Diagnostics

Research

13 pages, 1927 KiB

Open AccessArticle

Evolution of the Cross-Sectional Area of the Osseous Lumbar Spinal Canal across Decades: A CT Study with Reference Ranges in a Swiss Population

by Benoit Maeder, Fabio Becce, Sam Kehtari, Arnaud Monier, Etienne Chaboudez, Dominique A. Rothenfluh, Constantin Schizas and Steven D. Hajdu

Diagnostics 2023, 13(4), 734; https://doi.org/10.3390/diagnostics13040734 - 15 Feb 2023

Cited by 1 | Viewed by 1535

Abstract

Spinal canal dimensions may vary according to ethnicity as reported values differ among studies in European and Chinese populations. Here, we studied the change in the cross-sectional area (CSA) of the osseous lumbar spinal canal measured in subjects from three ethnic groups born [...] Read more.

Spinal canal dimensions may vary according to ethnicity as reported values differ among studies in European and Chinese populations. Here, we studied the change in the cross-sectional area (CSA) of the osseous lumbar spinal canal measured in subjects from three ethnic groups born 70 years apart and established reference values for our local population. This retrospective study included a total of 1050 subjects born between 1930 and 1999 stratified by birth decade. All subjects underwent lumbar spine computed tomography (CT) as a standardized imaging procedure following trauma. Three independent observers measured the CSA of the osseous lumbar spinal canal at the L2 and L4 pedicle levels. Lumbar spine CSA was smaller at both L2 and L4 in subjects born in later generations (p < 0.001; p = 0.001). This difference reached significance for patients born three to five decades apart. This was also true within two of the three ethnic subgroups. Patient height was very weakly correlated with the CSA at both L2 and L4 (r = 0.109, p = 0.005; r = 0.116, p = 0.002). The interobserver reliability of the measurements was good. This study confirms the decrease of osseous lumbar spinal canal dimensions across decades in our local population. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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13 pages, 1635 KiB

Open AccessArticle

Physiological Femoral Condylar Morphology in Adult Knees—A MRI Study of 517 Patients

by Marc-Pascal Meier, Yara Hochrein, Dominik Saul, Mark-Tilmann Seitz, Paul Jonathan Roch, Katharina Jäckle, Ali Seif Amir Hosseini, Wolfgang Lehmann and Thelonius Hawellek

Diagnostics 2023, 13(3), 350; https://doi.org/10.3390/diagnostics13030350 - 18 Jan 2023

Cited by 3 | Viewed by 1949

Abstract

Background: In the age of individualised arthroplasty, the question arises whether currently available standard implants adequately consider femoral condylar morphology (FCM). Therefore, physiological reference values of FCM are needed. The aim was to establish physiological reference values for anterior (ACO) and posterior condylar [...] Read more.

Background: In the age of individualised arthroplasty, the question arises whether currently available standard implants adequately consider femoral condylar morphology (FCM). Therefore, physiological reference values of FCM are needed. The aim was to establish physiological reference values for anterior (ACO) and posterior condylar offset (PCO) as well as for the length of the medial (LMC) and lateral femoral condyles (LLC). Methods: The knee joints of 517 patients (mean age: 52.3 years (±16.8)) were analysed retrospectively using MRI images. Medial (med) and lateral (lat) ACO and PCO, as well as LMC and LLC, were measured. All FCM parameters were examined for association with age, gender, side and osteoarthritis. Results: Mean ACOmed was 2.8 mm (±2.5), mean ACOlat was 6.7 mm (±2.3), mean PCOmed was 25.7 mm (±4.6), mean PCOlat was 23.6 mm (±3.0), mean LMC was 63.7 mm (±5.0) and mean LLC was 64.4 mm (±5.0). Except for PCOmed, the mean values of all other FCM parameters were significantly higher in male knees compared to female knees. ACOmed and PCOmed showed significant side-specific differences. There were no significant differences in relation to age and osteoarthritis. Conclusion: The study showed significant differences in FCM side- and gender-specifically in adult knees. These aspects should be considered in the discussion of individual and gender-specific knee joint replacement. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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10 pages, 6347 KiB

Open AccessArticle

CT-Guided Radiofrequency Thermal Ablation for the Treatment of Atypical, Early-Onset Osteoid Osteoma in Children Younger than 4 Years Old: Single-Institution Experience and Literature Review

by Nicolas Papalexis, Giuliano Peta, Federico Ponti, Gianmarco Tuzzato, Marco Colangeli, Giancarlo Facchini and Paolo Spinnato

Diagnostics 2022, 12(11), 2812; https://doi.org/10.3390/diagnostics12112812 - 16 Nov 2022

Cited by 2 | Viewed by 2082

Abstract

The aim of our study is to report our experience on CT-guided radiofrequency ablation (RFA) for osteoid osteoma (OO) in children under 4 years of age and to review the literature regarding this atypical, early onset of the disease. We retrospectively reviewed the [...] Read more.

