Skeletal Radiology最新文献

{"title":"Are artificial intelligence generated lower extremity radiographic measurements accurate in a cohort with implants?","authors":"Holden Archer, Shuda Xia, Seth Reine, Louis Camilo Vazquez, Oganes Ashikyan, Parham Pezeshk, Ajay Kohli, Yin Xi, Joel E Wells, Allan Hummer, Matthew Difranco, Avneesh Chhabra","doi":"10.1007/s00256-025-04936-z","DOIUrl":"https://doi.org/10.1007/s00256-025-04936-z","url":null,"abstract":"<p><strong>Objective: </strong>Leg length discrepancy (LLD) and malalignment of the lower extremity can lead to pain and increased risk of osteoarthritis. Radiographic measurements on anteroposterior (AP) full-length radiographs can be used to assess LLD and lower extremity alignment. The primary aim of this study was to evaluate the accuracy of AI software in performing lower extremity radiographic measurements in patients with implants. The secondary aim was to compare its efficiency to that of radiologists.</p><p><strong>Materials and methods: </strong>This study used the following eight angles and five lengths: hip-knee-angle (HKA), anatomical-tibiofemoral angle (aTFA), anatomical-mechanical-axis angle (AMA), joint-line-convergence angle (JLCA), mechanical-lateral-proximal-femur-angle (mLPFA), mechanical-lateral-distal-femur-angle (mLDFA), mechanical-medial-proximal-tibia-angle (mMPTA), mechanical-lateral-distal-tibia- angle (mLDTA), femur length, tibia length, full leg length, leg-length-discrepancy (LLD), and mechanical-axis-deviation (MAD). Two radiologists and AI software independently performed these measurements on 156 legs. The statistical methods used to assess AI performance were intraclass correlation coefficient (ICC) and Bland-Altman analysis.</p><p><strong>Results: </strong>The AI generated output for 129/156 legs. 11/13 of the variables showed excellent agreement (ICC ≥ 0.75) between AI and the readers. Bland Altman performance targets were met for 5/13 variables. The mean (standard deviation) reading time for the AI and two readers, respectively, was 38 (6) seconds, 181 (41) seconds, and 214 (77) seconds.</p><p><strong>Conclusion: </strong>In a cohort with lower extremity metal implants, AI-based leg length measurements were fast and accurate although most angular measurements were not.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979131","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":"https://doi.org/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":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and future role of CT and advanced CT applications in inflammatory arthritis in the clinic and trials.","authors":"Torsten Diekhoff, Sevtap Tugce Ulas","doi":"10.1007/s00256-025-04931-4","DOIUrl":"https://doi.org/10.1007/s00256-025-04931-4","url":null,"abstract":"<p><p>Computed tomography (CT) has traditionally been underutilized in the imaging of inflammatory arthritis due to its limitations in assessing soft tissue inflammation and concerns over radiation exposure. However, recent technological advancements have positioned CT as a more viable imaging modality for arthritis, offering high specificity and sensitivity in detecting structural bone changes. However, advances in ultra-low-dose CT protocols and AI-driven image reconstruction have significantly reduced radiation exposure while maintaining diagnostic quality. Dynamic CT and spectral CT techniques, including dual-energy CT (DECT), have broadened CT's application in assessing dynamic joint instabilities and visualizing inflammatory changes through material-specific imaging. Techniques such as CT subtraction imaging and iodine mapping have enhanced the detection of active soft-tissue inflammation, virtual non-calcium reconstructions, and the detection of bone marrow edema. Possible CT applications span various forms of arthritis, including gout, calcium pyrophosphate deposition disease (CPPD), psoriatic arthritis, and axial spondyloarthritis. Beyond its diagnostic capabilities, CT's ability to provide detailed structural assessment positions is a valuable tool for monitoring disease progression and therapeutic response, particularly in clinical trials. While MRI remains superior for soft tissue evaluation, CT's specificity for bone-related changes and its potential for integration into routine arthritis management warrant further exploration and research. This review explores the current and emerging roles of CT in arthritis diagnostics, with a focus on novel applications and future potential.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007525","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":"B-mode artefacts relevant in rheumatological musculoskeletal ultrasound-impact on image interpretation and their diagnostic value.","authors":"Lene Terslev, Emilio Filippucci, Søren Torp-Pedersen","doi":"10.1007/s00256-025-04928-z","DOIUrl":"https://doi.org/10.1007/s00256-025-04928-z","url":null,"abstract":"<p><p>When performing ultrasound examinations, artefacts are a frequent challenge and cannot be eliminated completely. Understanding and recognizing artefacts are of utmost importance. This paper describes and explains the most commonly encountered B-mode artefacts in rheumatologically applied musculoskeletal (MSK) and vascular ultrasound particularly those which may have additional diagnostic value or often lead to misdiagnosis. Knowledge and understanding of artefacts provide more precise and uniform interpretations of the ultrasound examinations minimizing variability in findings and ensuring generalizability of research results.