Diffusion-weighted imaging for the differentiation of Ewing sarcoma from osteosarcoma
AbstractObjectiveThe purpose of this study is to assess the ability of apparent diffusion coefficient (ADC) values in differentiating Ewing sarcoma and osteosarcoma.Materials and methodsThis retrospective cross-sectional observational study included a total of 35 patients with a recent diagnosis of Ewing sarcoma (n = 13) and osteosarcoma (n = 22) who underwent conventional MRI and diffusion-weighted imaging (DWI). Three ADC measurements from the areas of the lowest diffusivity in ADC maps (ADCmin), and other areas with low diffusivity (ADCother), were made independently by two observers on pre-t...
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Musculoskeletal imaging features of non-Langerhans cell histiocytoses
This article reviews the musculoskeletal imaging appearances of the commoner N-LCH. (Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Introducing image-guided synovial aspiration and biopsy in assessing peri-prosthetic joint infection: an early single-centre experience
ConclusionPercutaneous image-guided SAB is a valuable technique in assessing suspected PJI, with most samples indicative of infective status and causative organisms when validated against intra-operative results and specialist MDT evaluation. Image-guided SB is a safe and useful additional procedure following failed SA with equivalent levels of diagnostic accuracy. (Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Magnetic resonance imaging of deltoid muscle/tendon tears: a descriptive study
ConclusionThe middle (acromial) portion of the deltoid is more frequently affected in patients with RCTs than in those with trauma. Although deltoid tears are commonly associated with RCT, calcific tendinopathy and chronic bursitis may also be seen in patients with deltoid tears. (Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Inter- and intra-observer reliability of radiological grading systems for knee osteoarthritis
This study included 100 patients who had undergone both AP and Rosenberg X-ray views of the knee and evaluated using four radiological grading systems. These included Kellgren& Lawrence (K&L), International Knee Documentation Committee (IKDC), Ahlb äck and Fairbank. Evaluations were performed by two observers, independently, at two separate time points, 8 weeks apart. The data was then statistically analysed and inter- and intra-observer reliability calculated.ResultsA significant difference was found between AP and Rosenberg views for all four grading systems (p 
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Relationship between anterior cruciate ligament rupture and the posterior tibial and meniscal slopes in professional soccer athletes
The objectives of this study are to assess whether there is a relationship between anterior cruciate ligament rupture and the lateral and medial posterior tibial slopes, as well as the lateral and medial posterior meniscal slopes and posterior tibial and meniscal delta-slopes.Materials and methodsA retrospective case-control study was conducted in professional soccer athletes, using images from knee magnetic resonance imaging scans in athletes with clinical and radiological diagnosis of anterior cruciate ligament rupture, and control group, with no signs of ligament rupture.ResultsThe lateral and medial posterior tibial sl...
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Pseudoaneurysm within a desmoid tumor in an extremity: report of 2 cases
We report two patients with extremity desmoid tumor who were each found at MRI to have an unsuspected pseudoaneurysm within their tumor after prior treatments (surgery and systemic therapy in one, surgery alone in the other). Such a pseudoaneurysm probably results from weakening of an arterial wall by adjacent desmoid tumor, as well as from local trauma. Due to the potential risk for life-threatening rupture of a pseudoaneurysm, one patient underwent surgical repair and the other, coil embolization. To our knowledge the presence of pseudoaneurysm has been reported within a few cases of abdominal desmoid tumor but not withi...
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Magnetic resonance imaging of trunk and extremity myxoid liposarcoma: diagnosis, staging, and response to treatment
AbstractMyxoid liposarcoma (MLS) accounts for approximately 30% of all liposarcomas. The majority are intermediate-grade tumours, but the presence of>5% round cell component renders it a high-grade sarcoma with subsequent poorer outcome. MLS most commonly arises in the lower extremities, has a predilection for extra-pulmonary sites of metastatic disease, and is recognized to be radiosensitive. The purpose of the current article is to review the role of MRI in the management of MLS, including the characteristic features of the primary tumour, features which help to identify a round cell component and thus determine progn...
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Ultrasound-guided percutaneous needle tenotomy using Tenex system for refractory lateral epicondylitis; short and long-term effectiveness and contributing factors
AbstractBackgroundUltrasound-guided percutaneous needle tenotomy (USPNT) has been proposed as an alternative treatment to surgical intervention for lateral epicondylitis (LE). The Tenex system (Tenex Health Inc., Lake Forest, CA, USA) for USPNT is an ultrasonic device involving a needle which oscillates at high frequency to debride and aspirate diseased tendon under ultrasound image guidance. This investigation evaluates the efficacy of USPNT using the Tenex system for LE refractory to conservative management. We also seek to evaluate patient-specific factors which may correlate with treatment response.Materials and method...
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Methotrexate-associated lymphoproliferative disorder of the thoracic spine in a patient with rheumatoid arthritis receiving methotrexate: a case report
AbstractMethotrexate-associated lymphoproliferative disorder is recognized as a lymphoma that occurs following methotrexate administration. The lesion of the spine is extremely rare, and only one case of lesion in the lumbar spine has been reported so far. Here, we present a case of methotrexate-associated lymphoproliferative disorder of the thoracic spine in a 54-year-old woman with rheumatoid arthritis. The lesion formed an extra-skeletal tumor mass from lateral to the vertebral body to the paravertebral muscle extending posterior to the epidural space without bone destruction. Magnetic resonance imaging showed low signa...
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Gluteus minimus tendon: MR imaging features and patterns of tendon tearing
AbstractPurposeTo highlight the spectrum of pathology and patterns of gluteus minimus tendon tearing observed on MR imaging of the hip.Methods and materialsRetrospective review of consecutive hip MRI exams with findings of gluteus minimus tendon (GMin) pathology. A total of 194 exams in 178 patients (148 female, mean age 61) were reviewed. MRI exams are assessed for GMin: tendinopathy, partial, or complete tendon tears. GMin muscular fatty atrophy, enthesopathic cortical irregularities of the greater trochanter (GT), and peri-trochanteric edema or bursal fluid collections were assessed in all cases. In all cases of complet...
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