The aim of our study is to report our experience on CT-guided radiofrequency ablation (RFA) for osteoid osteoma (OO) in children under 4 years of age and to review the literature regarding this atypical, early onset of the disease. We retrospectively reviewed the clinical and radiological records of the patients treated with CT-guided RFA for OO at our institution (2006–2021), including those under 4 years of age. Data regarding technical success, clinical success, and biopsy diagnostic yield were collected. Moreover, we performed a literature review including previous articles on early-onset OO. We found only 12 patients that were under 4 years of age (12/842–1.4%) at the time of RFA treatment: 4 F and 8 M, mean age at the time of the treatment 35.3 months (range 22–46 months). The mean follow-up was 22.8 months (range 6–96 months). Technical success was achieved in all cases (12/12). In all patients (12/12), a complete remission of the pain symptoms was achieved at clinical follow-up controls. No recurrence of pain or complications were documented. The histopathological diagnosis was confirmed in 4 patients (4/12–33.3%). Moreover, we found another 9 articles in the literature with a main focus on early-onset OO (<4 years old), with a total of 12 patients included; 6 of those patients (6/12–50%) were treated with CT-guided RFA, with success reported 5 cases (5/6–83.3%). Our series of cases treated at a single institution, together with the existing data from the literature, confirms that CT-guided RFA is effective and safe for the treatment of osteoid osteoma, even in atypical, early onset in children under 4 years of age. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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13 pages, 1510 KiB

Open AccessArticle

Physiological Offset Parameters of the Adult Shoulder Joint—A MRI Study of 800 Patients

by Marc-Pascal Meier, Lars Erik Brandt, Dominik Saul, Paul Jonathan Roch, Friederike Sophie Klockner, Ali Seif Amir Hosseini, Wolfgang Lehmann and Thelonius Hawellek

Diagnostics 2022, 12(10), 2507; https://doi.org/10.3390/diagnostics12102507 - 16 Oct 2022

Cited by 1 | Viewed by 2101

Abstract

Background: Humeral offset (HO) and glenoidal offset (GO) are important morphological parameters in diagnostics and therapy for shoulder pathologies. However, physiological reference values have not yet been sufficiently determined. The aim of the present study was to establish physiological reference values for [...] Read more.

Background: Humeral offset (HO) and glenoidal offset (GO) are important morphological parameters in diagnostics and therapy for shoulder pathologies. However, physiological reference values have not yet been sufficiently determined. The aim of the present study was to establish physiological reference values for shoulder offset parameters (SOPs). Methods: MRI images of the shoulder joints of 800 patients (mean age: 50.13 years [±16.01]) were analysed retrospectively. HO, GO, lateral glenoidal humeral offset (LGHO), humeral shaft axis offset (HAO) and cortical offset (CO) were measured. SOPs were examined for associations with age, gender, side and osteoarthritis. Results: The mean HO was 26.19 (±2.70), the mean GO was 61.79 (±5.67), the mean LGHO was 54.49 (±4.69), the mean HAO was 28.17 (±2.82) and the mean CO was 16.70 (±3.08). For all SOPs, significantly higher values were measured in male shoulders. There was a significantly (p < 0.001) higher mean value for HO, GO and LGHO in right shoulders. There was a significant correlation between age and LGHO, and HAO and CO, but not between age and HO or GO. Shoulders with osteoarthritis and non-osteoarthritis did not differ in the mean value of HO, GO, LGHO and HAO, except for CO (p = 0.049). Conclusion: Reference values for SOPs in the adult shoulder joint were determined for the first time. Significant gender-specific differences were found for all measured SOPs. In addition, it was seen that for some SOPs, the joint side and the patient’s age has to be taken into account in shoulder diagnostics and surgery. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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13 pages, 3109 KiB

Open AccessArticle

Feasibility of Arterial Spin Labeling Magnetic Resonance Imaging for Musculoskeletal Tumors with Optimized Post-Labeling Delay

by Chien-Hung Lin, Tsyh-Jyi Hsieh, Yi-Chen Chou and Clement Kuen-Huang Chen

Diagnostics 2022, 12(10), 2450; https://doi.org/10.3390/diagnostics12102450 - 10 Oct 2022

Cited by 1 | Viewed by 1882

Abstract

Arterial spin labeling (ASL) magnetic resonance imaging (MRI) is used to perform perfusion imaging without administration of contrast media. However, the reliability of ASL for musculoskeletal tumors and the influence of post-labeling delay (PLD) have not been fully clarified. This study aimed to [...] Read more.

