Bone age assessment is essential in evaluating pediatric growth disorders. Artificial intelligence (AI) systems offer potential improvements in accuracy and reproducibility compared to traditional methods. To compare the performance of a commercially available artificial intelligence-based software (BoneView BoneAge, Gleamer, Paris, France) against two human-assessed methods—the Greulich-Pyle (GP) atlas and Tanner-Whitehouse version 2 (TW2)—in a pediatric population. This proof-of-concept study included 203 pediatric patients (mean age, 9.0 years; range, 2.0–17.0 years) who underwent hand and wrist radiographs for suspected endocrine or growth-related conditions. After excluding technically inadequate images, 157 cases were analyzed using AI and GP-assessed methods. A subset of 35 patients was also evaluated using the TW2 method by a pediatric endocrinologist. Performance was measured using mean absolute error (MAE), root mean square error (RMSE), bias, and Pearson’s correlation coefficient, using chronological age as reference. The AI model achieved a MAE of 1.38 years, comparable to the radiologist’s GP-based estimate (MAE, 1.30 years), and superior to TW2 (MAE, 2.86 years). RMSE values were 1.75 years, 1.80 years, and 3.88 years, respectively. AI showed minimal bias (–0.05 years), while TW2-based assessments systematically underestimated bone age (bias, –2.63 years). Strong correlations with chronological age were observed for AI (r=0.857) and GP (r=0.894), but not for TW2 (r=0.490). BoneView demonstrated comparable accuracy to radiologist-assessed GP method and outperformed TW2 assessments in this cohort. AI-based systems may enhance consistency in pediatric bone age estimation but require careful validation, especially in ethnically diverse populations.

Fractures are one of the most common reasons of admission to emergency department affecting individuals of all ages and regions worldwide that can be misdiagnosed during radiologic examination. Accurate and timely diagnosis of fracture is crucial for patients, and artificial intelligence that uses algorithms to imitate human intelligence to aid or enhance human performs is a promising solution to address this issue. In the last few years, numerous commercially available algorithms have been developed to enhance radiology practice and a large number of studies apply artificial intelligence to fracture detection. Recent contributions in literature have described numerous advantages showing how artificial intelligence performs better than doctors who have less experience in interpreting musculoskeletal X-rays, and assisting radiologists increases diagnostic accuracy and sensitivity, improves efficiency, and reduces interpretation time. Furthermore, algorithms perform better when they are trained with big data on a wide range of fracture patterns and variants and can provide standardized fracture identification across different radiologist, thanks to the structured report. In this review article, we discuss the use of artificial intelligence in fracture identification and its benefits and disadvantages. We also discuss its current potential impact on the field of radiology and radiomics.

In the last few years CBCT’s applications have expanded, especially in the field of musculoskeletal. In this study, we aim to analyze the diagnostic value and the use of CBCT in Emergency Radiology for the evaluation of extremity trauma. The present retrospective study included a total of 72 distal limb trauma cases who were admitted in the Emergency Radiology Department of “Policlinico Riuniti di Foggia” during September 2022 to December 2023. All the cases required further medical diagnostic investigation after an initial examination CR. Among these, 12 were excluded for suspected poly-traumas and MDCT was directly performed. Of the 60, divided into 2 groups, 42 had negative or non-diagnostic CR result, and CBCT was performed as second-level exam, 18 with a fracture confirmed by CR underwent CBCT for surgical planning. In the first group, 17 (40.5

CBCT is an imaging tool represented by an X-ray computed tomography delivering a conic-shape X-rays source. This system produces volumetric data during a single rotation of both X-ray beam and detector around the stationary patient. CBCT is able to produce three-dimensional images as for MDCT, however, accounting some advantages over it: lower radiation dose, faster volumetric dataset acquisition, higher spatial resolution and bone contrast. For these reasons, CBCT has recently been described and adopted for extremities imaging in orthopedics. Misinterpretation of fractures may determine a delayed treatment and poor outcome for patients treated in the ED. CBCT, by easily identifying occult cortical fractures and using a lower dose of radiation, is proposed as an alternative or supplement to direct radiograms, optimizing the cost-effectiveness ratio and limiting the number of unnecessary immobilizations. The first experiences document excellent performance of CBCT in emergency radiology departments, especially thanks to transverse imaging in trauma of the extremities.

