Skeletal Radiology最新文献

{"title":"Exact radiological-pathological correlation of chondrosarcomas using a patient-specific 3D mold.","authors":"Maryse Lejoly, Thomas Van Den Berghe, David Creytens, Wouter Huysse, Gwen Sys, Renaat Coopman, Koenraad L Verstraete","doi":"10.1007/s00256-025-04942-1","DOIUrl":"https://doi.org/10.1007/s00256-025-04942-1","url":null,"abstract":"<p><strong>Objective: </strong>To identify aggressive regions in high-grade and dedifferentiated chondrosarcomas on MRI by obtaining an exact correlation between radiology and histopathology.</p><p><strong>Materials and methods: </strong>One chondrosarcoma grade II (CSII), chondrosarcoma grade III (CSIII) and dedifferentiated chondrosarcoma (DDCS) were segmented on (DCE-)MRI images. Around the segmentations, a patient specific mold was constructed and 3D-printed with cutting grooves perfectly aligned with selected MRI slices. In this way, resection specimens could be cut at the same locations as the MRI slices. Histopathology slides were stained with hematoxylin-eosin and CD31 (vascularization) and correlated with the (DCE-)MRI. Histopathologically, atypical cartilaginous tumor (ACT), CSII, CSIII and DDCS regions were delineated and vascular hotspots were selected by an experienced pathologist. Exact point-to-point correlation was performed.</p><p><strong>Results: </strong>ACT, CSII, CSIII and DDCS regions all had similar mean signal intensity on T1-weighted images. On fat-saturated T2-weigthed images, CSII and CSIII regions had a higher mean signal intensity. On fat-saturated T1-weighted images after gadolinium contrast injection and on wash-in parametric maps DDCS regions had the highest mean signal intensity and highest wash-in values. There was a higher microvessel density in CSII and CSIII regions. This corresponded with a thick enhancing rim on fat-saturated T1-weighted images after gadolinium contrast injection and with a higher wash-in.</p><p><strong>Conclusion: </strong>This new 3D mold helps to identify high-grade chondrosarcoma regions with myxoid. This may be useful for targeted biopsy and histopathological investigation.</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":"144012622","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":"Evaluating key ultrasound findings and their correlations with hip joint aspiration and prosthetic joint infection diagnosis following total hip arthroplasty.","authors":"Xuanzhen Piao, Barry Baylosis, Akira M Murakami, Andrew J Kompel","doi":"10.1007/s00256-025-04941-2","DOIUrl":"https://doi.org/10.1007/s00256-025-04941-2","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between specific ultrasound findings with the success of hip joint aspiration and the presence of joint infection in patients with hip arthroplasty.</p><p><strong>Materials and methods: </strong>138 patients who underwent ultrasound-guided aspiration were analyzed, focusing on hip joint capsular thickness, joint fluid echogenicity, synovial component visualization, and vascularity. These parameters were evaluated for their correlation with technically successful aspiration and infection status, using clinical data and the modified Musculoskeletal Infection Society (MSIS) criteria. Intra- and inter-reader reliability was also assessed for all measured parameters.</p><p><strong>Results: </strong>Capsular thickness with a cutoff of 10 mm or greater, showed strong associations with technically successful aspiration (p = 0.0001) and joint infection (p = 0.0005), with high intra- and inter-observer reliability. Fluid echogenicity, when categorized as hypoechoic and moderate/heterogeneous, also showed significant associations with technically successful aspiration (p = 0.0001) and joint infection (p = 0.0009). While visualization of the synovial component did not correlate with aspiration outcomes (p = 0.24), it demonstrated a significant association with joint infection (p = 0.0007). Vascularity showed no significant correlation with technically successful aspiration (p = 0.22) or infection (p = 0.05).</p><p><strong>Conclusion: </strong>Ultrasound is valuable in measuring variables that can be associated with a technically successful aspiration and the presence of prosthetic joint infection in patients with a history of total hip arthroplasty. Capsular thickness, particularly at a 10 mm cutoff, emerged as a sensitive and quantifiable parameter that can improve pre-procedural assessment accuracy. While other findings, such as fluid echogenicity and synovial component visualization showed potential, they are best interpreted alongside other clinical and imaging data.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998790","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 in clinical trials of axial spondyloarthritis: what type of imaging should be used.","authors":"Iris Eshed, Kay Geert A Hermann","doi":"10.1007/s00256-025-04935-0","DOIUrl":"https://doi.org/10.1007/s00256-025-04935-0","url":null,"abstract":"<p><p>Axial spondyloarthritis (axSpA) is a chronic inflammatory condition predominantly affecting the sacroiliac joints and spine. Early and accurate diagnosis is crucial to prevent structural damage and improve patient outcomes. Imaging plays a pivotal role in axSpA diagnosis, monitoring, and clinical trials, offering insights into both inflammatory activity and structural progression. Conventional radiography has been foundational for detecting structural changes, such as syndesmophytes and erosions, but it is limited by poor sensitivity for early disease detection and significant interobserver variability. Advanced imaging modalities, such as magnetic resonance imaging (MRI) and low-dose computed tomography (ld-CT), have emerged as more sensitive tools. MRI excels in identifying active inflammation, particularly bone marrow edema, and is integral to early diagnosis and disease monitoring. ld-CT provides superior spatial resolution for detecting structural lesions while minimizing radiation exposure. However, challenges remain in achieving standardized imaging protocols and consistent scoring systems across clinical trials. Scoring systems like the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), Spondyloarthritis Research Consortium of Canada (SPARCC) scores, and Berlin methods require rigorous calibration to ensure reliability. The purpose of this review is to explore the strengths and limitations as well as the use in clinical trials of the different imaging modalities and to offer guidance on selecting the most suitable imaging techniques for assessing both disease activity and structural progression in clinical trials.