology.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3001-3007"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563018","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":"Precision of photon-counting detector CT compared to conventional CT for total wrist arthroplasty migration: a cadaveric and clinical study.","authors":"Gustav Lind, Erik Tesselaar, Olof Sandberg, Simon Farnebo","doi":"10.1007/s00256-026-05293-1","DOIUrl":"10.1007/s00256-026-05293-1","url":null,"abstract":"<p><strong>Objectives: </strong>Implant loosening is a serious complication after total wrist arthroplasty. Radiostereometric analysis has been the gold standard for measurement of implant migration; however, the use of bead free computer tomography radiostereometric analysis (CT-RSA) has emerged as an alternative due to its higher precision. In this study, the precision of a novel photon-counting detector CT (PCD-CT) was compared to conventional energy-integrating detector CT (EID-CT) at different radiation doses.</p><p><strong>Methods: </strong>One cadaveric wrist with total wrist arthroplasty (TWA) implant was scanned 40 times with EID-CT and PCD-CT at two radiation doses. Additionally, eight patients with the same implant were scanned with PCD-CT post-surgery, and after 6 and 12 months. PCD-CT scans were reconstructed with 0.2-mm and 1.0-mm slice thickness. Precision data for the cadaveric wrist and migration data for the patients were calculated using CT-RSA.</p><p><strong>Results: </strong>The precision of total implant rotation was significantly better with PCD-CT at half the radiation dose (0.08°) compared to full-dose EID-CT (0.15°, p = 0.002). Similarly, translational precision at the implant tip was higher with half-dose PCD-CT (0.02 mm) than with EID-CT (0.03 mm, p = 0.04). For migration, the proximal component had moved (median) -0.04 mm distally at 6 months and 0.01 mm at 12 months. The rotation around the axis at these time points was 0.03° and 0.06°, respectively.</p><p><strong>Conclusions: </strong>In this cadaveric precision study, PCD-CT enabled CT-RSA measurements with high precision at a lower radiation dose than conventional EID-CT. The accompanying eight-patient in vivo cohort should be interpreted as a feasibility cohort and showed only small descriptive early migration values during the first postoperative year. Larger longitudinal studies are needed to determine clinically relevant migration thresholds and the value of this method for detecting implant loosening.\"</p><p><strong>Relevance statement: </strong>Photon‑counting detector computed tomography and computed tomography micromotion analysis allow high-definition tracking of total wrist arthroplasty migration at half the radiation dose of conventional CT, offering a high‑precision, low‑dose tool for early detection of implant loosening.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2835-2844"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607577","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":"Skeletal coccidioidomycosis: an atypical pediatric presentation.","authors":"Lane H McCoy, John S A Chrisinger, Benjamin E Northrup, Jonathan C Baker","doi":"10.1007/s00256-026-05313-0","DOIUrl":"10.1007/s00256-026-05313-0","url":null,"abstract":"<p><p>Coccidioidomycosis is most commonly a self-limited pulmonary infection. Disseminated disease is rare, occurring in fewer than 1% of cases, with skeletal involvement representing an uncommon manifestation in children. We report a case of skeletal coccidioidomycosis in a previously healthy 12-year-old with pelvic involvement and no antecedent pulmonary symptoms. The patient presented with 1.5 months of progressive, atraumatic left pelvic pain, night sweats, and weight loss, without respiratory complaints. Radiographs demonstrated a lytic lesion of the left ilium extending toward the acetabulum, with ill-defined margins and prominent surrounding reactive sclerosis. Mineralized matrix production was absent. Magnetic resonance imaging revealed an extensive marrow-replacing lesion contiguous with a heterogeneous soft-tissue component exhibiting focal internal enhancement. The lesion demonstrated diffusion restriction, consistent with abscess formation, while the hip joint was preserved and there was no neurovascular involvement. Although these findings raised concern for malignancy, there were subtle infection-favoring features and subsequent biopsy was performed. Histopathology demonstrated fungal elements with associated giant cell reaction. The patient was treated initially with intravenous amphotericin B and transitioned to oral itraconazole following culture confirmation of Coccidioides, with a planned prolonged antifungal course. At 6-month follow-up, the patient had resumed full activity with complete resolution of pain and preserved pelvic function. This case highlights the importance of including coccidioidomycosis in the differential diagnosis of aggressive pediatric osseous lesions. Recognition of key imaging features, including lytic osseous destruction with surrounding sclerosis and a heterogeneous soft-tissue component with diffusion restriction, can facilitate timely diagnosis, prevent misdiagnosis, and reduce morbidity risk.