Background: Accurate hindfoot alignment (HA) assessment is essential for surgical planning of foot and ankle procedures, as measurement errors may lead to inappropriate indication. Weight-bearing computed tomography (WBCT) enables HA assessment through coronal images, typically aligned perpendicular to the second ray. However, this forefoot-based reference may not be appropriate in all clinical scenarios, particularly when isolated hindfoot evaluation is required. This exploratory study sought to evaluate how 3 anatomical reference axes affect HA measurements in patients with different foot deformities. Methods: This retrospective cohort study examined 136 WBCT and standard foot radiographs of patients older than 18 years. HA was measured as hindfoot alignment angle (HAA) in coronal images perpendicular to (1) second ray, (2) ankle mortise (bisection of medial and lateral malleoli), and (3) forefoot midpoint (bisection of first and fifth metatarsal heads). Meary, Sgarlato, hallux valgus, and intermetatarsal I-II and I-V angles assessed foot morphology. Spearman correlation analysis was performed to assess relationships between 2-dimensional (2D) parameters and HAA measurements. Results: Median age was 50.3 years and 64% were female. HAA showed significant variations across different reference systems (second ray: 10.0 degrees, ankle mortise: 15.2 degrees, forefoot midpoint: 12.7 degrees; P < .01), with 20.6% of feet showing a discrepancy exceeding 10 degrees between the second ray and ankle mortise. Spearman correlation analysis showed correlation between HAA and Meary angle across all reference axes (ρ = −0.58 to −0.49, P < .01), and between HAA and Sgarlato angle with second ray referencing (ρ = −0.41, P < .01). Conclusions: Reference axis selection substantially influences 2D HA measurements on WBCT. The ankle mortise reference could provide isolated measurement of HA regardless of concurrent forefoot deformities. When using 2D measurement methods, reference system selection could be tailored to whether surgical planning requires comprehensive foot alignment assessment or isolated hindfoot evaluation. Level of Evidence: Level III, retrospective cohort study.

OBJECTIVE:Photon-counting detector (PCD) computed tomography (CT) systems allow the reconstruction of virtual monoenergetic images (VMIs) from inherently available spectral data. However, qualitative and quantitative evaluations of VMI in combination with tin-prefiltration (Sn) and iterative metal artifact reduction (iMAR), as well as their comparison to energy-integrating detector (EID) CT, are limited; therefore, the objective was to compare their performance qualitatively and quantitatively in the setting of lumbar spine instrumentation. MATERIALS AND METHODS:Retrospectively, 100 clinical Sn CT scans after lumbar spine fusion surgery (50 EID and 50 PCD) were analyzed. Metal artifacts were quantitatively and qualitatively assessed in EID standard (EID std ), PCD standard (PCD std ), and PCD VMI at 120 keV (PCD VMI120 ), PCD iMAR (PCD iMAR ), and combined PCD VMI at 120 keV + iMAR (PCD VMI120+iMAR ). Regions of interest were placed in the most hyperdense and hypodense areas near metal artifacts, and the attenuation and SD/noise (SD) of Hounsfield Units (HU) were assessed as a quantitative artifact surrogate. For qualitative evaluation, 2 independent readers rated 6 image features on a 4-point Likert Scale. RESULTS:Seventy-four patients were included, of whom 26 underwent both an EID and a PCD CT. Radiation doses were significantly lower ( P < 0.01) for PCD CT [median CTDIvol of 6.4 mGy (4.6 to 8.4)] compared with EID CT [median CTDI vol of 12.5 mGy (11.1 to 13.7)]. Hypodense artifact attenuation was significantly reduced ( P < 0.01) with PCD iMAR (HU -260), PCD VMI120 (-176), and PCD VMI120+IMAR (-60) compared with EID std (-626). Hyperdense artifact attenuation was significantly reduced ( P < 0.01) in PCD VMI120 (HU 103) and PCD VMI120+IMAR (-1) compared with EID std (577). Qualitative artifact extent was rated significantly less severe in PCD iMAR and PCD VMI120+iMAR images compared with EID std ( P ≤ 0.01), while trabecular and cortical bone visibility was rated lower in PCD iMAR (2.73) and PCD VMI120 (2.63), P < 0.01, and lowest in PCD VMI120+iMAR (1.82) compared with EID std (3.19), P < 0.01. Significantly ( P < 0.01) more silhouette artifacts were present in the 100 kVp subgroup compared with the 140 kVp subgroup in PCD VMI120 and PCD VMI120+iMAR , and significantly ( P < 0.01) more dark zone artifacts in the PCD VMI120 series at 100 kVp compared with 140 kVp. CONCLUSION:PCD CT with VMI 120 or iMAR achieved artifact reduction comparable to EID CT for lumbar spine metal artifact reduction, at nearly half the radiation dose. Combining VMI120 + iMAR provided the strongest qualitative and quantitative artifact reduction, but at the cost of the lowest cortical and trabecular bone visibility. 140 kVp acquisitions should be favored over 100 kVp acquisitions in PCD to reduce the occurrence of "dark zone" and "silhouette artifacts", suggesting a fixed tube voltage instead of an automatic tube voltage setting in instrumented lumbar spine imaging. VMI reconstruction of tin-filtered lumbar spine CT effectively reduces metal artifacts, with PCD favored over EID for its inherent spectral capabilities and the potential for substantial dose reduction.