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037842","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":"AI as teacher: effectiveness of an AI-based training module to improve trainee pediatric fracture detection.","authors":"Sean O'Rourke, Sophia Xu, Stephanie Carrero, Harrison M Drebin, Ariel Felman, Andrew Ko, Adam Misseldine, Sofia G Mouchtaris, Brett Musialowicz, Tony T Wong, John R Zech","doi":"10.1007/s00256-025-04927-0","DOIUrl":"https://doi.org/10.1007/s00256-025-04927-0","url":null,"abstract":"<p><strong>Objective: </strong>Prior work has demonstrated that AI access can help residents more accurately detect pediatric fractures. We wished to evaluate the effectiveness of an unsupervised AI-based training module as a pediatric fracture detection educational tool.</p><p><strong>Materials and methods: </strong>Two hundred forty radiographic examinations from throughout the pediatric upper extremity were split into two groups of 120 examinations. A previously developed open-source deep learning fracture detection algorithm ( www.childfx.com ) was used to annotate radiographs. Four medical students and four PGY-2 radiology residents first evaluated 120 examinations for fracture without AI assistance and subsequently reviewed AI annotations on these cases via a training module. They then interpreted 120 different examinations without AI assistance. Pre- and post-intervention fracture detection accuracy was evaluated using a chi-squared test.</p><p><strong>Results: </strong>Overall resident fracture detection accuracy significantly improved from 71.3% pre-intervention to 77.5% post-intervention (p = 0.032). Medical student fracture detection accuracy was not significantly changed from 56.3% pre-intervention to 57.3% post-intervention (p = 0.794). Eighty-eight percent of responding participants (7/8) would recommend this model of learning.</p><p><strong>Conclusion: </strong>We found that a tailored AI-based training module increased resident accuracy for detecting pediatric fractures by 6.2%. Medical student accuracy was not improved, likely due to their limited background familiarity with the task. AI offers a scalable method for automatically generating annotated teaching cases covering varied pathology, allowing residents to efficiently learn from simulated experience.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995540","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":"https://doi.org/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":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-13","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":"Global insights on diversity, equity, and inclusion-perspectives and experiences from musculoskeletal radiologists of the International Skeletal Society DEI Committee.","authors":"Avneesh Chhabra, Erin F Alaia, Matthew D Bucknor, Jung-Ah Choi, Bruce B Forster, Soterios Gyftopoulos, Daichi Hayashi, Amanda Isaac, Khaled Matrawy, Kevin C McGill, Kambiz Motamedi, Mahesh Prakash, Aline Serfaty, Stacy E Smith, Kathryn J Stevens, Miriam A Bredella","doi":"10.1007/s00256-025-04926-1","DOIUrl":"https://doi.org/10.1007/s00256-025-04926-1","url":null,"abstract":"<p><p>Diversity, equity, and inclusion (DEI) is important for delivering high-quality, culturally competent care and ensuring equal access to resources and opportunities in healthcare. However, the implementation of DEI has been met with unique challenges and successes across the globe. The International Skeletal Society (ISS), a multidisciplinary musculoskeletal society, made a conscious effort to promote DEI. This article discusses advantages and controversies of DEI approaches, DEI initiatives implemented by the ISS, and experiences of the ISS DEI committee members from their respective continents. The ISS DEI committee implemented educational webinars with expert panel discussions, revising membership criteria and policies for enhancing inclusiveness, advising on programing and speakers for the annual meeting, and fostering mentorship. From a global perspective, in North America, DEI has improved health outcomes and patient care, but anti-DEI legislation has posed significant challenges. Europe relies on international recruitment but faces challenges in staff retention. South America's cultural diversity necessitates culturally sensitive approaches, but discussions about DEI are scarce, and gender inequalities persist in leadership. In Africa, DEI principles are underdeveloped, with limited engagement among stakeholders. In Asia, DEI is emerging, with more women being appointed to faculty positions and leadership roles in academic societies. The implementation of meaningful DEI initiatives requires long-term institutional buy-in and the global participation and commitment of employees and institutional leaders at all levels.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051440","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":"Improving tissue contrast visualization in two-point Dixon MRI using dark-fat processing: application in clinical knee imaging.","authors":"Sheng-Qing Lin, Sebastian Fonseca, Dhilip Andrew, Durga Udayakumar, Flavio Duarte Silva, Avneesh Chhabra, Ananth J Madhuranthakam","doi":"10.1007/s00256-025-04925-2","DOIUrl":"https://doi.org/10.1007/s00256-025-04925-2","url":null,"abstract":"<p><strong>Objective: </strong>To improve tissue contrast visualization in water-only images from two-point turbo spin-echo (TSE) Dixon MRI using dark-fat image processing and evaluate in retrospectively acquired clinical knee images.