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"3021-3025"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607522","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":"Routine MRI for opportunistic osteoporosis screening: diagnostic accuracy of vertebral bone quality and a novel femoral bone quality score compared with DXA.","authors":"Margrit Elis Müller, João Paulo Colhado Ferreira, Laura Mulazzani Minuzzi Macedo, Lucia Li, Akemi Osawa, Leonardo Kazunori Tsuji, Daisy Terumi Kase, Lucas Kenzo Miyahara, André Yui Aihara, Adham do Amaral E Castro","doi":"10.1007/s00256-026-05330-z","DOIUrl":"10.1007/s00256-026-05330-z","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate vertebral bone quality (VBQ) and femoral bone quality (FBQ) scores as potential imaging markers of bone mineral density (BMD) for opportunistic osteoporosis screening in at‑risk patients and to assess their correlation with DXA T-scores.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included women ≥ 40 years and men ≥ 50 years who underwent DXA and lumbar spine, hip, or pelvic MRI within 60 days. All MRI examinations were performed at 1.5 T. VBQ and FBQ were obtained using manually placed circular ROIs. FBQ was derived from coronal T1-weighted images using two approaches: femoroacetabular joint fluid (FBQfa) and cerebrospinal fluid (FBQcsf). Interobserver reproducibility was assessed using intraclass correlation coefficient (ICC). Correlations with DXA T-scores and diagnostic performance for osteoporosis were analyzed using Pearson coefficients and ROC curves.</p><p><strong>Results: </strong>Among 248 patients, VBQ demonstrated excellent reproducibility (ICC = 0.922) and a weak-to-moderate negative correlation with DXA T-scores (r = -0.307; p < 0.001). VBQ values increased across DXA bone density categories, with an optimal cutoff of 3.61 for osteoporosis (AUC = 0.71). FBQcsf showed high reproducibility (ICC = 0.874) compared with FBQfa (ICC = 0.462) but no evidence of correlation with DXA (p = 0.151). FBQcsf distinguished normal BMD from osteopenia (p = 0.002) and, after adjustment for age and sex, also differentiated patients with osteopenia from those with osteoporosis (p = 0.011).</p><p><strong>Conclusion: </strong>VBQ can serve as an opportunistic exploratory screening marker of low BMD. FBQcsf may complement VBQ by identifying early marrow-related changes, although further validation is required.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2953-2965"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689833","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":"Isolated Goutallier Grade 4 supraspinatus atrophy: a rare case without rotator cuff tear or nerve compression.","authors":"Trisha Mukherjee, Arash D Tehranzadeh, John M Itamura, Brian K Lee","doi":"10.1007/s00256-026-05280-6","DOIUrl":"10.1007/s00256-026-05280-6","url":null,"abstract":"<p><p>The supraspinatus muscle is susceptible to atrophy, with fatty infiltration most commonly attributed to chronic full-thickness tendon tears. Chronic denervation due to suprascapular nerve entrapment may also be responsible for supraspinatus atrophy. However, such cases typically show concurrent supraspinatus and infraspinatus involvement due to the muscles' shared innervation by the suprascapular nerve. We report a rare case of isolated supraspinatus atrophy in a 66-year-old male with intact rotator cuff tendons, preserved infraspinatus morphology, and no evidence of tendon tear or nerve compression lesion. The patient presented with gradually worsening anterior shoulder pain that began following a workout injury, without accompanying weakness or neurological symptoms. Magnetic resonance imaging revealed Goutallier Grade 4 fatty atrophy of the supraspinatus muscle and advanced acromioclavicular joint arthritis. Given the absence of typical structural etiologies, a chronic subclinical denervation pattern was considered. Two plausible mechanisms were explored: (1) selective injury of an early-branching motor division of the suprascapular nerve supplying the supraspinatus, and (2) an atypical manifestation of Parsonage-Turner syndrome, both of which can lead to isolated supraspinatus denervation without overt clinical deficits. To the best of our knowledge, this represents only the second documented case of isolated supraspinatus atrophy without rotator cuff disruption, nerve compression, or infraspinatus involvement. The case reinforces the diagnostic value of magnetic resonance imaging and highlights the importance of considering neural etiologies in cases where imaging findings deviate from classic rotator cuff pathology.