Abstract:Femoroacetabular impingement syndrome is a significant morphology-driven hip disorder in which abnormal osseous geometry and dynamic hip motion lead to intra- and/or extra-articular mechanical conflict. Repetitive impingement induces chondrolabral injuries, promoting early joint degeneration and representing a major pathway to osteoarthritis. Although cam and pincer morphologies and femoral torsion abnormalities are commonly observed on imaging, these features alone are not sufficient for diagnosis, requiring integration with clinical evaluation. Abstract:Imaging plays a pivotal role in assessing femoroacetabular impingement syndrome, from diagnosis to preoperative planning and postoperative follow-up. Conventional radiography remains indispensable for the primary assessment of hip morphology. Computed tomography provides high-resolution three-dimensional characterization of osseous structures and torsional alignment. Magnetic resonance imaging, including direct magnetic resonance arthrography and traction or position-specific protocols, allows detailed evaluation of chondrolabral lesions, cartilage integrity, and periarticular soft tissues. Quantitative cartilage imaging and three-dimensional modeling further enhance detection of early degeneration, motion-dependent impingement, and dynamic instability. Abstract:Accurate differentiation between impingement and instability is critical. Imaging findings guide planning, patient selection, and prognostication, supporting surgical interventions while minimizing risks. This review provides a structured overview of femoroacetabular impingement syndrome pathomechanics and imaging, highlighting conventional and advanced modalities, established and emerging diagnostic parameters, and their implications for patient-specific management.

To analyze pain relief for chronic coccydynia after CT-guided, pericoccygeal ropivacaine and triamcinolone injection over time and to investigate possible imaging predictors of successful and maintained pain relief. In this retrospective study, chronic coccydynia patients receiving CT-guided pericoccygeal injections with ropivacaine and triamcinolone were assessed for pain relief post-injection, using a numeric rating scale (NRS, 0–10) and percentage pain reduction (PPR,

Background The aim of this study was to investigate changes in hamstring architecture and size over a 4-year period, explore sex-specific differences, and examine associations with biological maturation in adolescent competitive alpine skiers.Materials and methods 59 competitive alpine skiers (27 females, 32 males; baseline age: 14.9 ± 0.7 years) competing at regional to national level were examined at baseline and follow-up. BMI was calculated and biological maturation estimated using the sex-specific Mirwald equation. Ultrasound imaging assessed biceps femoris long head architecture and maximal anatomical cross-sectional area (ACSAmax) of all hamstring muscles. ACL injuries were retrospectively recorded and verified using medical records and MRI. Participants were grouped as uninjured (n = 53) and ACL-injured (n = 6).Results Mixed ANOVA revealed significant main and interaction effects for hamstring muscle size, but not for architecture. Post hoc analyses showed that hamstring muscle size increased in both sexes (all p < 0.001), except for the semitendinosus in females (p = 0.499). Biological maturation was associated with changes in femur length (R² = 0.32, p < 0.001) and total hamstring muscle size (R² = 0.52, p < 0.001). As a secondary observation, female skiers who later sustained an ACL injury (n = 5) descriptively showed smaller semitendinosus size across both time points.Conclusions This study provides new insights into hamstring development in adolescent alpine skiers and highlights the role of biological maturation. Hamstring size increased, with greater hypertrophy in males. The smaller semitendinosus size in ACL-injured females may be relevant for injury prevention.