MRI findings of tibialis anterior friction syndrome: a mimic of tibial stress injury
ConclusionPeritendinous fluid around an intact tibialis anterior tendon over the mid-to-distal third tibia, with surrounding subcutaneous, periosteal and tibialis anterior myotendinous junction oedema is demonstrable on MRI in a subset of patients presenting as suspected tibial stress injury. A friction syndrome of tibialis anterior between the superior extensor retinaculum and the anterior tibia is proposed as the aetiology of this entity. (Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Test yourself answer: multiple firm soft tissue masses
(Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

A 29-year-old male with a long history of atraumatic wrist pain
(Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Test yourself question: multiple firm soft tissue masses
(Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

A 29-year-old male with a long history of atraumatic wrist pain
(Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Intraosseous lipomas originating from simple bone cysts
(Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Correction to: Magnetic Resonance Imaging of Deltoid Muscle/Tendon Tears: A Descriptive Study
Incorrect family name of Vahid Entezari. (Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Correction to: Stenosing tenosynovitis of the extensor digitorum tendons of the hand: clinical and sonographic features
A Correction to this paper has been published:https://doi.org/10.1007/s00256-021-03796-7 (Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Browser ’s Notes
(Source: Skeletal Radiology)
Source: Skeletal Radiology - August 15, 2021 Category: Radiology Source Type: research

Clinicoradiographic predictors of percutaneous bone biopsy results among patients with suspected thoracolumbar spine infection
ConclusionThe presence of a paraspinal fluid collection or epidural abscess is correlated with positive biopsy yield, and paraspinal fluid collections should be targeted for biopsy. Other imaging findings did  not correlate with biopsy yield. Biopsy may not offer additional information for patients with positive blood cultures. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Osseous defect of the anteroinferior femoral head: is it associated with femoroacetabular impingement (FAI)?
ConclusionThe femoral head defect is a common finding in MRI examinations of the hip and is situated in the anteroinferior location. There was no association with FAI yet a non-significant trend towards lower femoral antetorsion in patients with femoral head defects. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