Arterial spin labeling (ASL) magnetic resonance imaging (MRI) is used to perform perfusion imaging without administration of contrast media. However, the reliability of ASL for musculoskeletal tumors and the influence of post-labeling delay (PLD) have not been fully clarified. This study aimed to evaluate the performance of ASL with different PLDs in the imaging of musculoskeletal tumors. Forty-five patients were enrolled and were divided into a malignant group, a hypervascular benign group, a hypovascular benign group and a control group. The tissue blood flow (TBF) of the lesions and normal muscles was measured and the lesion-to-muscle TBF ratio and differences were calculated. The results showed that both the TBF of lesions and muscles increased as the PLD increased, and the TBF of muscles correlated significantly and positively with the TBF of lesions (all p < 0.05). The TBF and lesion-to-muscle TBF differences of the malignant lesions were significantly higher than those of the hypovascular benign lesions and the control group in all PLD groups (all p < 0.0125) and only those of the hypervascular benign lesions in the longest PLD (3025 ms) group (p = 0.0120, 0.0116). In conclusion, ASL detects high TBF in malignant tumors and hypervascular benign lesions, and a longer PLD is recommended for ASL to differentiate musculoskeletal tumors. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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9 pages, 2215 KiB

Open AccessArticle

An Experimental Study of a 3D Bone Position Estimation System Based on Fluoroscopic Images

by Yuichi Yoshii, Yuta Iwahashi, Satoshi Sashida, Pragyan Shrestha, Hidehiko Shishido, Itaru Kitahara and Tomoo Ishii

Diagnostics 2022, 12(9), 2237; https://doi.org/10.3390/diagnostics12092237 - 16 Sep 2022

Cited by 4 | Viewed by 1754

Abstract

To compare a 3D preoperative planning image and fluoroscopic image, a 3D bone position estimation system that displays 3D images in response to changes in the position of fluoroscopic images was developed. The objective of the present study was to evaluate the accuracy [...] Read more.

To compare a 3D preoperative planning image and fluoroscopic image, a 3D bone position estimation system that displays 3D images in response to changes in the position of fluoroscopic images was developed. The objective of the present study was to evaluate the accuracy of the estimated position of 3D bone images with reference to fluoroscopic images. Bone positions were estimated from reference points on a fluoroscopic image compared with those on a 3D image. The four reference markers positional relationships on the fluoroscopic image were compared with those on the 3D image to evaluate whether a 3D image may be drawn by tracking positional changes in the radius model. Intra-class correlations coefficients for reference marker distances between the fluoroscopic image and 3D image were 0.98–0.99. Average differences between measured values on the fluoroscopic image and 3D bone image for each marker corresponding to the direction of the bone model were 1.1 ± 0.7 mm, 2.4 ± 1.8 mm, 1.4 ± 0.8 mm, and 2.0 ± 1.6 mm in the anterior-posterior view, ulnar side lateral view, posterior-anterior view, and radial side lateral view, respectively. Marker positions were more accurate in the anterior-posterior and posterior-anterior views than in the radial and ulnar side lateral views. This system helps in real-time comparison of dynamic changes in preoperative 3D and intraoperative fluoroscopy images. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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27 pages, 8690 KiB

Open AccessArticle

In Vivo Study of Local and Systemic Responses to Clinical Use of Mg–1Ca Bioresorbable Orthopedic Implants

by Răzvan Adam, Iulian Antoniac, Silviu Negoiță, Cosmin Moldovan, Elena Rusu, Carmen Orban, Sorin Tudorache and Tudor Hârșovescu

Diagnostics 2022, 12(8), 1966; https://doi.org/10.3390/diagnostics12081966 - 14 Aug 2022

Viewed by 1859

Abstract

(1) Background: Resorbable Mg-based implants represent a new direction in orthopedic surgery but have some drawbacks, such as their rapid biodegradation and increased rate of corrosion. Some in vitro studies hypothesized that tissue necrosis, incision dehiscence, risk of gas embolization in vital organs, [...] Read more.