OBJECTIVE:To evaluate the impact of tin-filtered photon-counting detector (PCD) computed tomography (CT) in combination with high-energy virtual monoenergetic imaging (VMI) and iterative metal artifact reduction (iMAR) on metal artifact reduction, image quality, and assessment of intragraft and extragraft bone fusion, in patients after anterior cervical discectomy and fusion (ACDF). MATERIALS AND METHODS:Patients who underwent ACDF and postoperative tin-filtered PCD-CT between 2023 and 2026 were retrospectively analyzed. Metal artifacts were quantitatively and qualitatively assessed in standard polychromatic (T3D), iMAR (T3DiMAR), VMI at 120 keV (VMI120), and combined VMI120 + iMAR (VMI120+iMAR) reconstructions. Quantitative analysis included measurement of hypodense and hyperdense artifact attenuation and corrected noise. Three musculoskeletal radiologists independently scored 5 imaging features on 4-point Likert scales and assessed the presence of secondary artifacts. Subgroup analyses were performed for polyetheretherketone (PEEK)-tantalum versus titanium cages and for 140 versus 100 kVp acquisitions. RESULTS:Forty-four patients (23 with PEEK-tantalum cages, 21 with titanium cages) were included. VMI120+iMAR achieved the strongest metal artifact reduction with hypodense artifacts from -362.5 Hounsfield Units (HU) to -38 HU and hyperdense artifacts from 218.5 to 83.5 HU, as well as significant noise improvements compared with T3D (all P<0.001); effects were most pronounced near titanium cages. T3DiMAR provided comparable artifact reduction to VMI120+iMAR in PEEK-tantalum cages (P=0.55 to 0.83) but inferior artifact reduction in titanium cages (P<0.001). Bone-metal interface conspicuity improved significantly with VMI120 and VMI120+iMAR (P≤0.01). Intragraft and extragraft bone fusion visibility was rated highest with standard T3D images (median 3 to 4), whereas the most pronounced impairments were observed for VMI120+iMAR (median 2 to 3, P≤0.01). iMAR-based techniques introduced secondary artifacts, including pseudo-osteolysis (20.5% to 38.6%), and white zone artifacts (50% to 56.8%), while dark zone and silhouette artifacts were less common (4.5% to 6.8%). White zone artifacts were significantly more frequent at 140 versus 100 kVp (P<0.05), while dark zone and silhouette artifacts were exclusively observed at 100 kVp. Inter-reader agreement was substantial to almost perfect (κ=0.62 to 0.94). CONCLUSIONS:Tin-filtered PCD-CT with VMI120+iMAR offers the most effective metal artifact reduction after ACDF and improves bone-metal interface conspicuity, particularly near titanium cages, followed by T3DiMAR. However, these advanced reconstructions may impair diagnostic accuracy for bone fusion assessment due to reconstruction-induced artifacts. iMAR-based reconstructions introduced pseudo-osteolysis that may simulate pseudoarthrosis, as well as white zone artifacts that may mimic false bony bridging in a material-dependent and kVp-dependent manner. Therefore, a reconstruction-specific approach is recommended for the clinical evaluation of ACDF patients, balancing metal artifact reduction against diagnostic reliability for bone fusion.