A fully automated rib fracture detection system on chest CT images and its impact on radiologist performance
ConclusionRadiologists achieved the highest performance in diagnosing and classifying rib fractures on CT images when assisted by the deep learning model. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Musculoskeletal imaging manifestations of beta-thalassemia
AbstractBeta-thalassemia is a heterogeneous group of anemic disorders caused by the absence or defective production of beta-globin chains. Their clinical manifestations vary from asymptomatic to severe symptoms leading to a transfusion-dependent anemic state. The genes that cause thalassemia are prevalent in Asian and African populations, particularly concentrated in the Middle East, Mediterranean region, parts of India, and South East Asia. Over time, the disease causes various musculoskeletal abnormalities with complex pathophysiology secondary to chronic anemia. The compensatory mechanisms result in diffuse marrow hyper...
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Improving detection of Hill-Sachs fractures on radiographs
ConclusionHill-Sachs fractures are often not recognized on post-reduction radiographs. Diagnosis of Hill-Sachs lesion can be significantly increased if radiologists are aware that the internal rotation view may fail to show the injury, and if all 4 views of a shoulder series are scrutinized. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Measuring stem anteversion after total hip arthroplasty: posterior condylar tangent versus transepicondylar axis
ConclusionsTEA and PC demonstrated to achieve a good correlation, not dependent from the condyle morphology. However, the difference between the two measurements (5 °) can severely influence the combined anteversion (10–20%): due to clinical applicability and better inter/intra-observer agreement, TEA should be preferred for measuring stem anteversion. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Association between Patellofemoral and medial Tibiofemoral compartment osteoarthritis progression: exploring the effect of body weight using longitudinal data from osteoarthritis initiative (OAI)
AbstractObjectivesTo investigate the associations of medial and lateral patellofemoral osteoarthritis (PF-OA) at baseline with symptomatic and radiographic OA outcomes in the medial tibiofemoral compartment (MTFC) over 4  years, according to baseline overweight status.MethodsData and MRI images of 600 subjects in the FNIH-OA biomarkers consortium were used. Symptomatic worsening and radiographic progression of MTFC-OA were defined using Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scores and MTFC joint space narrowing (JSN) from baseline to 4-year follow-up. Baseline MRIs were read to establi...
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Hydroxyapatite deposition disease of the wrist with intraosseous migration to the lunate bone
We report a case of acute HA depot located at the volar site of the right wrist with affection of the deep flexor tendons and intraosseous migration into the lunate bone in a 50-year-old female. There are two main goals of this case report: First, to remind the diagnosis of HADD as a cause of wrist pain and also of carpal tunnel syndrome, as this entity being often misdiagnosed clinically, and second, to report a rare case of intraosseous migration of HA crystals into the lunate bone. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Predictive signs of peripheral rim instability with magnetic resonance imaging in no-shift-type complete discoid lateral meniscus
ConclusionsA linear fluid signal at the anterior meniscus and anterior parameniscal soft-tissue edema were important signs of anterior PRI, whereas bulging of the margin had high specificity and either bulging of the meniscal margin or absence of popliteomeniscal fascicle had high sensitivity in detecting posterior PRI on routine MRI of no-shift-type CDLM.Level of evidenceLevel IV therapeutic case series. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Musculoskeletal involvement of COVID-19: review of imaging
This article aims to provide a first comprehensive summary of musculoskeletal manifestations of COVID-19 with review of imaging. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament
ConclusionUltrasound-guided aspiration, fenestration, and injection are an effective, safe, minimally invasive and radiation-free technique for management of mucoid degeneration of ACL with excellent immediate- and long-term results. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Long head biceps tendon instability: diagnostic performance of known and new MRI diagnostic signs
ConclusionThese diagnostic signs, both known and new, individually and/or in combination, provide a valid tool in the MRI diagnosis of long head biceps tendon instability. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Ultrasound features of traumatic digital nerve injuries of the hand with surgical confirmation
ConclusionUltrasound long axis may be less useful, and those short axis may be more reliable for assessing digital nerve injuries than previously reported. Neuromas are hypoechoic and well-defined, and their size can vary based on time from injury. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Radiomics on radiography predicts giant cell tumor histologic response to denosumab
ConclusionRadiomics analysis of plain radiographs quantifies time-dependent matrix mineralization and trabecular reconstitution that mark positive response of giant cell tumors of bone to denosumab. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Hanging protocol optimization of lumbar spine radiographs with machine learning
ConclusionMachine learning techniques can be successfully implemented to optimize lumbar spine x-ray hanging protocols by accounting for views, hardware, dynamic position, and rotation correction. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Influence of TFCC foveal tear on the location of lunate chondromalacia in ulnar impaction syndrome
ConclusionThis study showed that lunate chondromalacia associated with idiopathic ulnar impaction syndrome occurs more frequently on the volar side of the lunate. Also, TFCC foveal tear, which causes DRUJ instability, leads to broader lunate chondromalacia in idiopathic ulnar impaction syndrome. Therefore, further analysis of the pattern of lunate chondromalacia can provide a clue for DRUJ instability. (Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Parosteal osteosarcoma with a manifestation of subperiosteal low-grade central osteosarcoma
We report the peculiar case of a parosteal osteosarcoma arising beneath the periosteum in a 12-year-old boy. He complained of difficulty in left knee flexion. Plain radiography showed a uniformly dense mineralized mass in the bone cortex and parosteal ossified nodules at the metaphysis and diaphysis of the left distal femur. Periosteal reaction was not evident. Uniquely, plain radiography had a smooth outline and revealed gradually thickening mass toward the center. Histologically, the tumor showed a proliferation of spindle-shaped cells with parallel-oriented dense bone trabeculae and hyaline cartilaginous tissue disclosi...
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Slowly enlarging gluteal mass
(Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Slowly Enlarging Gluteal Mass
(Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Browser's Notes
(Source: Skeletal Radiology)
Source: Skeletal Radiology - July 13, 2021 Category: Radiology Source Type: research