(1) Background: Resorbable Mg-based implants represent a new direction in orthopedic surgery but have some drawbacks, such as their rapid biodegradation and increased rate of corrosion. Some in vitro studies hypothesized that tissue necrosis, incision dehiscence, risk of gas embolization in vital organs, interference with coagulation processes, and trophocyte viability impairment can occur. (2) Methods: We conducted an in vivo study on ten rabbit cases, in two groups; group one, consisting of six cases, received cylindrical implants of Mg–1Ca alloy in tibial intramedullary bone tissue. Group two, consisting of four cases, received Mg–1Ca parallelepiped implants, in the thigh muscular tissue. We recorded and compared weight (preoperatively and at 2, 4, and 6 weeks postoperatively), complete blood count, serum electrolytes, liver and kidney functional markers, and coagulation parameters, prior to and at 6 weeks after surgery. Local evolution was assessed radiologically and with tissue biopsies with complete pathology analysis. (3) Results: All biological markers and clinical evolution were favorable, showing good integration of the implants with none of the local or systemic signs of degradation. (4) Conclusions: Our study shows that the clinical use of Mg–1Ca bioresorbable alloys can be safe as none of the cited local or systemic complications have been identified. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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13 pages, 1575 KiB

Open AccessArticle

Ultrasound Imaging of the Superficial Fascia in the Upper Limb: Arm and Forearm

by Carmelo Pirri, Nina Pirri, Diego Guidolin, Veronica Macchi, Raffaele De Caro and Carla Stecco

Diagnostics 2022, 12(8), 1884; https://doi.org/10.3390/diagnostics12081884 - 4 Aug 2022

Cited by 9 | Viewed by 2898

Abstract

The superficial fascia has received much attention in recent years due to its important role of compartmentalizing the subcutaneous tissue. Ultrasound (US) imaging, owing to its high definition, provides the possibility of better visualizing and measuring its thickness. The aim of this study [...] Read more.

The superficial fascia has received much attention in recent years due to its important role of compartmentalizing the subcutaneous tissue. Ultrasound (US) imaging, owing to its high definition, provides the possibility of better visualizing and measuring its thickness. The aim of this study was to measure and compare, with US imaging, the thickness of superficial fascia in the arm and forearm in different regions/levels. An observational study has been performed using US imaging to measure superficial fascia thickness in the anterior and posterior regions at different levels in a sample of 30 healthy volunteers. The results for superficial fascia thickness revealed statistically significant differences (p < 0.0001) in the arm between the anterior and posterior regions; in terms of forearm, some statistically significant differences were found between regions/levels. However, in the posterior region/levels of the arm, the superficial fascia was thicker (0.53 ± 0.10 mm) than in the forearm (0.41 ± 0.10 mm); regarding the anterior regions/levels, the superficial fascia of the arm (0.40 ± 0.10 mm) was not statistically different than the forearm (0.40 ± 0.12 mm). In addition, the intra-rater reliability was good (ICC_2,k: 0.88). US helps to visualize and assess the superficial fascia inside the subcutaneous tissue, improving the diagnosis of fascial dysfunction, and one of the Us parameters to reliably assess is the thickness in different regions and levels. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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13 pages, 3740 KiB

Open AccessArticle

Individual Evaluation of the Common Extensor Tendon and Lateral Collateral Ligament Improves the Severity Diagnostic Accuracy of Magnetic Resonance Imaging for Lateral Epicondylitis

by Kazuhiro Ikeda, Takeshi Ogawa, Akira Ikumi, Yuichi Yoshii, Sho Kohyama, Reimi Ikeda and Masashi Yamazaki

Diagnostics 2022, 12(8), 1871; https://doi.org/10.3390/diagnostics12081871 - 2 Aug 2022

Cited by 5 | Viewed by 3448

Abstract

The effectiveness of magnetic resonance imaging for diagnosing lateral epicondylitis severity is controversial. We aimed to verify whether individual evaluations of the common extensor tendon and lateral collateral ligament would improve the severity diagnostic accuracy of magnetic resonance imaging for lateral epicondylitis. We [...] Read more.