To evaluate the relationship between Pacinian corpuscle (PC) count on forefoot MRI in diabetic sensorimotor polyneuropathy (DSP) and large-fiber sensory dysfunction as quantified by nerve conduction studies (NCS). Thirty-nine patients with type 2 diabetes and neurologically confirmed DSP (mean age 67.9 ± 13.5 years; 29 males) underwent forefoot MRI and NCS, including compound muscle and sensory nerve action potentials (cMAP, sNAP) and conduction velocities of tibial, peroneal, and sural nerves. PC counts were assessed in the subcutaneous and deep regions of each digit. Spearman’s rank correlation analysis examined the relationship between total PC counts and sural sNAP amplitudes. Based on motor and sensory amplitudes and age-adjusted conduction velocities of NCS, 10 patients were classified as having mild-to-moderate DSP, and 29 as having severe DSP. Severe DSP was associated with sensory large-fiber impairment, with 86.1

To compare diagnostic performance of four radiomics-based machine learning models for detecting Modic type 1-changes of the lumbar spine in photon-counting detector (PCD)-CT images, using MRI as the reference standard. In this retrospective single-center study, 60 patients who underwent lumbar spine PCD-CT and MRI within a one-week interval showing Modic type 1-changes were analyzed. A total of 105 radiomic features were extracted from 360 segmented vertebrae, of which 348 were included in the final analysis after quality control. Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest, Extreme Gradient Boosting (XGBoost), and support vector machines (SVM) were trained and evaluated using nested cross-validation. Discriminatory performance of the models was evaluated by area under the receiver operating characteristic curve (AUC). AUC values were compared using the DeLong Test with Benjamini–Hochberg correction to adjust for multiple testing. Diagnostic accuracy was assessed by calculating sensitivity, specificity and F1-score for each model. LASSO achieved the highest AUC (0.842, 95

To describe typical MRI findings 1 year after reverse total shoulder arthroplasty (rTSA) implantation. Metal artifact reduction (MARS) MRI including CSSEMAC techniques was prospectively acquired in N = 25 consecutive patients (18/25 female; 61–80 years) 1 year after rTSA. MRI findings of bone and soft tissue and artifact reduction were assessed semi-quantitatively. Clinical Constant-Murley scores (CMS) were obtained, including its subscores pain, activities-of-daily-living (ADL), range-of-motion (ROM), and strength. Preoperative MRI was available in 13/25 subjects. Statistical analyses included descriptive statistics, Spearman correlations, nonparametric tests, and multivariable regression models. MARS MRI of rTSA showed overall good image quality. Subacromial edema (88

OBJECTIVES:To apply compressed sensing (CS) PETRA sequence to MRI near metallic implants, and to investigate the use of an extended phase encoding in csPETRA without significantly increasing the total acquisition time. MATERIALS AND METHODS:Using a 3D realistic model of an orthopedic implant, csPETRA with regular and extended phase encoding was simulated. csPETRA protocols with phase-encoded samples covering from 3.2% to 6.5% of k-space were prepared with a total acquisition time of up to 7±1 minutes and compared to a TSE sequence with VAT and SEMAC in grid phantoms with 3 different total knee arthroplasty implants. In vivo measurements on a patient with a wrist implant and a patient with a knee prosthesis were performed. Quantitative analysis based on the artifact size and qualitative comparison of the tested sequences are presented. RESULTS:In the csPETRA images, geometric distortions were reduced by 40% compared to those in the SEMAC-VAT images. A ratio of 6.5% for the central single-point imaging (SPI) coverage yielded a 20% improvement in artifact size compared to 3.2% coverage, and a 16-fold acceleration reduced the total scan time to 8 minutes. CONCLUSIONS:csPETRA with a higher SPI/radial ratio achieves a 20% reduction in artifact size relative to the minimum SPI/radial ratio, that is, conventional PETRA, without a time penalty. In addition, it reduces SAR by a factor of 2.5 compared to SE-based techniques. csPETRA should currently be regarded as a complementary research tool rather than a standalone clinical sequence, with potential niche applications such as high-resolution (0.5 mm isotropic) field mapping and implant assessment, or imaging patients with strict SAR or acoustic-noise constraints, while its clinical value requires further validation together with the development and evaluation of suitable soft-tissue contrast mechanisms.

