Skeletal Radiology最新文献

{"title":"Visual assessment and quantitative analysis of dual-energy CT virtual non-calcium in imaging diagnosis of multiple myeloma.","authors":"Linlin Liang, Fangyan Xiao, Luxiao Liang, Chaotian Luo, Fei Peng, Xiaojing Ning, Cheng Tang, Ruchang Chen, Fuling Huang, Peng Peng","doi":"10.1007/s00256-024-04805-1","DOIUrl":"10.1007/s00256-024-04805-1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the reliability and diagnostic performance of dual-energy CT virtual non-calcium imaging in diagnosing bone marrow infiltration in multiple myeloma.</p><p><strong>Materials and methods: </strong>Seventy-two patients with multiple myeloma and ten controls were recruited. Patients received dual-energy CT and MRI while controls underwent dual-energy CT only, covering the cervical, thoracic, and lumbar spine and the pelvis. Virtual non-calcium images were compared with magnetic resonance images for confirmation and pattern classification. Fleiss Kappa analysis assessed consistency between virtual non-calcium and MRI classifications. Inter-observer agreement for virtual non-calcium and CT attenuation values was evaluated using Bland-Altman analysis. Diagnostic performances across various sites were evaluated using analysis of variance and receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>Dual-energy CT achieved higher consistency in classifying bone marrow infiltration in multiple myeloma than did MRI (kappa = 0.944). In the overall analysis, the mean virtual non-calcium attenuation values in the bone marrow infiltration group (- 28.3 HU; 95% confidence interval (CI), - 32.1, - 24.6) were higher than those in the non-bone marrow infiltration (- 97.5 HU; 95% CI, - 104.7, - 90.3) and control (- 89.1 HU; 95% CI, - 95.1, - 83.1; F = 172.027, P < 0.001) groups. The optimal cutoff values for virtual non-calcium attenuation varied across the overall (- 42.2 HU), cervical spine (- 21.9 HU), thoracic spine (- 42.8 HU), lumbar spine (- 56.9 HU), and pelvis (- 66.3 HU).</p><p><strong>Conclusion: </strong>Dual-energy CT virtual non-calcium imaging and MRI exhibited good consistency in categorising bone marrow infiltration patterns in multiple myeloma. Different virtual non-calcium attenuation value cutoffs should be used to diagnose bone marrow infiltration in various body regions.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1059-1070"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393088","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":"Hemophilic pseudotumor in the bilateral forearms: a unique case report.","authors":"Sami F Alaraj, Samuel O Krider, Ahmed Elsayes, Eseosa Bazuaye, Glenn M Garcia","doi":"10.1007/s00256-024-04760-x","DOIUrl":"10.1007/s00256-024-04760-x","url":null,"abstract":"<p><p>Hemophilic pseudotumor (HP) is a rarely encountered cystic mass that forms as a result of repeated bleeding from extra-articular soft tissues. HP cases have been previously documented in several locations in the body, most commonly in the femur and pelvis. To date, no upper extremity case involving the bilateral forearms has been reported. The current case involves an adult male with uncontrolled hemophilia who presented with diffuse enlargement of the bilateral forearms with associated pain. Radiographs and magnetic resonance imaging (MRI) were subsequently performed revealing variable aged hemorrhagic, expansile, lytic intramedullary lesions. In keeping with the history, a subsequent radiologic diagnosis of HP was favored, among other differentials, including benign and malignant processes with biopsy confirming the diagnosis. The hemorrhagic masses were surgically excised after initial management with factor VIII replacement. This case details a unique presentation of this pathology in the bilateral forearms and highlights the diagnostic value of radiographs and MRI in diagnosis and management.