The effectiveness of magnetic resonance imaging for diagnosing lateral epicondylitis severity is controversial. We aimed to verify whether individual evaluations of the common extensor tendon and lateral collateral ligament would improve the severity diagnostic accuracy of magnetic resonance imaging for lateral epicondylitis. We obtained coronal images of the lateral elbow in three groups: healthy, clinically mild, and clinically severe. We used our scoring system for evaluation using combined and individual methods. We developed the receiver operating characteristic curve for diagnosis using the scores of the healthy and mild groups and that for severity diagnosis using the scores of the mild and severe groups. The scores, in decreasing value, were those of the severe, mild, and healthy groups, with a significant difference in both methods. The curve for diagnosis showed an area under the curve of 0.85 for the combined evaluation and 0.89 for the individual evaluation, without a significant difference between the methods (p = 0.23). The curve for severity diagnosis showed an area under the curve of 0.69 for combined and 0.81 for individual evaluation, with a significant difference between the methods (p = 0.046). Individual evaluation of the common extensor tendon and lateral collateral ligament improved the severity diagnostic accuracy of lateral epicondylitis. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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11 pages, 1197 KiB

Open AccessArticle

Morphological Parameters of the Hip Joint and Its Relation to Gender, Joint Side and Age—A CT-Based Study

by Thelonius Hawellek, Marc-Pascal Meier, Mark-Tilman Seitz, Johannes Uhlig, Ali Seif Amir Hosseini, Frank Timo Beil, Wolfgang Lehmann and Jan Hubert

Diagnostics 2022, 12(8), 1774; https://doi.org/10.3390/diagnostics12081774 - 22 Jul 2022

Cited by 3 | Viewed by 5371

Abstract

Background: Physiological reference values for morphological parameters of the hip (MPH) are of clinical importance for the treatment of painful, degenerated or fractured hip joints, as well as to detect morphological deformities, which could result in early osteoarthritis of the hip. Currently, [...] Read more.

Background: Physiological reference values for morphological parameters of the hip (MPH) are of clinical importance for the treatment of painful, degenerated or fractured hip joints, as well as to detect morphological deformities, which could result in early osteoarthritis of the hip. Currently, sufficient data for MPH are lacking. Therefore, it remains unclear if age-dependent alterations in adult hip morphology are physiological and if there are side- and gender-dependent differences. The aim of the study was to analyze MPH according to gender, side and age in a large-scaled cohort by CT scans. Methods: A total of 1576 hip joints from 788 patients (female: 257, male: 531; mean age: 58.3 years (±18.9; 18–92 years)) were analyzed by CT. For all hips, acetabular anteversion (AcetAV); lateral centrum edge angle (LCE); acetabular index (AI); femoral neck version (FNV); centrum-collum-diaphyseal angle (CCD); and anterior alpha angle (AαA) were measured. Results: The mean values in this cohort were: AcetAV 20.5° (±6.9); LCE 40.8° (±8.8); AI 0.3° (±5.3); FNV 11.0° (±9.8); CCD 129.9° (±7.4); and AαA 41.2° (±7.7). There was a detectable side-specific difference for AcetAV (p = 0.001); LCE (p < 0.001); CCD (p < 0.001); and AαA (p < 0.001). All the analyzed parameters showed a significant gender-specific difference, except for AI (p = 0.37). There was a significant correlation between age and AcetAV (r = 0.17; p < 0.001); LCE (r = 0.39; p < 0.001); AI (r = −0.25; p < 0.001); CCD (r = −0.15; p < 0.001); and AαA (r = 0.09; p < 0.001), except FNV (p = 0.79). Conclusions: There are side-, gender- and age-specific alterations in hip morphology, which have to be considered in treating hip joint pathologies. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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12 pages, 2829 KiB

Open AccessArticle

Morphological Analysis of the Tibial Slope in 720 Adult Knee Joints

by Marc-Pascal Meier, Yara Hochrein, Dominik Saul, Mark-Tilmann Seitz, Friederike Sophie Klockner, Wolfgang Lehmann and Thelonius Hawellek

Diagnostics 2022, 12(6), 1346; https://doi.org/10.3390/diagnostics12061346 - 28 May 2022

Cited by 1 | Viewed by 2869

Abstract

Background: The tibial slope (TS) defines the posterior inclination of the tibial plateau (TP). The “individual physiological” TS plays a crucial role in knee-joint stability and should be taken into account in knee-joint surgery. The aim of this study was to analyse [...] Read more.