BACKGROUND:Slice encoding for metal artifact correction (SEMAC) is used in MRI for total hip arthroplasties for metal artifact reduction. However, ripple artifacts often arise near the implant, impairing diagnosis in affected regions. HYPOTHESIS:Applying a wavelet domain filter (WD-Filter) might reduce ripple artifacts and improve image quality. STUDY TYPE:Retrospective. SUBJECTS:100 patients with primary total hip arthroplasty (female: 51, mean age: (64 ± 13) years; male: 49, mean age: (65 ± 13) years) who underwent clinically indicated MRI using compressed sensing SEMAC. FIELD STRENGTH/SEQUENCES:1.5 T; compressed sensing-accelerated turbo spin-echo (TSE)-based SEMAC sequence. ASSESSMENT:Three readers rated 250 ripple artifacts before and after applying the WD-filter. 4-point Likert scales were used for the intensity of ripple artifacts (Likert-RA, "none": 1, "mild": 2, "moderate": 3, "severe": 4) and the image quality (Likert-IQ, "poor": 1, "moderate": 2, "good": 3, "excellent": 4). The relative reduction of the signal intensity standard deviation ( Δ S D ROI $$ \Delta S{D}_{ROI} $$ ) was measured in a region of interest (ROI) containing the ripple artifact. STATISTICAL TESTS:Inter-reader agreement was assessed with Fleiss' kappa, with 95% confidence intervals. Differences between pre- and post-filter ratings (Likert-RA and Likert-IQ) were evaluated using the Wilcoxon signed-rank test, while Δ S D ROI $$ \Delta S{D}_{ROI} $$ was compared using a two-sided paired t-test. A p value of less than 0.05 indicated statistical significance. RESULTS:Prior to WD-Filter application, 122 ± 2 $$ \left(122\pm 2\right) $$ ripple artifacts were rated as "severe", 95 ± 3 $$ \left(95\pm 3\right) $$ as "moderate", and 32 ± 1 $$ \left(32\pm 1\right) $$ as "mild". After filtering, 168 ± 4 $$ \left(168\pm 4\right) $$ artifacts were rated as "none", and 82 ± 4 $$ \left(82\pm 4\right) $$ as "mild". Upon filter application, Likert-RA and Likert-IQ significantly improved from 3.4 ± 0.7 $$ \left(3.4\pm 0.7\right) $$ to 1.3 ± 0.5 $$ \left(1.3\pm 0.5\right) $$ and 1.4 ± 0.5 $$ \left(1.4\pm 0.5\right) $$ to 3.4 ± 0.6 $$ \left(3.4\pm 0.6\right) $$ , respectively, with a large effect size (r > 0.89) and "almost perfect" inter-rater agreement (kappa range: 0.86-0.96). The filtered images showed a significantly reduced Δ SD ROI $$ \Delta {\mathrm{SD}}_{\mathrm{ROI}} $$ compared to the unfiltered images (relative change: 19 % ± 10 % $$ \left(19\%\pm 10\%\right) $$ ). DATA CONCLUSION:The WD-Filter effectively reduced ripple artifacts in MRI of total hip arthroplasty and improved image quality. EVIDENCE LEVEL:3. TECHNICAL EFFICACY:Stage 3.

