The development of musculoskeletal radiology for 100 years as presented in the pages of Acta Radiologica.

During the last 100 years, musculoskeletal radiology has developed from bone-only radiography performed by everyone to a dedicated subspecialty, still secure in its origins in radiography but having expanded into all modalities of imaging. Like other subspecialties in radiology, it has become heavily dependent on cross-sectional and functional imaging, and musculoskeletal interventions play an important role in tumor diagnosis and treatment and in joint diseases. All these developments are reflected in the pages in Acta Radiologica, as shown in this review.

The classic: Radiography of the trapeziometacarpal joint. Degenerative changes of this joint. 1936.

This classic article is a translation and reprint (Appendix 1. Supplemental material is available with the online version of CORR.) from the French of the original article by M. Robert, entitled La radiographie de l'articulation trapézo-métacarpienne. Les arthroses de cette jointure. The original article was published in Société de Radiologie Méd de France, Bulletins.1936;24:687-689. (Reproduced with kind permission of the SFR.).

The history of clinical musculoskeletal radiology.

The discipline of musculoskeletal radiology has evolved into a major imaging subspecialty in the years since the first use of x-rays to diagnose fractures. Musculoskeletal radiology expertise has experienced enormous developments in diagnostic sensitivity and specificity and in image-guided treatment options, in addition to technologic advances far beyond x-rays. Advances in cross-sectional imaging such as CT and MR imaging and educational and research endeavors have contributed further to the growth of musculoskeletal radiology as a distinct subspecialty.

Conventional radiography in musculoskeletal imaging.

Conventional radiography in musculoskeletal imaging has a venerable past. This article outlines the development of radiographic techniques. It then discusses the continuing advantages of conventional radiography in many specific circumstances and acknowledges the circumstances in which CT, MRI, ultrasound, and nuclear imaging are more useful modalities.

History of arthrography.

Arthrography has evolved during the last century from crude techniques with postprocedural radiographic imaging to modern CT and MR arthrographic techniques. Arthrography saw its widest use in the 1960s and 1970s, but indications for its use in many joints decreased significantly after the introduction of cross-sectional imaging modalities such as CT and MR imaging. Arthrography continues to provide valuable anatomic information about the joints and provides accurate depiction of internal derangement.

Eugen Bircher (1882-1956) the first knee surgeon to use diagnostic arthroscopy.

Eugen Bircher was a strong advocate of diagnostic arthroscopy as shown in several papers on the topic of internal derangements of the knee published between 1921 and 1926. During that time, he performed about 60 endoscopic procedures, which usually preceded a meniscectomy. We believe that this was the first time arthroscopy was used in a large scale for clinical purposes. Bircher was the head surgeon of the busy provincial Aarau General Hospital, a right-wing politician, and a highly ranked army officer. His interest in knee surgery was supported by his friend Fritz Steinmann, who was the "man of the pin" and an early promoter of skeletal traction for fracture treatment. Bircher believed in the early surgical treatment of meniscal lesions and, later, in the reconstruction of cruciate ligament lesions. He used the Jacobaeus thoracolaparoscope for arthroscopy, but it had poor endoscopic qualities. The electric lamp at the tip of the optical device was not mechanically protected and was therefore endangered by every manipulation within the joint space. Also, the 90 degrees optical system delivered a dark image. By the late 1920s, Bircher had developed the technique of double-contrast arthrography, and he gave up endoscopy by 1930. In 1935, he left surgery and took a military command in the Swiss army; later he was a representative of the Farmers Party in the National Parliament until his death.