</p><p><strong>Materials and methods: </strong>Clinical knee MRI datasets from 36 patients were retrospectively compiled under IRB approval. The dark-fat water-only images were generated and compared with the conventional water-only images from two-point TSE-Dixon MRI. The water-only images from 20 patients were analyzed: (i) qualitatively by two experienced musculoskeletal radiologists, for overall image quality, fat suppression, anatomical visualization, and the absence of artifacts, using Wilcoxon rank tests, and (ii) quantitatively using apparent signal-to-noise ratio (aSNR) and apparent contrast-to-noise ratio (aCNR) from regions of interest (ROIs) with paired t-test. In the remaining 16 patients, the number of cruciate ligament tears identified on MRI was tabulated and compared with arthroscopy results.</p><p><strong>Results: </strong>Compared to conventional water-only images, dark-fat water-only images showed improved fat suppression (reader 1, P < 0.0001; reader 2, P < 0.05), improved overall image quality by reader 1 (P < 0.001), and improved visualization of the sciatic nerve for reader 1 (P < 0.01), while there were no significant differences for the other anatomical structures. aSNR was significantly reduced for bone marrow fat (P < 0.0001), and aCNR between meniscus and articular cartilage was significantly improved (P < 0.0001). There were a higher number of posterior cruciate ligament tears identified in MRI compared to arthroscopy.</p><p><strong>Conclusion: </strong>Dark-fat processed water-only images improved fat suppression and tissue contrast visualization, particularly sciatic nerves, compared to conventional water-only images from two-point TSE-Dixon MR imaging.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015783","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":"Assessment of neurovascular bundle involvement by an extremity sarcoma on MRI: a critical decision for sarcoma surgeon.","authors":"Dharmendra Kumar Singh, Divesh Jalan, Aarushi Narwani, Nishith Kumar, Ashish Rustagi, Alfa Shamim Saifi, Upinderjeet Singh, Supriya Kaur, Neha Nischal","doi":"10.1007/s00256-025-04924-3","DOIUrl":"https://doi.org/10.1007/s00256-025-04924-3","url":null,"abstract":"<p><p>Bone or soft tissue sarcoma of the extremity represents a varied group of mesenchymal tumors, with an extensive range of histopathology, epidemiology, and anatomical involvement. Many of these tumors grow to involve the adjacent major neurovascular bundles, leading to a paradigm shift of management between limb salvage and limb amputation. MRI is the gold standard imaging modality for assessing neurovascular involvement, primarily on T2-weighted fat suppressed (T2 W FS) axial and T1-weighted (T1 W) axial sequences. The differential imaging pattern or appearance of peritumoral edema and tumor has led to further insights in managing extremity sarcoma. This article aims to unfurl the various intricacies of neurovascular involvement by extremity sarcoma on MRI for a multidisciplinary management approach.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796461","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":"Magnetic resonance imaging assessment of epiphyseal invasion in paediatric osteosarcoma.","authors":"Jiazhi Zhu, Kunkun Sun, Qianyu Shi, Siyi Huang, Dasen Li, Wei Guo, Xiaodong Tang, Tao Ji","doi":"10.1007/s00256-025-04923-4","DOIUrl":"https://doi.org/10.1007/s00256-025-04923-4","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the reliability and reproducibility of magnetic resonance imaging (MRI) in the evaluation of epiphyseal invasion (EI).</p><p><strong>Methods: </strong>We included paediatric patients with open epiphyseal plates diagnosed with high-grade osteosarcoma (OS) located in the diaphysis or metaphysis of the long bones. Patients underwent neoadjuvant chemotherapy and MRI, including T1-weighted and short tau inversion recovery (STIR)-/T2-weighted sequences. Significant tumour penetration through the growth plate into the epiphysis, high signal intensity in the epiphysis, oedema-like signals in the epiphysis, and growth plate discontinuity were assessed on MRI. Standardised uptake value (SUV) of the lesions and necrosis rate were included in analysis. Histopathological analysis was performed to confirm EI status.</p><p><strong>Results: </strong>Thirty-three patients (18 males and 15 females; 4-15 years old; mean age 10.7 years) were included. EI was present in 16 cases. Significant tumour penetration through the growth plate (p = 0.002-0.005), high signal intensity in the epiphysis (p < 0.001-0.005), and discontinuous growth plates (p = 0.002-0.010) were associated with EI, but the latter two showed moderate reproducibility. The association between oedema signals and EI status lacked statistical significance (p = 0.175-0.225), with low specificity and reproducibility. Pre-chemotherapy SUV correlated with EI (p = 0.006). Huvos grade III/IV was associated with a lower incidence of EI (p = 0.02).</p><p><strong>Conclusions: </strong>Significant tumour invasion through the growth plate, high signal intensity in the epiphysis, and growth plate discontinuity are reliable indicators of EI on MRI. Oedema-like signals in the epiphysis alone are not associated with tumour invasion.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781111","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}