Objective: Photon-counting detector (PCD) computed tomography (CT) systems allow the reconstruction of virtual monoenergetic images (VMIs) from inherently available spectral data. However, qualitative and quantitative evaluations of VMI in combination with tin-prefiltration (Sn) and iterative metal artifact reduction (iMAR), as well as their comparison to energy-integrating detector (EID) CT, are limited; therefore, the objective was to compare their performance qualitatively and quantitatively in the setting of lumbar spine instrumentation. Materials and Methods: Retrospectively, 100 clinical Sn CT scans after lumbar spine fusion surgery (50 EID and 50 PCD) were analyzed. Metal artifacts were quantitatively and qualitatively assessed in EID standard (EID std ), PCD standard (PCD std ), and PCD VMI at 120 keV (PCD VMI120 ), PCD iMAR (PCD iMAR ), and combined PCD VMI at 120 keV + iMAR (PCD VMI120+iMAR ). Regions of interest were placed in the most hyperdense and hypodense areas near metal artifacts, and the attenuation and SD/noise (SD) of Hounsfield Units (HU) were assessed as a quantitative artifact surrogate. For qualitative evaluation, 2 independent readers rated 6 image features on a 4-point Likert Scale. Results: Seventy-four patients were included, of whom 26 underwent both an EID and a PCD CT. Radiation doses were significantly lower ( P < 0.01) for PCD CT [median CTDIvol of 6.4 mGy (4.6 to 8.4)] compared with EID CT [median CTDI vol of 12.5 mGy (11.1 to 13.7)]. Hypodense artifact attenuation was significantly reduced ( P < 0.01) with PCD iMAR (HU -260), PCD VMI120 (-176), and PCD VMI120+IMAR (-60) compared with EID std (-626). Hyperdense artifact attenuation was significantly reduced ( P < 0.01) in PCD VMI120 (HU 103) and PCD VMI120+IMAR (-1) compared with EID std (577). Qualitative artifact extent was rated significantly less severe in PCD iMAR and PCD VMI120+iMAR images compared with EID std ( P ≤ 0.01), while trabecular and cortical bone visibility was rated lower in PCD iMAR (2.73) and PCD VMI120 (2.63), P < 0.01, and lowest in PCD VMI120+iMAR (1.82) compared with EID std (3.19), P < 0.01. Significantly ( P < 0.01) more silhouette artifacts were present in the 100 kVp subgroup compared with the 140 kVp subgroup in PCD VMI120 and PCD VMI120+iMAR , and significantly ( P < 0.01) more dark zone artifacts in the PCD VMI120 series at 100 kVp compared with 140 kVp. Conclusion: PCD CT with VMI 120 or iMAR achieved artifact reduction comparable to EID CT for lumbar spine metal artifact reduction, at nearly half the radiation dose. Combining VMI120 + iMAR provided the strongest qualitative and quantitative artifact reduction, but at the cost of the lowest cortical and trabecular bone visibility. 140 kVp acquisitions should be favored over 100 kVp acquisitions in PCD to reduce the occurrence of “dark zone” and “silhouette artifacts”, suggesting a fixed tube voltage instead of an automatic tube voltage setting in instrumented lumbar spine imaging. VMI reconstruction of tin-filtered lumbar spine CT effectively reduces metal artifacts, with PCD favored over EID for its inherent spectral capabilities and the potential for substantial dose reduction.

OBJECTIVE:This study aimed to analyze knee MRI reporting templates among radiologists of the International Skeletal Society (ISS) and to determine standardized information in the form of common data elements. MATERIALS AND METHODS:A total of 510 radiologists, all members of the ISS, were invited to complete a survey and submit knee MRI reporting templates used in clinical practice. Each template was analyzed for structure and common data elements, as defined by the National Institutes of Health. Common data elements were classified as value list, text, or number. Multi-option value list elements were recoded into binary values. The results were aggregated to quantify the prevalence of individual common data elements and groups. RESULTS:A total of 73 of 510 (14%) invited ISS members completed the survey. Forty-one respondents (56%) reported using templates, whereas 32 (44%) did not. Thirty-nine respondents submitted 62 templates from 22 countries. Templates originated mainly from Europe (38%), North America (31%), and Asia (18%). Among respondents who submitted templates, 49% used highly structured templates, 33% intermediate-structure templates, and 18% low-structure templates. Most intermediate templates were anatomy-based (62%) rather than compartment-based (38%). A total of 507 common data elements were extracted, comprising 75% value list elements, 23% text elements, and 2% number elements. CONCLUSION:Knee MRI reporting in this sample of ISS respondents was not standardized, with only a slight majority reporting template use and substantial heterogeneity in template structure. The analysis identified essential and consistently reported items.

