Highlights of the annual scientific meeting of the Society of Skeletal Radiology (SSR) 2019, Scottsdale, Arizona, USA.

Peer-reviewed abstracts presented at the 2019 Society of Skeletal Radiology (SSR) Annual Meeting were reviewed following oral presentation. Topics felt to be of potential interest to musculoskeletal (MSK) investigators and practicing clinicians are highlighted in this compilation and analysis of the meeting. New concepts regarding MSK imaging and intervention, MSK protocols and techniques, and quality improvement are included. ePoster highlights are also presented.

Standard and Advanced Imaging of Hip Osteoarthritis. What the Radiologist Should Know.

Osteoarthritis (OA) of the hip is caused by degeneration of articular cartilage and the underlying bone and can be divided into two types: primary (associated with advancing age) and secondary (subsequent to fractures, avascular necrosis, infection, developmental dysplasia, and femoroacetabular impingement). Radiography remains the first-line imaging modality for diagnosing and monitoring OA, due to its accessibility, low cost, and ease of interpretation. Kellgren-Lawrence and Tönnis classification systems are radiographic OA grading systems used primarily in research, and they reflect the degree of joint space narrowing, sclerosis, cysts, deformity of the femoral head and acetabulum, and osteophytes. Unenhanced computed tomography (CT) provides detailed visualization of the hip joint segments that may be difficult to appreciate on radiographs, such as the inferoposterior and posterolateral hip joint. CT arthrography, magnetic resonance imaging (MRI), and magnetic resonance arthrography with two-dimensional reconstructions can delineate labral abnormalities, cartilage lesions, and other intra-articular hip pathology. T2 and T2* mapping, delayed gadolinium-enhanced MRI of cartilage, T1rho, ultra-short echo time, and zero echo time are investigative MR techniques with promising evaluation of hip OA.

Postoperative Imaging of Sarcomas.

OBJECTIVE: The purpose of this article is to assist radiologists in developing an organized, systematic approach to imaging interpretation in the care of patients who have been surgically treated for sarcoma. CONCLUSION: Postoperative imaging interpretation of sarcoma can be complex and requires an organized, systematic approach that includes review of the patient's clinical and surgical history and pretreatment images to gain context for differentiating recurrence from time-dependent posttreatment changes.

Society of Skeletal Radiology 2017 annual meeting summary.

Peer-reviewed abstracts presented at the 2017 Society of Skeletal Radiology (SSR) Annual Meeting were reviewed following oral presentation. Topics felt to be of potential interest to musculoskeletal (MSK) investigators and practicing clinicians are highlighted in this compilation and analysis of the meeting. New concepts regarding MSK imaging and intervention, MSK protocols and techniques and quality improvement are included. ePoster highlights are also presented.

CT and MR Imaging of the Postoperative Ankle and Foot.

A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease. Appropriate use of surgical language in radiology reports is another important skill set to hone and is instrumental in providing a high-quality report to the referring surgeons. The pathophysiology of a myriad of surgical complaints, beginning from the Achilles tendon and concluding at the plantar plate, are presented, as are their common appearances at computed tomography and magnetic resonance imaging. Commonly encountered entities include Achilles tendon tear, spastic equinus, nonspastic equinus, talar dome osteochondral defect, tarsal tunnel syndrome, plantar fasciitis, pes planovalgus, pes cavovarus, peroneal tendinosis, lateral ligament complex pathology, Morton neuroma, plantar plate tear, and metatarsophalangeal joint instability. Computer-generated three-dimensional models are included with many of the procedures to provide a more global view of the surgical anatomy. Correlation with intraoperative photographs is made when available. When appropriate, discussion of postoperative complications, including entities such as infection and failure of graft integration, is presented, although a comprehensive review of postoperative complications is beyond the scope of this article. Notably absent from the current review are some common foot and ankle procedures including hallux valgus and hammertoe corrections, as these are more often evaluated radiographically than with cross-sectional imaging. ©RSNA, 2016.

Society of Skeletal Radiology 2016 Annual Meeting Summary.