Chordoma: 18F-FDG PET/CT and MRI imaging features
ConclusionOn18F-FDG PET/CT imaging, chordomas demonstrate moderate, heterogeneous FDG uptake. Predominant T2 hyperintensity and small foci of internal increased T1 signal are common on MRI. The inherent FDG avidity of chordomas suggests that18F-FDG PET/CT may be a useful modality for staging, evaluating treatment response, and assessing for recurrent or metastatic disease. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

Fast field echo resembling a CT using restricted echo-spacing (FRACTURE): a novel MRI technique with superior bone contrast
ConclusionThe cortical and trabecular bone contrast generated by FRACTURE yields clinically relevant information for diagnosis and management of a subset of patients in whom it may potentially obviate the need for a preoperative CT scan. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

Limited usefulness of classic MR findings in the diagnosis of tenosynovial giant cell tumor
ConclusionBlooming on GRE MRI has low sensitivity for nodular tenosynovial giant cell tumors and is not universal in diffuse tumors. There was high interobserver variability in assessment of blooming. Intralesional fat signal is not a useful sign and may occur adjacent to tendons which lack a tendon sheath and may occur in a subcutaneous location. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

Magnetic resonance imaging evaluation of patients with clinically diagnosed medial Epicondylitis
ConclusionIn patients with clinically diagnosed ME, MRI demonstrated diverse abnormal findings in the CFT origin, ulnar collateral ligament, ulnar nerve, and bone. Among the findings, the severity CFT origin signal changes, which indicates the severity of tendon degeneration in ME, was associated with the follow-up pain level. This information can be helpful in consulting on the prognosis of nonoperative treatment in patients with clinically diagnosed ME. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