This paper is a scientific contribution on basic safety standards, related to protection against hazards arising from exposure to ionizing radiation: medico-legal issues resulting from the research of the University of Campania and the study conducted by the Italian Society of Medical and Interventional Radiology are reported.

The history of the Italian medical imaging industry is a history of pioneering and excellence, but also of defeats and lost opportunities. The starting point of this story is the end of the last century and more precisely that day in 1896 when the image of a hand X-rayed by Röentgen was shown in a public meeting. The image was approximate, but the diagnostic and therapeutic perspectives offered by the new technology were quickly understood in both the medical and industrial sectors. This narrative review summarizes a quarter of a century of evolution, a period of strong growth stimulated by competition with the overseas companies.

This paper is a scientific contribution on basic safety standards, related to protection against hazards arising from exposure to ionizing radiation: medico-legal issues resulting from the research of the University of Campania and the study conducted by the Italian Society of Medical and Interventional Radiology are reported.

The development of new ultra-high-frequency devices with a resolution of 30 μm makes it possible to use ultrasound in the study of new small anatomical units and to apply this tool to new fields of pathology. Cutaneous melanoma is a severe skin disease with an incidence of approximately 160 000 new cases each year and 48 000 deaths. In this paper, we evaluate the role of HFUS in the diagnosis of cutaneous melanoma, describe the sonographic appearance of skin layers in the pre-excision phase as well as of lesion features, and correlate the characteristics with pathological examination.

Musculoskeletal ultrasound involves the study of many superficial targets, especially in the hands, wrists, and feet. Many of these areas are within the first 3 cm of the skin surface and are ideal targets for ultra-high-frequency ultrasound. The high spatial resolution and the superb image quality achievable allow foreseeing a wider use of this novel technique, which has the potential to bring innovation to diagnostic imaging.

Ischemic colitis represents the most frequent form of intestinal ischemia occurring when there is an acute impairment or chronic reduction in the colonic blood supply, resulting in mucosal ulceration, inflammation, hemorrhage and ischemic necrosis of variable severity. The clinical presentation is variable and nonspecific, so it is often misdiagnosed. The most common etiology is hypoperfusion, almost always associated with generalized atherosclerotic disease. The severity ranges from localized and transient ischemia to transmural necrosis of the bowel wall, becoming a surgical emergency, with significant associated morbidity and mortality. The diagnosis is based on clinical, laboratory suspicion and radiological, endoscopic and histopathological findings. Among the radiological tests, enhanced-CT is the diagnostic investigation of choice. It allows us to make the diagnosis in an appropriate clinical setting, and to define the entity of the ischemia. MR may be adopted in the follow-up in patients with iodine allergy or renal dysfunctions, or younger patients who should avoid radiological exposure. In the majority of cases, supportive therapy is the only required treatment. In this article we review the pathophysiology and the imaging findings of ischemic colitis.

The treatment of chronic wrist pain, due to posttraumatic, degenerative, or inflammatory arthritis, is challenging to adequately manage. The ideal surgical procedure should preserve wrist mobility and provide long-lasting pain relief. In this regard, denervation aims to decrease wrist pain by interrupting sensory innervation, without impairing motor function, and avoids the need for postoperative immobilization to decrease the risk of stiffness. For these reasons, denervation is particularly attractive as a possible treatment for chronic wrist pain. Our aim was to describe our novel technique for partial percutaneous wrist denervation, performed by radiofrequency ablation of the posterior and anterior interosseous nerves, and to report on the prospective outcomes over a 1-year follow-up for 3 patients (4 wrists) treated as of March 2019. The technique is performed on an outpatient basis and does not require postprocedure wrist immobilization or restriction in activities of daily living or work. Findings at the 1-year follow-up indicate that partial denervation improved grip strength, provided pain relief, maintained wrist motion, and improved subjective report of disabilities of the arm, shoulder, and hand. One patient did not report a benefit of the procedures, with other patients being very satisfied. Our percutaneous procedure is an evolution of the traditional partial denervation technique, providing advantages of being less invasive, not requiring restriction of movement or activities in the postoperative phase, can be performed on an out-patient basis, and does not preclude the subsequent use of invasive surgical procedures, as needed.