Background: The tibial slope (TS) defines the posterior inclination of the tibial plateau (TP). The “individual physiological” TS plays a crucial role in knee-joint stability and should be taken into account in knee-joint surgery. The aim of this study was to analyse the specific morphology of the TS for the medial (med) and lateral (lat) TP in relation to patient characteristics and the measurement method. Methods: In this retrospective study, MRI images of knee joints from 720 patients (mean age: 49.9 years [±17.14]) were analysed. The TS was assessed using two established methods according to Hudek (TSH) and Karimi (TSK) for the med and lat TP and gender/side specificity was analysed. Results: TSH for the med and lat TP showed significantly (p < 0.001) different values compared to TSK (TSK_med: 2.6° (±3.7), TSH_med: 4.8° (±3.5); TSK_lat: 3.0° (±4.0), TSH_lat: 5.2° (±3.9)). The angles of the lat TP were significantly higher than those of the med TP (TSK: p < 0.001; TSH: p = 0.002). Females showed a higher med and lat TS compared to males (p < 0.001). Conclusions: The measurement method has an influence on the values of the TS in knee-joint MRIs. The TS is significantly different for the med and lat TP regardless of the measurement method. There are gender-specific differences for the TS. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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Review

Jump to: Research, Other

12 pages, 625 KiB

Open AccessReview

Addressing Challenges of Opportunistic Computed Tomography Bone Mineral Density Analysis

by Kirsten N. Bott, Bryn E. Matheson, Ainsley C. J. Smith, Justin J. Tse, Steven K. Boyd and Sarah L. Manske

Diagnostics 2023, 13(15), 2572; https://doi.org/10.3390/diagnostics13152572 - 2 Aug 2023

Cited by 4 | Viewed by 1849

Abstract

Computed tomography (CT) offers advanced biomedical imaging of the body and is broadly utilized for clinical diagnosis. Traditionally, clinical CT scans have not been used for volumetric bone mineral density (vBMD) assessment; however, computational advances can now leverage clinically obtained CT data for [...] Read more.

Computed tomography (CT) offers advanced biomedical imaging of the body and is broadly utilized for clinical diagnosis. Traditionally, clinical CT scans have not been used for volumetric bone mineral density (vBMD) assessment; however, computational advances can now leverage clinically obtained CT data for the secondary analysis of bone, known as opportunistic CT analysis. Initial applications focused on using clinically acquired CT scans for secondary osteoporosis screening, but opportunistic CT analysis can also be applied to answer research questions related to vBMD changes in response to various disease states. There are several considerations for opportunistic CT analysis, including scan acquisition, contrast enhancement, the internal calibration technique, and bone segmentation, but there remains no consensus on applying these methods. These factors may influence vBMD measures and therefore the robustness of the opportunistic CT analysis. Further research and standardization efforts are needed to establish a consensus and optimize the application of opportunistic CT analysis for accurate and reliable assessment of vBMD in clinical and research settings. This review summarizes the current state of opportunistic CT analysis, highlighting its potential and addressing the associated challenges. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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15 pages, 7436 KiB

Open AccessReview

Percutaneous CT-Guided Bone Biopsies: Indications, Feasibility and Diagnostic Yield in the Different Skeletal Sites—From the Skull to the Toe

by Paolo Spinnato, Marco Colangeli, Raffaella Rinaldi and Federico Ponti

Diagnostics 2023, 13(14), 2350; https://doi.org/10.3390/diagnostics13142350 - 12 Jul 2023

Cited by 7 | Viewed by 2180

Abstract

CT-guided bone biopsies are currently the diagnostic tool of choice for histopathological (and microbiological) diagnoses of skeletal lesions. Several research works have well-demonstrated their safety and feasibility in almost all skeletal regions. This comprehensive review article aims at summarizing the general concepts in [...] Read more.