BACKGROUND:Current literature lacks consensus on managing latent unstable isolated syndesmotic injuries. Stability is considered a prerequisite for a good clinical outcome. But so far, it is unknown how stable isolated syndesmotic lesions heal after conservative and surgical treatment. PURPOSE:The purpose of this study was to retrospectively analyze patients with isolated Grade II syndesmotic lesions according to syndesmotic stability, structural changes and clinical outcome. And whether there is a difference between conservative and surgical treatment. STUDY DESIGN:Retrospective case-control study METHODS: A retrospective analysis of 20 patients (10 conservatively treated, 10 surgically treated) with isolated syndesmotic lesions was conducted, with a minimum 2-year follow-up. Evaluation included bilateral external torque CT for syndesmotic stability, MRI for ligament healing structural changes, and clinical examination with foot-specific patient-reported outcome measures (PROMs). RESULTS:Scarred syndesmosis demonstrated stability in external rotation, with non-significant changes compared to the healthy contralateral side: anterior distance (AD): 0.4 mm ±1.2 (p value 0.718), posterior distance (PD): -0.1 mm ±1.3 (p value 0.709), tibiofibular clear space (TCS): 0.3 mm ±0.8 (p value 0.321), external rotation (ER): 1.8 ° ±2.9 (p value 0.684). No statistically significant differences were observed between conservative and operative treatments regarding syndesmotic stability, structural changes, or clinical outcomes. CONCLUSION:Conservative and operative treatments for isolated Grade II syndesmotic lesions achieved comparable results in syndesmotic stability and healing.

The hip is a complex load-bearing joint susceptible to both acute traumatic and chronic overuse injuries. Traumatic injuries, such as acute fractures, dislocations, apophyseal avulsions, and muscle tears, typically follow high-energy events. In contrast, overuse injuries, for example, femoroacetabular impingement, stress fractures, labral degeneration, and greater trochanteric pain syndrome, arise gradually from repetitive mechanical overload. Early and accurate diagnosis requires a multimodal imaging approach: radiographs for baseline assessment, computed tomography for detailed osseous injury and alignment, magnetic resonance imaging and magnetic resonance arthrography for chondrolabral and soft tissue pathology, and ultrasound for dynamic evaluation of tendinous disorders. Understanding the mechanism, location, and severity of hip injuries is essential to guide prognosis, management, and prevention. This review provides a structured overview of traumatic and overuse hip injuries, highlighting imaging features that enable timely detection, precise characterization, and tailored interventions to optimize functional outcomes.

To validate the feasibility of a three-dimensional dual-echo-steady-state (3D-DESS) sequence at 7-T MRI to reliably depict the detailed anatomy in the cervical spine. Seventy-eight asymptomatic volunteers (age 36.4 ± 11.6 years) were imaged, using a 3D-DESS sequence at 7-T MRI. The course of the vertebral artery (VA) and the visualization of dorsal root ganglia (DRG) were analyzed by two fellowship-trained musculoskeletal radiologists. Additionally, degenerative changes were graded. Uncovertebral arthrosis was present in 47.4

To evaluate the impact of calcium suppression (CaSupp) imaging of spectral computed tomography (SpCT) on fracture detection in clinical routine in the acute trauma setting of the hand and wrist. Retrospective inclusion of 125 patients who underwent both X-ray and SpCT examinations of the hand and wrist in an acute trauma setting. Two independent readers evaluated fracture presence on X-ray, conventional CT, and conventional CT plus CaSupp images (time interval 4 weeks, each). Bone bruise (BBr) presence was evaluated on CaSupp images. Sensitivity and specificity were calculated according to the consensus reading as the reference standard. Of the 125 patients (mean age, 55 years ± 19.5 [SD]; 67 female), 120 presented with at least one fracture, for a total of 212 fractured bones. Sensitivity was increased significantly for both readers in CT + CaSupp (94.3 and 97.2

