Seminars in Musculoskeletal Radiology

No abstract text is available yet for this article.

This history page in the series "Leaders in MSK Radiology" is dedicated to the achievements of Dr. John Caffey, whose name is associated with infantile cortical hyperostosis, also known as Caffey's disease.

A regional acceleration of bone remodeling may possibly follow biomechanical insults to the bone. This review assesses the literature and clinical arguments supporting the hypothetical association between accelerated bone remodeling and bone marrow edema (BME)-like signal intensity on magnetic resonance imaging. BME-like signal is defined as a confluent ill-delimited area of bone marrow with a moderate decrease in signal intensity on fat-sensitive sequences and a high signal intensity on fat-suppressed fluid-sensitive sequences...

Depending on the age and location within the skeleton, bone marrow can be mostly fatty or hematopoietic, and both types can be affected by marrow necrosis. This review article highlights the magnetic resonance imaging findings of disorders in which marrow necrosis is the dominant feature.Fatty marrow necrosis is detected on T1-weighted images that show an early and specific finding: the reactive interface. Collapse is a frequent complication of epiphyseal necrosis and detected on fat-suppressed fluid-sensitive sequences or using conventional radiographs...

Magnetic resonance imaging (MRI) of the axial skeleton, spine, and sacroiliac (SI) joints is critical for the early detection and follow-up of inflammatory rheumatologic disorders such as axial spondyloarthritis, rheumatoid arthritis, and SAPHO/CRMO (synovitis, acne, pustulosis, hyperostosis, and osteitis/chronic recurrent multifocal osteomyelitis). To offer a valuable report to the referring physician, disease-specific knowledge is essential. Certain MRI parameters can help the radiologist provide an early diagnosis and lead to effective treatment...

Diabetic foot and ankle complications contribute to substantial mortality and morbidity. Early detection and treatment can lead to better patient outcomes. The primary diagnostic challenge for radiologists is distinguishing Charcot's neuroarthropathy from osteomyelitis. Magnetic resonance imaging (MRI) is the preferred imaging modality for assessing diabetic bone marrow alterations and for identifying diabetic foot complications. Several recent technical advances in MRI, such as the Dixon technique, diffusion-weighted imaging, and dynamic contrast-enhanced imaging, have led to improved image quality and increased capability to add more functional and quantitative information...

This article discusses the presumed pathophysiology of osseous sport-related stress changes, the optimal imaging strategy for detecting the lesions, and the progression of the lesions as seen on magnetic resonance imaging. It also describes some of the most common stress-related injuries in athletes by anatomical location and introduces some new concepts in the field.

Bone marrow edema (BME)-like signal intensity involving the epiphyses of tubular bones represents a frequent magnetic resonance imaging finding associated with a wide spectrum of bone and joint disorders. It is important to distinguish this finding from cellular infiltration of bone marrow and to be aware of the differential diagnosis of underlying causes. With a general focus on the adult musculoskeletal system, this article reviews the pathophysiology, clinical presentation, histopathology, and imaging findings of nontraumatic conditions associated with epiphyseal BME-like signal intensity: transient bone marrow edema syndrome, subchondral insufficiency fracture, avascular necrosis, osteoarthritis, arthritis, and bone neoplasms...

This article provides an overview of the imaging appearances of normal adult bone marrow with an emphasis on magnetic resonance imaging. We also review the cellular processes and imaging features of normal developmental yellow-to-red marrow conversion and compensatory physiologic or pathologic red marrow reconversion. Key imaging features that differentiate between normal adult marrow, normal variants, non-neoplastic hematopoietic disorders, and malignant marrow disease are discussed, as well as posttreatment changes...

The dynamic and developing pediatric skeleton is a well-elucidated process that occurs in a stepwise faction. Normal development has been reliably tracked and described with Magnetic Resonance (MR) imaging. The recognition of the normal patterns of skeletal development is essential, as normal development may mimic pathology and vice versa. The authors review normal skeleton maturation and the corollary imaging findings while highlighting common marrow imaging pitfalls and pathology.