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1109-1117"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749010","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":"Extrapulmonary hyalinizing granuloma: a rare case with intra-articular and tenosynovial involvement.","authors":"Mohanad Alhumayed, Ryan P Austin, Eric Y Chang","doi":"10.1007/s00256-024-04762-9","DOIUrl":"10.1007/s00256-024-04762-9","url":null,"abstract":"<p><p>Extrapulmonary hyalinizing granuloma (EPHG) is a notably rare condition, representing an exaggerated chronic immune response to antigenic stimuli. This report presents the first documented case of intra-articular and tenosynovial EPHG with radiological evaluation and pathological confirmation in a 60-year-old man presenting with wrist pain and swelling. Imaging findings were relatively symmetric with marked distension of the distal radioulnar joints and extensor tendon sheaths with masses and nodules of various sizes surrounded by synovitis and accompanied by bony erosions. On US, the masses were heterogeneous but mostly hypo- to iso-echoic compared to muscle and relatively hypovascular. On MRI, compared to muscle, the nodules exhibited iso-intense signal on T1-weighted images, iso- to mildly hyper-intense signal on T2-weighted fat-suppressed images, and minimal enhancement on post-contrast images. The diagnosis of EPHG was revealed through biopsy and pathologic examination with glucocorticoids being effective in treatment.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1119-1124"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760842","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":"MRI features distinguishing pediatric Lyme arthritis from septic arthritis.","authors":"Joshua E Powell, Vincent K Lee, Suraj S Parikh, Andrew J Nowalk, Amisha J Shah","doi":"10.1007/s00256-024-04804-2","DOIUrl":"10.1007/s00256-024-04804-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to identify distinguishing MRI features of Lyme arthritis (LA), an increasingly prevalent cause of pediatric infectious arthritis in the USA, to enable rapid discrimination from septic arthritis (SA) and facilitate appropriate management.</p><p><strong>Materials and methods: </strong>A single-center, retrospective analysis was conducted on a convenience sample of pediatric patients with LA in an endemic area using EPIC electronic health record data between January 2010 and December 2020. Patients with positive serologic testing and concurrent MRI were selected. MRI scans were reviewed by a subspecialty-trained pediatric radiologist. Key MRI features analyzed include joint effusion, synovitis, myositis, soft tissue edema, and osseous edema and erosions. MRI features, demographics, and clinical data were compared using univariable and multivariable analyses.</p><p><strong>Results: </strong>Fifty cases of knee LA and 13 cases of knee SA were included. Larger joint effusion (p = 0.0055, z =  - 2.779) and abnormally thickened synovium (p = 0.0011, χ² = 10.622) were more associated with LA. In contrast, increased myositis, subcutaneous edema, and osseous changes were more prevalent in SA. Abnormal bone marrow signal (p < 0.0001, χ² = 36.893) and bone erosion (p < 0.0001, χ² = 25.506) were observed in 84.6% (11/13) and 46.2% (6/13) of SA cases, respectively, while no bone erosion was found in LA.</p><p><strong>Conclusion: </strong>MRI can be a valuable tool in differentiating LA from SA. Abnormal synovium and increasing joint effusion favor LA, while increasing soft tissue edema and osseous changes favor SA. Notably, the presence of bone erosion effectively excluded LA from consideration.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1043-1057"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381623","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":"Correction to: Rhabdomyolysis following diphenhydramine overdose-a case report.","authors":"Adil Basha, Rifat Karatas, Atul Kumar Taneja, Avneesh Chhabra, Flavio Duarte Silva","doi":"10.1007/s00256-025-04873-x","DOIUrl":"10.1007/s00256-025-04873-x","url":null,"abstract":"","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1165"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011127","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":"Intraosseous hibernoma mimicking sclerotic bone metastasis-a case report.","authors":"Ali Shaikh, Adil Basha, George Ray, Justin A Bishop, Avneesh Chhabra","doi":"10.1007/s00256-024-04758-5","DOIUrl":"10.1007/s00256-024-04758-5","url":null,"abstract":"<p><p>Intraosseous hibernoma is an uncommon presentation of brown adipose tissue benign tumors. Imaging differential diagnoses include bone island, sclerotic metastasis, lymphoma, hemangioma, and sclerotic myeloma. In this report, a 72-year-old patient presented with right hip pain following a fall injury, leading to an extensive diagnostic workup. Initial CT of the pelvis without contrast suggested potential sclerotic metastatic disease. MRI findings could not be definitive. Further assessment with CT-guided biopsy and S-100 immunohistochemical staining confirmed a rare diagnosis of intraosseous hibernoma. This case describes multimodality imaging characteristics of a rare intraosseous hibernoma with discussion of imaging features of differential diagnostic considerations of related benign and malignant bone lesions.