Background Pain drawing (PD) body charts are widely used in back pain research, but the representation of sex in these charts has not been systematically evaluated. Objective This study aims to evaluate sex representation in PD body charts used in back pain research, assess the perception of a newly designed sex-neutral body chart, and explore user preferences for sex representation in PD body charts. Methods We conducted a multimethod study comprising: (1) a scoping review to assess sex representation and the reporting of sex in PD body charts in back pain literature, (2) an expert opinion study where anatomy experts evaluated the perceived sex of extracted body charts, and (3) a survey among a representative sample of UK adults with and without back pain to assess the perception of a newly designed sex-neutral body chart and explore preferences for sex representation in PD body charts. Results From 349 full-text papers, 108 articles met the inclusion criteria. Most (103/108, 95.4%) did not report the sex of the body charts used, and only 5.6% (6/108) included both male and female charts. Experts showed fair to moderate agreement (Fleiss κ=0.306; Gwet AC1=0.456) in assessing the sex of charts, with most charts assessed as male based on majority ratings (59/108, 54.6%) and classified as male-biased relative to the sex distribution of study participants (76/108, 67.7%). The newly designed sex-neutral body chart was perceived as sex-neutral by 68.5% (204/298) of survey participants across diverse groups. However, perceptions varied by racial group: 73% (181/248) of White participants viewed it as sex-neutral, compared to 42.5% (17/40) of participants from smaller racial groups (χ²2=15.9; P=.001). Female participants slightly preferred female charts (85/154, 55.2%); male participants preferred sex-neutral ones (88/144, 61.1%). Nonetheless, most female participants (82/154, 53.3%) and male participants (107/144, 74.3%) considered the option to choose between male, female, and sex-neutral chart versions unimportant. Conclusions Our study reveals reporting gaps and a predominant male bias in the representation of sex in PD body charts used in back pain research. The newly developed sex-neutral body chart was widely perceived as sex-neutral, offering a promising step toward more inclusive pain assessment. However, variations in perception across racial groups highlight the need for cultural considerations in design. These findings underscore the potential of sex-neutral and culturally sensitive body charts to enhance the inclusivity and equity of back pain research and clinical practice.

To establish evidence-based consensus statements on imaging of scaphoid fractures. Nineteen hand surgeons formulated a preliminary list of eleven questions on imaging of scaphoid fractures. Based on this preliminary list, radiologists crafted statements considering literature and their clinical experience, then refined them through an iterative Delphi process to revise the questions and statements. A maximum of three Delphi rounds was scheduled until group consensus was achieved for an individual statement, whichever arose first. Twenty-eight radiologists drafted the statements and acted as Delphi panellists. Panellists rated their level of agreement with each statement on an 11-point numeric rating scale, the score ‘0’ indicated complete disagreement and the score ‘10’ indicated complete agreement, respectively. Group consensus was specified as a score of ‘8’ or higher for ≥ 23/28 panellists. Eight of eleven questions and statements achieved group consensus in the first Delphi round. The remaining three questions and statements achieved group consensus in the second Delphi round, indicating more controversial topics. It was agreed that radiographs are the initial imaging technique of choice for suspected scaphoid fractures. MRI or CT are advocated for suspected radiographically occult scaphoid fractures. CT is the method of choice for assessment of osseous consolidation. Contrast-enhanced MRI is the preferred imaging modality for assessing vascularisation of scaphoid nonunion. CT is the most valuable technique in the postoperative evaluation of scaphoid fractures. Delphi-based consensus statements suggest imaging pathways to diagnose scaphoid fractures, assess osseous fracture consolidation and evaluate pre- and postoperative fractures. Question How can an international and interdisciplinary team of hand surgeons and musculoskeletal radiologists develop practical consensus statements on imaging of scaphoid fractures? Findings All eleven statements achieved group consensus among experts using the Delphi technique for consensus-building. Imaging pathways were suggested to diagnose and assess scaphoid fractures. Clinical relevance statement International, interdisciplinary and evidence-based consensus statements on imaging of scaphoid fractures were achieved using the Delphi technique. The focus of the statements was to diagnose scaphoid fractures, assess osseous fracture consolidation and evaluate pre- and postoperative fractures.