MRI features of low-grade and high-grade chondrosarcoma in enchondromatosis
AbstractObjectiveTo identify magnetic resonance imaging (MRI) features which aid differentiation of low-grade chondral tumours (LGCT-enchondroma and grade 1 chondrosarcoma) from high-grade chondral tumours (HGCT) in patients with enchondromatosis.Materials and methodApproval from our local Research and Innovation Centre of The Institute of Orthopaedics was gained. Patients with enchondromatosis who had biopsy and/or resection of chondral lesions over a 13-year period were identified. The pre-biopsy MRI study was assessed by two experienced musculoskeletal radiologists for tumour origin (intramedullary or surface), cortical...
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

Ultrasound findings of plantar plate tears of the lesser metatarsophalangeal joints
AbstractLesser metatarsophalangeal (MTP) joint plantar plate tears are a common and increasingly recognised cause of metatarsalgia, MTP joint instability and forefoot deformity. Increased interest in early accurate diagnosis of plantar plate tears follows recent surgical innovations allowing direct plantar plate repair. The purpose of this review is to describe the ultrasound features of normal lesser MTP joint plantar plates and to characterise and illustrate the direct and indirect ultrasound findings of plantar plate tears. Lesser MTP joint plantar plate tears are most commonly located at the 2nd MTP joint, involving th...
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

Influence of pregnancy/childbirth on long-term bone marrow edema and subchondral sclerosis of sacroiliac joints
AbstractObjectiveTo investigate long-term effects of pregnancy/childbirth on bone marrow edema (BME) and subchondral sclerosis of sacroiliac joints (SIJ) in comparison to MRI changes caused by spondyloarthritis (SpA) and assess the influence of birth method and number of children on SIJ-MRI changes.Materials and methodsThis is a retrospective cohort study with 349 women (mean age 47 ± 14 years) suffering low back pain. Four subgroups were formed based on SpA diagnosis and childbirth (CB) history. Two musculoskeletal radiologists scored the presence of BME and sclerosis on SIJ-MRI using the Berlin method. Further, an...
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

Musculature adaption in patients with lumbosacral transitional vertebrae: a matched-pair analysis of 46 patients
AbstractObjectiveEven though lumbosacral transitional vertebrae (LSTV) are one of the most common congenital anomalies of the spine, their effect on surrounding soft tissues is not well-studied. We therefore aimed at analyzing the association between LSTV and changes in volume, mass, symmetry, and degeneration of lumbar and trunk muscles.Materials and methodsAbdomen –pelvis CT scans were analyzed in patients with LSTV and a matched control group. LSTV were classified according to the Castellvi classification. Muscles were segmented from the remaining soft tissue and their cross-sectional area and volume were examined...
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

Morphology of the entering and exiting nerve as a differentiating feature of benign from malignant peripheral nerve sheath tumours of the brachial plexus
AbstractObjectiveTo identify if morphology of the entering and exiting nerve involved by a nerve sheath tumour in the brachial plexus can help differentiate between benign (B) and malignant (M) peripheral nerve sheath tumours (PNSTs).Materials and methodsRetrospective review of 85 patients with histologically confirmed primary PNSTs of the brachial plexus over a 12.5-year period. Clinical data and all available MRI studies were independently evaluated by 2 consultant musculoskeletal radiologists blinded to the final histopathological diagnosis assessing for maximal lesion dimension, visibility and morphology of the enterin...
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research

Subluxation of the extensor carpi ulnaris on magnetic resonance imaging on neutral wrist position: correlation with tenosynovitis of the extensor carpi ulnaris and translation of the distal radioulnar joint
AbstractObjectiveTo identify the subluxation degrees of extensor carpi ulnaris (ECU) tendon on neutral wrist MRI in patients with ulnar-sided wrist pain and to evaluate the relationships of ECU subluxation with accompanying imaging findings such as ECU tenosynovitis, distal radioulnar joint (DRUJ) stability, and triangular fibrocartilage complex (TFCC) pathology.Materials and methodsA total of 297 MRIs of 292 patients having ulnar side pain were reviewed retrospectively. Degrees of ECU subluxation was classified into four grades: grade 0, no subluxation; grade 1, tendon displacement
Source: Skeletal Radiology - June 16, 2021 Category: Radiology Source Type: research