Peer-reviewed abstracts presented at the 2016 Society of Skeletal Radiology (SSR) Annual Meeting were reviewed following oral presentation. Topics felt to be of potential interest to musculoskeletal (MSK) investigators and practicing clinicians are highlighted in this compilation and analysis of the meeting. New concepts regarding MSK imaging and intervention, MSK protocols and techniques, radiology education and quality improvement are included. ePoster highlights are also presented.

Society of Skeletal Radiology 2015 annual meeting summary.

Peer-reviewed abstracts presented at the 2015 Society of Skeletal Radiology (SSR) 38th Annual Meeting were reviewed following oral presentation. Topics felt to be of potential interest to musculoskeletal (MSK) investigators and practicing clinicians are highlighted in this compilation and analysis of the meeting. New concepts regarding MSK imaging and intervention, MSK protocols and techniques, and quality improvement are included. ePoster highlights are also presented.

Imaging of ankle replacements.

Significant innovations in the field of total ankle replacement surgery have occurred since the early disappointing experiences with first-generation devices. In recent years, total ankle arthroplasties are commonly placed in patients with end-stage ankle osteoarthrosis, supplanting ankle arthrodesis as the procedure of choice at some institutions. Careful clinical and preoperative radiographic evaluation is helpful to plan concomitant ligament release, ligament reconstruction, or osteotomy. Careful attention to radiographic signs of early hardware loosening or subsidence can prompt intervention while bone loss is still minimal, and computed tomography has an adjunct role in the evaluation of periprosthetic lucency and osteolysis.

Society of Skeletal Radiology 2014 annual meeting summary.

Peer-reviewed abstracts presented at the 2014 Society of Skeletal Radiology (SSR) annual meeting were reviewed following oral presentation. Topics felt to be of potential interest to musculoskeletal (MSK) investigators and practicing clinicians are highlighted in this compilation and analysis of the meeting. New concepts regarding MSK imaging and intervention, MSK protocols and techniques, radiology education and quality improvement are included. ePoster highlights are also presented.

Imaging algorithms for evaluating suspected rotator cuff disease: Society of Radiologists in Ultrasound consensus conference statement.

The Society of Radiologists in Ultrasound convened a panel of specialists from a variety of medical disciplines to reach a consensus about the recommended imaging evaluation of painful shoulders with clinically suspected rotator cuff disease. The panel met in Chicago, Ill, on October 18 and 19, 2011, and created this consensus statement regarding the roles of radiography, ultrasonography (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography. The consensus panel consisted of two co-moderators, a facilitator, a statistician and health care economist, and 10 physicians who have specialty expertise in shoulder pain evaluation and/or treatment. Of the 13 physicians on the panel, nine were radiologists who were chosen to represent a broad range of skill sets in diagnostic imaging, different practice types (private and academic), and different geographical regions of the United States. Five of the radiologists routinely performed musculoskeletal US as part of their practice and four did not. There was also one representative from each of the following clinical specialties: rheumatology, physical medicine and rehabilitation, orthopedic surgery, and nonoperative sports medicine. The goal of this conference was to construct several algorithms with which to guide the imaging evaluation of suspected rotator cuff disease in patients with a native rotator cuff, patients with a repaired rotator cuff, and patients who have undergone shoulder replacement. The panel hopes that these recommendations will lead to greater uniformity in rotator cuff imaging and more cost-effective care for patients suspected of having rotator cuff abnormality.

Osteochondral lesions of the elbow.

Osteochondral lesions of the elbow are injuries that disrupt the cartilage and subjacent bone, and they most commonly involve the capitellum. The staging, prognosis, and treatment of osteochondral lesions in the elbow are based on a combination of radiographic, magnetic resonance imaging, and arthroscopic findings. Radiographic staging includes the radiolucent, separation, and free (advanced) stages. MR imaging features of instability include cysts, osteochondral fracture, T2 hyperintense rim, subchondral plate defects, and fluid-filled osteochondral defects. Finally, arthroscopic grading of osteochondral lesions increases in severity based on findings of softened cartilage, cartilage fissuring, exposed bone, loose but nondisplaced fragments, and eventually displaced fragments resulting in intra-articular bodies. This pictorial review focuses on osteochondral lesions in the capitellum and trochlea including osteochondritis dissecans, Panner disease, and acute trauma.