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1139-1146"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860835","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":"IgG4-related disease with subcutaneous involvement and the associated diagnostic challenges with MRI.","authors":"Tomonori Kawasaki, Jiro Ichikawa, Kojiro Onohara, Satoshi Kanno, Masanori Wako, Naofumi Taniguchi, Satoshi Ochiai, Tomoaki Torigoe, Yasuo Yazawa","doi":"10.1007/s00256-024-04768-3","DOIUrl":"10.1007/s00256-024-04768-3","url":null,"abstract":"<p><p>IgG4-related disease is a rare fibroinflammatory disorder characterized by the infiltration of IgG4-rich plasma cells. Herein, we report a case of IgG4-related disease of the subcutaneous tissue with atypical MRI findings and difficulties in the histopathological examination using needle biopsy. Based on the clinical presentation and MRI findings, the patient was diagnosed with a benign myxoid or cystic tumor. Additionally, histopathological findings from a needle biopsy suggested a myxoma. Therefore, the correct diagnosis of IgG4-related disease was not made preoperatively. The resected specimens confirmed IgG4-related disease with an IgG4/IgG ratio > 80%. Previous reports have shown that the MRI findings of IgG4-related disease mimic both malignancy and inflammation; surprisingly, the features of subcutaneous IgG-related disease, including tail sign, unclear border, and heterogeneous enhancement, were similar to those found in sarcoma. Therefore, histopathological findings are needed for a correct diagnosis. Furthermore, careful examination is essential because the neoplasm and inflammation may overlap with IgG4-related disease, and needle biopsy is not fully reflective of the tumor. As is highlighted in the present case, IgG4-related disease is often misdiagnosed; therefore, clinicians should adequately recognize that even if the histopathological findings in biopsy were consistent with those observed in the MRI, misdiagnosis may occur.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1147-1151"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860778","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":"Imaging characteristics of hip joint microinstability: a case-control study of hip arthroscopy patients.","authors":"Renuka M Vesey, Andrew A MacDonald, Matthew J Brick, Catherine J Bacon, Gen Lin Foo, Man Lu, Nicholas Lightfoot, Donna G Blankenbaker, Rebecca M Woodward","doi":"10.1007/s00256-024-04802-4","DOIUrl":"10.1007/s00256-024-04802-4","url":null,"abstract":"<p><strong>Objectives: </strong>Hip microinstability is a clinical entity increasingly recognized and treated but challenging to diagnose with a lack of objective criteria. This study assessed the prevalence and diagnostic accuracy of different imaging findings for hip microinstability on radiograph and MR.</p><p><strong>Methods: </strong>A retrospective case-control study of 224 hips treated with arthroscopic surgery by a single orthopedic surgeon, 112 hips with clinical microinstability and 112 controls without. Pre-operative radiograph and MRI/MRA imaging were evaluated by two musculoskeletal radiologists to assess morphological parameters and imaging signs reportedly associated with hip microinstability.</p><p><strong>Results: </strong>Four imaging features reached significance as predictors of microinstability via three-step logistic regression: labral hyperplasia and decreased lateral center edge angle on MR (OR 2.45 and 0.93, respectively) and the absence of positive ischial spine sign and absence of osteophytes on radiographs (OR 0.47 and 0.28, respectively). Increased acetabular anteversion and absence of cam lesions were more likely in the microinstability group (p = 0.02 and 0.04, respectively), but not independent predictors. Labral tears, chondral loss, abnormal ligamentum teres, anterior capsule thinning, iliocapsularis to rectus femoris ratio, posterior crescent sign, cliff sign, and femoro-epiphyseal acetabular roof (FEAR) index were not associated with microinstabillity.