Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2024: imaging immediately after neoadjuvant therapy in soft tissue sarcoma, soft tissue tumor surveillance, and the role of interventional radiology.

Objectives: An update of the first European Society of Musculoskeletal Radiology (ESSR) consensus on soft tissue tumor imaging in 2015 became necessary due to technical advancements, further insights into specific entities, and the revised WHO classification (2020) and AJCC staging system (2017). The third part of the revised guidelines covers algorithms and techniques beyond initial imaging: (1) Imaging after neoadjuvant therapy in soft tissue sarcoma, (2) sarcoma surveillance, and (3) special aspects, including surveillance of non-malignant entities and the role of interventional radiology.

Materials And Methods: A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries.

Soft tissue tumor imaging in adults: whole-body staging in sarcoma, non-malignant entities requiring special algorithms, pitfalls and special imaging aspects. Guidelines 2024 from the European Society of Musculoskeletal Radiology (ESSR).

Objectives: The revised European Society of Musculoskeletal Radiology (ESSR) consensus guidelines on soft tissue tumor imaging represent an update of 2015 after technical advancements, further insights into specific entities, and revised World Health Organization (2020) and AJCC (2017) classifications. This second of three papers covers algorithms once histology is confirmed: (1) standardized whole-body staging, (2) special algorithms for non-malignant entities, and (3) multiplicity, genetic tumor syndromes, and pitfalls.

Materials And Methods: A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries.

Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2023-overview, and primary local imaging: how and where?

Objectives: Early, accurate diagnosis is crucial for the prognosis of patients with soft tissue sarcomas. To this end, standardization of imaging algorithms, technical requirements, and reporting is therefore a prerequisite. Since the first European Society of Musculoskeletal Radiology (ESSR) consensus in 2015, technical achievements, further insights into specific entities, and the revised WHO-classification (2020) and AJCC staging system (2017) made an update necessary.

Complications of the Rigid Spine.

We present a short overview of the most common causes and imaging findings of a rigid spine including long-standing spondylarthritis, diffuse idiopathic skeletal hyperostosis, and the less common ossification of the posterior longitudinal ligament. The article also focuses on the pathogenesis and imaging findings of acute complications of the rigid spine due to fractures. These fractures may occur even after minor trauma and are difficult to detect on initial radiographs, resulting in a delayed diagnosis.

Interdisciplinary consensus statements on imaging of DRUJ instability and TFCC injuries.

Objectives: The purpose of this agreement was to establish evidence-based consensus statements on imaging of distal radioulnar joint (DRUJ) instability and triangular fibrocartilage complex (TFCC) injuries by an expert group using the Delphi technique.

Methods: Nineteen hand surgeons developed a preliminary list of questions on DRUJ instability and TFCC injuries. Radiologists created statements based on the literature and the authors' clinical experience.

Imaging of Lower Limb Tumors and Tumor-Like Conditions.

Bone and soft tissue lesions are frequently seen in the lower limbs. Many are non-neoplastic but may mimic tumours. In this article, we discuss a practical approach for the diagnosis and management of the most common tumours and tumour-like conditions seen in the lower limbs.

History Page: Leaders in MSK Radiology.

Charles Thurstan Holland was the first radiologist in the world and also the founder of the first radiology department. In the early days, radiographs were used primarily in the musculoskeletal system. Holland contributed significantly to the understanding of musculoskeletal radiology as seen on radiographs, including the appearance of ossification centers and accessory ossicles.

Neoplastic Elbow Diseases and Mimickers.

Tumors around the elbow are infrequent, and delayed diagnosis is a common theme because of the low incidence and lack of familiarity. However, just like any other site, the radiologic work-up of musculoskeletal tumors around the elbow remains the same, with plain films the first investigation in a patient with a suspected bone tumor and ultrasound the first modality to evaluate a soft tissue lump. The management of both bone and soft tissue tumors around the elbow is unique because of a large number of important structures in an anatomically confined space and little normal tissue to spare without severely compromising the joint's function.

Interdisciplinary consensus statements on imaging of scapholunate joint instability.

Objectives: The purpose of this agreement was to establish evidence-based consensus statements on imaging of scapholunate joint (SLJ) instability by an expert group using the Delphi technique.

Methods: Nineteen hand surgeons developed a preliminary list of questions on SLJ instability. Radiologists created statements based on the literature and the authors' clinical experience.

Imaging of Pediatric Bone Tumors and Tumor-like Lesions.

Bone lesions are commonly seen when reporting pediatric skeletal imaging. Distinguishing aggressive from nonaggressive lesions is essential in making the diagnosis. Not all aggressive lesions are neoplastic; indeed, osteomyelitis frequently presents with aggressive appearances and is far more commonly seen in the pediatric population than neoplastic lesions.

Imaging of Pediatric Soft Tissue Tumors and Tumor-like Conditions.

Lumps and bumps are frequently seen in children, and the vast majority are a result of trauma, infection, or inflammation. True soft tissue neoplastic lesions are rare; however, their wide and complex classifications make these lesions challenging to manage. Imaging features are usually nonspecific, and a reasonable list of differential diagnoses can be generated following consideration of the clinical presentation, age, and anatomical location of the lesion.

The Lisbon Agreement on Femoroacetabular Impingement Imaging-part 3: imaging techniques.

Objectives: Imaging diagnosis of femoroacetabular impingement (FAI) remains controversial due to a lack of high-level evidence, leading to significant variability in patient management. Optimizing protocols and technical details is essential in FAI imaging, although challenging in clinical practice. The purpose of this agreement is to establish expert-based statements on FAI imaging, using formal consensus techniques driven by relevant literature review.

The Lisbon Agreement on femoroacetabular impingement imaging-part 2: general issues, parameters, and reporting.

Objectives: Imaging assessment for the clinical management of femoroacetabular impingement (FAI) is controversial because of a paucity of evidence-based guidance and notable variability among practitioners. Hence, expert consensus is needed because standardised imaging assessment is critical for clinical practice and research. We aimed to establish expert-based statements on FAI imaging by using formal methods of consensus building.

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation.

Musculoskeletal (MSK) image-guided oncologic intervention is an established field within radiology. Numerous studies have described its clinical benefits, safety, cost effectiveness, patient satisfaction, and improved quality of life, thereby establishing image-guided oncologic intervention as a preferred pathway in treating patients presenting with specific benign MSK tumors. But there is a paradigm shift on the horizon because these techniques may also support established pillars (surgery, systemic treatment, radiotherapy) in the treatment of malignant MSK tumors.

Soft Tissue Sarcoma Follow-up Imaging: Strategies to Distinguish Post-treatment Changes from Recurrence.

Soft tissue sarcomas encompass multiple entities with differing recurrence rates and follow-up intervals. The detection of recurrences and their differentiation from post-therapeutic changes is therefore complex, with a central role for the clinical radiologist. This article describes approved recommendations.

Intraosseous lipomas originating from simple bone cysts.

Purpose: Fatty or part-fatty intraosseous lesions are occasionally encountered while imaging the skeletal system. A number of case reports have proposed involution of calcaneal bone cysts to intraosseous lipomas, but this has never been proven. This paper sets out to prove that simple bone cysts (SBCs) can involute to fatty lesions indistinguishable from intraosseous lipomas.

Stress Injuries of the Spine in Sports.

Spine sports stress injuries account for a significant amount of time loss at play in athletes, particularly if left unrecognized and allowed to progress. Spondylolysis makes up most of these stress injuries. This article focuses on spondylolysis, bringing together discussion from the literature on its pathomechanics and the different imaging modalities used in its diagnosis.