Imaging of benign soft tissue tumors.

The evaluation of soft tissue tumors should be approached systematically, with careful assessment of the patient's age, clinical presentation, anatomical location of the mass, and MRI characteristics. The imaging evaluation of a suspected soft tissue mass begins with conventional radiography to exclude an underlying osseous lesion and assess for any lesional calcification. MRI is particularly useful in evaluating the signal intensity, enhancement pattern, and extent of soft tissue masses that can expand beyond fascial planes and involve the neurovascular bundle, joint, or bone. Among the common benign soft tissue tumors, a fairly definitive imaging diagnosis can be made in cases of lipoma, elastofibroma dorsi, hemangiomas, myositis ossificans, giant cell tumor of tendon sheath, and peripheral nerve sheath tumors. In the remaining cases, the differential diagnosis can be narrowed by knowing the patient's demographics and any associated syndromes, in conjunction with recognizing specific MRI features. Knowledge of the World Health Organization's tumor designations and the incidence of specific tumors based on patient age and anatomical location are vital tools for the interpreting radiologist.

Society of Skeletal Radiology 2013 Annual Meeting summary.

Peer-reviewed abstracts presented at the 2013 Society of Skeletal Radiology (SSR) Annual Meeting were reviewed following oral presentation. Topics felt to be of potential interest to musculoskeletal investigators and practicing clinicians are highlighted in this compilation and analysis of the meeting. New concepts regarding musculoskeletal and spine imaging and intervention, musculoskeletal protocols and techniques, radiology education, and quality improvement are included. ePoster highlights are also presented.

Society of Skeletal Radiology 2011 Annual Meeting.

Peer-reviewed abstracts presented at the 2011 Society of Skeletal Radiology (SSR) Annual Meeting were reviewed again following oral presentation. Topics representing new concepts, new or novel imaging techniques, and instructive case series involving the musculoskeletal system, felt to be of potential interest to investigators and practicing clinicians, have been highlighted in this compilation and analysis. ePoster highlights have also been submitted.

Imaging characteristics of benign, malignant, and infectious jaw lesions: a pictorial review.

OBJECTIVE: The purpose of this article is to describe the indications and appropriate imaging studies for various jaw tumors and tumorlike lesions, the imaging findings, the differential diagnosis, and appropriate treatment options. CONCLUSION: It is important for radiologists to recognize the indications and appropriate imaging studies for various jaw lesions. Radiography is typically used for first-line imaging. If necessary, it is followed by CT for evaluation of osseous lesions and MRI for characterization of soft-tissue lesions.

Postoperative tumor imaging.

Accurately interpreting the imaging findings in patients with prior musculoskeletal tumors can be difficult. Because most patients have anatomical changes related to surgery in addition to postradiation and postchemotherapy changes, the radiologist must systematically and critically evaluate all available radiographs, sonograms, computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography scans to best differentiate normal posttreatment changes from residual or recurrent musculoskeletal tumor. Comparison with presurgical and postsurgical imaging is very important to detect subtle nodular tumor recurrence. Because postoperative fluid collections are relatively common, the radiologist must be vigilant for any nodular-enhancing foci that are actually residual or recurrent tumor.

Society of Skeletal Radiology 2010 Annual Meeting.

Peer-reviewed abstracts presented at the 2010 Society of Skeletal Radiology (SSR) Annual Meeting were reviewed again following oral presentation. Topics representing new concepts, new or novel imaging techniques, and instructive case series involving the musculoskeletal system, felt to be of potential interest to investigators and practicing clinicians, have been highlighted in this compilation and analysis.

Imaging of the tendons about the pelvis.

OBJECTIVE: This article will review the normal anatomy of the pelvic tendons as well as abnormalities such as tendinopathy, partial- and full-thickness tendon tears, myotendinous injuries, snapping hip syndrome, osseous avulsive injuries at tendinous attachments, calcific tendinitis, and tumor. CONCLUSION: MRI and sonography are useful imaging methods to directly evaluate suspected abnormalities of the pelvic tendons, although tendinous mineralization and associated osseous injuries can also be detected with radiography and CT.