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016983","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":"Bilateral gonococcal septic tenosynovitis and septic arthritis as a first presentation of HIV in a 53-year-old male.","authors":"Fielding S Fischer, Austin T Gregg, F Joseph Simeone, Arvin B Kheterpal","doi":"10.1007/s00256-025-04940-3","DOIUrl":"https://doi.org/10.1007/s00256-025-04940-3","url":null,"abstract":"<p><p>Infection with Neisseria gonorrhoeae is common, primarily affecting the urogenital system. Disseminated gonococcal infection (DGI) through the bloodstream is much less common but has important ramifications on the musculoskeletal system, as it can infect tendon sheaths and joints. We describe a case of bilateral gonococcal septic tenosynovitis and septic arthritis with contiguous osteomyelitis in the ankles/feet of a 53-year-old male whose presentation triggered an immunodeficiency workup revealing HIV. This case highlights challenges associated with the diagnosis of DGI, the need for heightened clinical suspicion in patients presenting with septic tenosynovitis, and the importance of recognizing clinical signs of immunodeficiency.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032932","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":"Obituary for Michael Kyriakos, M.D.","authors":"Louis P Dehner, Leonard B Kahn","doi":"10.1007/s00256-025-04937-y","DOIUrl":"https://doi.org/10.1007/s00256-025-04937-y","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029020","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":"Improved metal suppression using new generation low-field MRI: a biophantom feasibility study.","authors":"Johanna Luitjens, Katharina Ziegeler, Daehyun Yoon, Felix Gassert, Rupsa Bhattacharjee, Rawee Manatrakul, Chotigar Ngarmsrikam, Amy Becker, Yang Yang, Gabby B Joseph, Pan Su, Pedro Itriago-Leon, Sharmila Majumdar, Thomas M Link","doi":"10.1007/s00256-024-04809-x","DOIUrl":"10.1007/s00256-024-04809-x","url":null,"abstract":"<p><strong>Objective: </strong>Novel 0.55 MRI scanners have the potential to reduce metal artifacts around orthopedic implants. The purpose of this study was to compare metal artifact size and depiction of anatomy between 0.55 T and 3.0 T MRI in a biophantom.</p><p><strong>Materials and methods: </strong>Steel and titanium screws were implanted in 12 porcine knee specimens and imaging at 0.55 T and 3 T MRI was performed using the following sequences: turbo spin-echo (TSE), TSE with view angle tilting (VAT), and slice encoding for metal artifact correction (SEMAC) with proton-density (PD) and T2-weighted short-tau inversion-recovery (T2w-STIR) contrasts. Artifacts were measured, and visualization of anatomy (cartilage, bone, growth plates, cruciate ligaments) was assessed and compared between groups.</p><p><strong>Results: </strong>Metal artifacts were significantly smaller at 0.55 T. The smallest artifact sizes were achieved with SEMAC at 0.55 T for both PD and T2w-STIR sequences; corresponding relative size reductions vs. 3.0 T were 78.7% and 79.4% (stainless steel) and 45.3% and 1.4% (titanium). Depiction of anatomical structures was superior at 0.55 T.</p><p><strong>Conclusion: </strong>Substantial reduction of artifact size resulting in superior depiction of anatomical structures is possible on novel 0.55 T MRI systems. Further clinical studies are required to elucidate patient-relevant advantages.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1093-1099"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372817","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":"Intravertebral collateral enhancement resembling sclerotic metastatic disease in a case of cervical epidural abscess.","authors":"Daniel K Schneider, Ahmet Hakan Ok, Claus S Simpfendorfer, Michael C Forney, Naveen Subhas","doi":"10.1007/s00256-024-04761-w","DOIUrl":"10.1007/s00256-024-04761-w","url":null,"abstract":"<p><p>Vertebral body enhancement is occasionally seen on postcontrast CT imaging in the absence of osseous pathology. This enhancement can mimic sclerotic osseous metastatic disease, leading to a diagnostic dilemma for radiologists and increasing the chance of misinterpretation. Existing literature has focused on the association between this enhancement and concomitant central venous system obstruction. We report a 61-year-old woman with a history of nasopharyngeal carcinoma presenting with an epidural abscess who exhibited vertebral body enhancement resembling sclerotic metastatic disease without imaging evidence of central venous obstruction or vertebral osseous metastatic disease. Awareness of this unique presentation may prevent the incorrect diagnostic errors and their associated negative effects on patients.