Pelvic floor dysfunctions embrace a large series of different conditions in which functional abnormalities of the pelvic floor lead to impairment in urinary and sexual functions and in rectal voiding. A multidisciplinary approach is needed in the evaluation of these patients, as well as the adoption of imaging studies adequate to explore the complex anatomy of the region and its dynamic functionality. Available imaging studies include: endoanal and transperineal ultrasound, X-ray defecography and MR defecography. The purpose of this review article is to illustrate the technique, indications, the current role, and diagnostic value of each one of these. The recent availability of new imaging techniques and related advantages will also be discussed.

The pathogenesis of acute ischaemic colitis depends on two different forms of vascular colonic insult: occlusive injury and non-occlusive injury. Clinically, ischaemic colitis may be classified as two major forms: mild (non-gangrenous) and acute fulminant (gangrenous). The classic presentation is abdominal pain, diarrhoea and/or rectal bleeding, but it is not specific and highly variable and so the diagnosis usually depends on clinical suspicion and is supported by serologic and colonoscopic findings. Imaging methods have their role in diagnosing IC. While plain radiography and ultrasound can orient the diagnosis, CT allows to define the morphofunctional alterations discriminating the non-occlusive forms from the occlusive forms and in most cases to estimate the timing of ischaemic damage. Purpose of the review is to define the role of CT in the early identification of pathological findings and in the definition of evolution of colonic ischaemic lesions, in order to plan the correct therapeutic approach, suggesting the decision of medical or surgical treatment.

Radiography remains the imaging standard for fracture detection after trauma. The radiographic diagnosis of most fractures and dislocations poses little difficulty to radiologists: however, occasionally these injuries are quite subtle or even impossible to detect on radiographs. Missed diagnoses of fracture potentially have important consequences for patients, clinicians, and radiologists. Radiologists play a pivot role in the diagnostic assessment of the trauma patients: emergency radiologists who are more practiced at seeking out and discerning traumatic fractures can provide an invaluable service to their clinical colleagues by ensuring that patients do not endure delayed diagnoses. This is a narrative review article aims to highlight the spectrum of fractures in adults potentially missed on plain radiographs, the causes of error in diagnosis of fractures in the emergency setting and the key elements to reduce misdiagnosis of fractures.

To create an animal model of acute renal ischemia induced by systemic hypoperfusion, controllable and reproducible to study, in real time, hemorrhagic shock changes with micro-imaging.

Scapular fractures are one of the most difficult fractures to diagnose on radiographs. Detection can be challenging because of the obscuration by the overlying structures or incomplete imaging due to difficult patient collaboration. Familiarity with imaging characteristics of these abnormalities will allow radiologists to better diagnose and characterize scapular fractures. Three-dimensional computed tomographic scans are considered the gold standard for scapular diagnoses. Treatment strategies differ depending on the type of scapular fractures, but the site and degree of displacement will determine whether surgical intervention should be considered. Complications can occur in fractures that are undiagnosed or improperly evaluated. The purpose of this article is to describe imaging features of traumatic scapular injury, and discuss the role of diagnostic imaging in clinical decision making after shoulder trauma.

Among patients admitted in emergency departments for acute cervical spine trauma, only a few have a confirmed and significant injury requiring surgical intervention. Imaging plays a key role in screening for unstable lesions that can be responsible for devastating neurologic complications or death. The complex anatomy of the cervical spine is associated with a wide spectrum of osseous and ligamentous pathologies. This review focuses on the imaging features of the main cervical spine fractures that can be encountered in emergency radiology.

More than two million people tear their anterior cruciate ligament (ACL) each year, and ACL reconstruction occupies a significant proportion of everyday orthopedic practice, being one of the most commonly performed sports medicine surgical procedures. Patients with postoperative symptoms are frequently imaged to monitor ligament grafts and to identify complications. Given the number of patients undergoing ACL reconstruction, knowledge of the potential complications of this surgery is essential for radiologists. This article provides a review of imaging of ACL reconstruction procedures and the potential complications specific to this surgery.