Conventional magnetic resonance imaging (MRI) remains the modality of choice to image bone marrow. However, the last few decades have witnessed the emergence and development of novel MRI techniques, such as chemical shift imaging, diffusion-weighted imaging, dynamic contrast-enhanced MRI, and whole-body MRI, as well as spectral computed tomography and nuclear medicine techniques. We summarize the technical bases behind these methods, in relation to the common physiologic and pathologic processes involving the bone marrow...

No abstract text is available yet for this article.

This history page in the series "Leaders in MSK Radiology" is dedicated to the memory and achievements of the French physician Jacques Calvé, whose name is partially associated with the medical eponym Legg-Calvé-Perthes disease.

This article reviews situations in which surgical treatment is required in the context of different types of pathology in the foot and ankle of children, focusing on the role of imaging in surgical planning and postsurgical assessment. The types of pathology analyzed from this perspective are congenital pathology, neuromuscular disorders, osteochondral lesions, fractures and infection, ligament injuries, and tumors.We address the most common pitfalls of postsurgical imaging of the ankle and foot in children...

A variety of foot and ankle pathologies can impair patient's daily activities, ultimately requiring surgical management. However, with improvements in image-guided intervention, the joints, soft tissues, and osseous structures may be accessible using various percutaneous techniques as a potential alternative therapeutic tool, avoiding the need for surgery with its associated risks and morbidity. This article discusses the potential range of image-guided interventional treatments. Injections, aspiration, biopsies, cryoablation, and radiofrequency ablation are described...

This article discusses soft tissue tumors of the ankle and foot region in adults, including tumors of the joints, and also briefly addresses tumor-simulating lesions. We offer general recommendations and describe specific aspects of common entities in that region, such as typical imaging appearance, therapeutic strategies, and posttherapeutic considerations. Focal masses and diffuse swelling are common in the foot and ankle region; most of them are non-neoplastic. Some of the tumors, such as plantar fibromatosis, tenosynovial giant cell tumor, synovial chondromatosis, or schwannoma, have a very typical appearance on magnetic resonance imaging...

Management of the diabetic foot is complex and challenging, requiring a multidisciplinary approach. Imaging plays an important role in the decision-making process regarding surgery. This article discusses the presurgical perspective and postsurgical evaluation of the diabetic foot.

Magnetic resonance imaging (MRI) is a robust method used for both preoperative and postoperative evaluation of Morton's neuroma and other neural lesions. MRI is used to confirm the diagnosis and for precise localization, estimation of outcome, and differential diagnoses. The differential diagnoses include mechanically induced plantar plate ruptures with associated Morton's neuroma-like tumors in the intermetatarsal/interdigital spaces; mechanical fibrosis cushion formations and pseudo bursae in the plantar foot adipose tissue; rheumatologic affections, such as rheumatoid nodules, gouty nodules, and intermetatarsal bursitis; and lastly the tenosynovial giant cell tumor (formerly called pigmented villonodular synovitis)...

Capsuloligamentous injury of the first metatarsophalangeal (MTP) joint (eponymously called "turf toe") mostly occurs in athletes and involves acute trauma, whereas tears of the lesser MTP joint plantar plate typically are an attritional-degenerative condition. This article reviews the anatomy, pathophysiology, mechanism and patterns of injury, grading and classification of injury, imaging appearances (pre- and postoperative), and management of first MTP joint capsuloligamentous injuries and lesser MTP joint plantar plate tears...

The plantar fascia is an important structure in the foot that acts as a major stabilizer of the longitudinal arch, along with the midfoot ligaments and intrinsic and extrinsic muscles. It is composed predominantly of longitudinally oriented collagen fibers that vary in thickness and are organized into bundles closely associated with the interstitial tissues of the foot. This composition enables the plantar fascia to withstand the weight-bearing forces concentrated on the foot while standing, jumping, walking, or running...