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1133-1138"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856366","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":"Multiple myeloma: What is the most cost-effective imaging strategy for initial detection of bone lesions?","authors":"Soterios Gyftopoulos, Arnau Hanly, Naveen Subhas, Noopur Raje, Connie Y Chang","doi":"10.1007/s00256-024-04810-4","DOIUrl":"10.1007/s00256-024-04810-4","url":null,"abstract":"<p><strong>Objective: </strong>To determine the cost-effectiveness of different imaging modalities for initial detection of multiple myeloma (MM)-defining bone lesions.</p><p><strong>Methods: </strong>A Markov model from the health care system perspective for patients with MGUS was used to evaluate the incremental cost-effectiveness of five imaging techniques: skeletal survey (SS), low-dose computed tomography (LDCT), positron emission computed tomography (PETCT), and whole-body magnetic resonance imaging (WBMRI) with and without diffusion (DIFF). Model inputs, including probabilities, utilities, and costs were obtained from comprehensive literature review. Costs were estimated in 2024 U.S. dollars, effectiveness was measured in quality adjusted life years (QALYs), willingness-to-pay (WTP) threshold was set to $100,000/QALY, and timeframe of the simulation was 20 years. Model analyses included Monte Carlo microsimulation and probabilistic sensitivity analysis (PSA).</p><p><strong>Results: </strong>The most cost-effective imaging strategy was dependent on the number of patient risk factors for progression from MGUS to myeloma. At a WTP threshold of $100,000, for patients with no risk factors for progression, LDCT amassed the greatest net monetary benefit (NMB) ($1,030,913.57) while incurring the second lowest costs ($44,870.73). For patients with 1 or 2 risk factors for progression, WBMRI + DIFF amassed the greatest NMB (1 risk factor: $802,637.30, 2 risk factors: $664,430.36). WBMRI and PETCT were absolutely dominated in all cases. PSA also found that the most cost-effective strategy was dependent on the WTP threshold.</p><p><strong>Conclusion: </strong>Our model suggests that LDCT and WBMRI + DIFF can be the most cost-effective imaging strategies for the initial diagnosis of MM in patients, depending on the number of risk factors for progression.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1081-1091"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding on MRI characteristics of neuromuscular choristoma: a single center retrospective review.","authors":"Tomas Marek, B Matthew Howe, Robert J Spinner","doi":"10.1007/s00256-025-04932-3","DOIUrl":"https://doi.org/10.1007/s00256-025-04932-3","url":null,"abstract":"<p><strong>Objective: </strong>Neuromuscular choristoma (NMC) is a rare condition affecting peripheral nerves, most commonly the proximal sciatic nerve. It is characterized by the presence of muscle tissue within the nerve. Patients typically present with neuropathic symptoms. NMC is associated with the development of NMC-associated desmoid-type fibromatosis (NMC-DTF). In this study, we report findings of qualitative and quantitative MRI signal intensities to further expand on known MRI imaging features of NMC.</p><p><strong>Methods and materials: </strong>Retrospective analysis of NMC cases of the sciatic nerve from our institution was conducted. The sciatic nerve was selected as a model example due to its common involvement. Inclusion criteria were a confirmed NMC diagnosis and available MR exams. MRI signal intensities from the affected nerves and normal contralateral nerves were compared, normalized to muscle signal intensity for consistency across different MRI sequences.</p><p><strong>Results: </strong>Fourteen patients (8 men, 6 women) met the inclusion criteria. No significant differences in T1 or T2 signal intensities were found between NMC and unaffected nerves. However, NMC demonstrated significantly higher post-contrast signal intensities (p = 0.003) compared to unaffected nerves. These findings were consistent across the proximal and distal segments of the affected nerve.</p><p><strong>Conclusion: </strong>Our study expands the understanding of MRI features in NMC. The increased post-contrast enhancement in NMC may serve as a useful diagnostic tool and could potentially play a role in detecting areas at risk for future DTF development. This highlights the importance of comprehensive imaging, including post-contrast sequences and ideally imaging of the entire course of the affected nerve.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rhabdomyolysis following diphenhydramine overdose-a case report.","authors":"Adil Basha, Rifat Karatas, Atul Kumar Taneja, Avneesh Chhabra, Flavio Duarte Silva","doi":"10.1007/s00256-024-04850-w","DOIUrl":"10.1007/s00256-024-04850-w","url":null,"abstract":"<p><p>Antihistamines, such as diphenhydramine, are active ingredients of a wide variety of antiallergics, sedatives, and sleep preparations and are often abused for purposes of euphoric effects or suicidal attempts. Antihistaminic overdose presents with symptoms of increased anticholinergic activity including urinary retention, mydriasis, and dry mucous membranes. However, antihistamine-induced rhabdomyolysis is a rare condition that presents with widespread skeletal muscle breakdown and release of metabolites into the circulation, resulting in myalgias and acute kidney injury. In this article, we report a rare case of rhabdomyolysis following the ingestion of a large quantity of diphenhydramine for a suicide attempt, who also presented with significantly elevated creatine kinase and acute renal injury. To our knowledge, this is the first case report of diphenhydramine rhabdomyolysis with MRI findings' correlation.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1159-1163"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807922","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}