CT-guided bone biopsies are currently the diagnostic tool of choice for histopathological (and microbiological) diagnoses of skeletal lesions. Several research works have well-demonstrated their safety and feasibility in almost all skeletal regions. This comprehensive review article aims at summarizing the general concepts in regard to bone biopsy procedures, current clinical indications, the feasibility and the diagnostic yield in different skeletal sites, particularly in the most delicate and difficult-to-reach ones. The choice of the correct imaging guidance and factors affecting the diagnostic rate, as well as possible complications, will also be discussed. Since the diagnostic yield, technical difficulties, and complications risk of a CT-guided bone biopsy significantly vary depending on the different skeletal sites, subdivided analyses of different anatomical sites are provided. The information included in the current review article may be useful for clinicians assisting patients with possible bone neoplasms, as well as radiologists involved in the imaging diagnoses of skeletal lesions and/or in performing bone biopsies. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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14 pages, 1998 KiB

Open AccessReview

Transcatheter Arterial Embolization for Alleviating Chronic Musculoskeletal Pain and Improving Physical Function: A Narrative Review

by Bow Wang, Keng-Wei Liang, Chia-Hui Chen and Chien-Kuo Wang

Diagnostics 2023, 13(1), 134; https://doi.org/10.3390/diagnostics13010134 - 30 Dec 2022

Cited by 8 | Viewed by 3721

Abstract

Chronic musculoskeletal pain imposes immense suffering and diminishes the quality of life for millions of patients worldwide; the pain persists despite the use of standard conservative treatments. Increases in our understanding of the pathophysiological mechanisms underlying musculoskeletal disorders indicate the involvement of inappropriate [...] Read more.

Chronic musculoskeletal pain imposes immense suffering and diminishes the quality of life for millions of patients worldwide; the pain persists despite the use of standard conservative treatments. Increases in our understanding of the pathophysiological mechanisms underlying musculoskeletal disorders indicate the involvement of inappropriate angiogenesis. Accordingly, the resulting neovessels are the target of emerging treatments for chronic musculoskeletal pain, including transarterial embolization. The use of this noninvasive procedure to treat pain refractory to standard therapy in a variety of musculoskeletal conditions is the focus of numerous recent investigations. Here, we describe the pathophysiological indications for the use of transarterial embolization and summarize the findings of studies investigating its use in a variety of histopathological conditions and anatomical sites. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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Other

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11 pages, 3694 KiB

Open AccessSystematic Review

Point-of-Care Ultrasound for the Evaluation and Management of Posterior Cruciate Ligament Injuries: A Systematic Review

by Anca Gabriela Stoianov, Jenel Marian Patrascu, Bogdan Gheorghe Hogea, Bogdan Andor, Sorin Florescu, Liviu Coriolan Misca, Ruxandra Laza, Roxana Manuela Fericean, Adelina Mavrea, Artiom Terzi and Jenel Marian Patrascu, Jr.

Diagnostics 2023, 13(14), 2352; https://doi.org/10.3390/diagnostics13142352 - 12 Jul 2023

Cited by 1 | Viewed by 1756

Abstract

Posterior cruciate ligament (PCL) injuries, though less common than other knee ligament injuries, pose significant management challenges. This study aimed to systematically review and analyze the current evidence on the use of point-of-care ultrasound (POCUS) for the evaluation and management of PCL injuries. [...] Read more.

Posterior cruciate ligament (PCL) injuries, though less common than other knee ligament injuries, pose significant management challenges. This study aimed to systematically review and analyze the current evidence on the use of point-of-care ultrasound (POCUS) for the evaluation and management of PCL injuries. It was hypothesized that POCUS has comparable diagnostic accuracy to magnetic resonance imaging (MRI) and that the use of POCUS improves patient outcomes and reduces healthcare costs. A comprehensive systematic review of articles published up to April 2023 was conducted using PubMed, Web of Science, Cochrane, and Scopus databases and adhered to the PRISMA guidelines. Studies were selected based on relevance to the research question, with a focus on diagnostic accuracy, reliability, clinical utility, and cost-effectiveness of POCUS in PCL injuries. Seven studies, analyzing a total of 242 patients with PCL injuries, were included. The reported sensitivity and specificity of POCUS for diagnosing PCL injuries ranged from 83.3% to 100% and 86.7% to 100%, respectively, across the studies. In one study, POCUS demonstrated a positive predictive value (PPV) of 87.9% and a negative predictive value (NPV) of 82.4%. Additionally, three studies reported 100% accuracy in PCL injury detection using POCUS, suggesting a substantial potential for cost savings by eliminating the need for MRI. This systematic review supports the use of POCUS in the evaluation and management of PCL injuries, suggesting that POCUS is a reliable, cost-effective tool with high diagnostic accuracy comparable to that of MRI, offering the potential to improve patient outcomes and reduce healthcare costs. The data collated in this review can inform clinical practice and guide future research in the field. Full article

(This article belongs to the Special Issue Recent Advances in Bone and Joint Imaging)

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