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2983-2987"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228115","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":"Comprehensive evaluation of juvenile idiopathic arthritis using whole-body MRI: a prospective cross-sectional analysis.","authors":"Mariam Said ElMedany, Mohamed S Barakat, Ali A Farahat, Ghada Farouk El-Deriny, Karim M Elsharkawi","doi":"10.1007/s00256-026-05222-2","DOIUrl":"10.1007/s00256-026-05222-2","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the role of whole-body magnetic resonance imaging (WBMRI) using a noninvasive, non-contrast protocol in detecting clinical and subclinical inflammation in pediatric patients with juvenile idiopathic arthritis (JIA) and to assess its impact on treatment decisions.</p><p><strong>Methods: </strong>This prospective cross-sectional study included pediatric patients diagnosed with JIA according to ILAR criteria. All participants underwent WBMRI using STIR sequences to assess peripheral and axial joints and entheses. Clinical and laboratory data, including ESR, CRP, ANA, RF, and HLA-B27, were collected for correlation with imaging findings. Two experienced musculoskeletal radiologists independently reviewed the images. Sensitivity, specificity, predictive values, and diagnostic accuracy were calculated.</p><p><strong>Results: </strong>Forty patients (27 females, 13 males; mean age 11.7 ± 2.6 years) were enrolled. Clinically active disease was present in 72.5%. Subclinical inflammation was identified in 81.8% of clinically inactive patients. Overall, radiological activity was detected in 77.5%, predominantly in peripheral joints (83.7%), with joint effusion being the most frequent finding (34.2%). Sacroiliitis and enthesitis were detected in 12.5% and 10%, respectively. WBMRI demonstrated a sensitivity of 75.9%, and imaging findings led to treatment modification in 50% of cases.</p><p><strong>Conclusions: </strong>Non-contrast WBMRI is a sensitive tool for detecting clinical and subclinical inflammation in JIA. Although specificity is relatively low, its comprehensive whole-body assessment supports its value in evaluating disease activity and guiding therapeutic decisions while avoiding contrast-related risks.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2747-2757"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729793","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":"The role of repeat CT-guided biopsy in suspected infectious spondylodiscitis.","authors":"Lorenzo Bertolotti, Ugo Chamard-Champliaud, Nicolas Stacoffe, Sylvain Grange, Paul Segui, Catherine Cyteval, Maxime Pastor","doi":"10.1007/s00256-026-05323-y","DOIUrl":"10.1007/s00256-026-05323-y","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective observational study assesses the diagnostic yield of CT-guided disc-vertebral biopsies in patients with suspected infectious spondylodiscitis. It focuses on the utility of a second biopsy after an initial negative result and evaluates factors associated with microbiological positivity.</p><p><strong>Materials and methods: </strong>It included adult patients undergoing CT-guided biopsies between January 2019-June 2024 at a single tertiary care center. The exclusion criteria were as follows: non-infectious indications (e.g., metastases, primary bone tumors, and crystal deposition disease) or biopsy results inconsistent with infection.</p><p><strong>Results: </strong>In total, 93 biopsies were analyzed in 79 patients: 79 first and 14 repeat biopsies. The microbiological yield of first biopsies was 53.2% (42/79; 95% CI 42.3-63.8), while repeat biopsies yielded positive results in 35.7% (5/14; 95% CI 16.3-61.2), increasing the overall diagnostic yield to 59.5% (47/79). The diagnostic yield of repeat biopsies did not significantly differ from first biopsies (p = 0.36). Higher C-reactive protein (CRP) levels were associated with positive results (median 40 vs 20 mg/L; p = 0.008; adjusted OR 1.57 per unit increase in log-transformed CRP, p = 0.043). No association was found with age, gender, or leukocyte count. Blood cultures were positive in 7.8% (7/90) and showed high concordance with biopsy findings (6/7 matching pathogens). In post-surgical infections, the diagnostic yield reached 80% (4/5).</p><p><strong>Conclusion: </strong>A negative initial biopsy did not preclude microbiological identification on repeat sampling, supporting the role of repeat biopsy in selected patients with persistent suspicion of infection. Higher CRP levels were associated with biopsy positivity.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2897-2906"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664422","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}