</p><p><strong>Conclusion: </strong>Imaging features may be predictive of hip microinstability in some cases. Decreased LCEA, increased acetabular anteversion, and labral hyperplasia were associated with microinstability in this study, while many other published imaging findings were not. Imaging remains complementary, but not definitive, in the diagnosis of hip microinstability.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1031-1041"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375926","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":"Phenotypic variations in knee osteoarthritis: insights from MRI and radiographic comparisons.","authors":"Ozgur Tosun, Kazim Ayberk Sinci, Caner Baysan, Yasemin Kucukciloglu, Mehmet Aksit, Cemal Kazimoglu, Gokay Karaca, Atilla Hikmet Cilengir","doi":"10.1007/s00256-024-04807-z","DOIUrl":"10.1007/s00256-024-04807-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between MRI-based phenotypes (cartilage-meniscus, subchondral bone, and inflammatory) and radiography-based atrophic and hypertrophic phenotypes, aiming to demonstrate MRI's diagnostic capability in identifying complex osteoarthritis phenotypes that radiography cannot fully capture.</p><p><strong>Materials and methods: </strong>This single-center retrospective study examined knee radiographs and MRIs of patients from November 2021 to April 2023 to identify osteoarthritis phenotypes. Radiographs were staged by the Kellgren-Lawrence system, and both modalities were classified into atrophic or hypertrophic phenotypes. MRIs were further classified into three phenotypes: cartilage-meniscus, subchondral bone, and inflammatory. Associations between phenotypes, Kellgren-Lawrence stage, age, and gender were analyzed with Pearson chi-square test and student T-test. Reliability measurements were evaluated using kappa statistic.</p><p><strong>Results: </strong>A total of 214 knees from 187 individuals (73.3% women, 26.7% men; mean age 57.1 ± 9.1 years) were included. The hypertrophic MRI phenotype was significantly associated with cartilage-meniscus and subchondral bone phenotypes (p < 0.001). Cartilage-meniscus and subchondral bone phenotypes were less prevalent in Kellgren-Lawrence stage 2 than in stages 3 and 4 (p < 0.001 and p = 0.004, respectively). The subchondral bone phenotype was more common in men (p = 0.022), and the cartilage-meniscus phenotype in the elderly (p < 0.001). Radiography and MRI had substantial agreement (Kappa = 0.637, p < 0.001) in diagnosing hypertrophic and atrophic phenotypes.</p><p><strong>Conclusion: </strong>The hypertrophic phenotype was associated with cartilage-meniscus and subchondral bone phenotypes, with lower prevalences in Kellgren-Lawrence stage 2 knees. MRI offers enhanced phenotypic characterization, which facilitates more precise and individualized management in osteoarthritis care. Despite limitations compared to MRI, radiography remains valuable for the evaluation of hypertrophic and atrophic phenotypes.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1011-1020"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353396","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 molecular pathology in soft tissue tumor diagnosis: what the radiologist needs to know.","authors":"Naveen Parasu, Denny Mathew, Sharief Aboelmagd, Snezana Popovic, Hadas Benhabib","doi":"10.1007/s00256-025-04934-1","DOIUrl":"https://doi.org/10.1007/s00256-025-04934-1","url":null,"abstract":"<p><p>For both general radiologists and those specializing in soft tissue sarcoma imaging, understanding the importance and basic concepts of molecular pathology is becoming increasingly relevant to current clinical practice. As molecular research identifies the most fundamental causes and markers of disease, diagnostic testing is increasingly focused on the cell nucleus and its genetic material. Identifying molecular abnormalities, such as mutations, deletions, and amplifications, has advanced our ability to diagnose genetic diseases, including a variety of cancers. Over the past two decades, molecular pathology has rapidly evolved, enhancing our understanding of sarcoma pathogenesis, diagnosis, and classification. This progress forms the foundation of the 2020 WHO classification of soft tissue and bone tumors. This article will highlight cases where molecular diagnostics are crucial for the definitive classification and diagnosis of select soft tissue tumors, with MRI correlation and key teaching points.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046079","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}