Internal Derangements of Joints—Past, Present, and Future

Abstract

The past 50 years have transformed imaging of the joints. Whereas musculoskeletal imaging consisted predominantly of conventional radiography when Investigative Radiology was founded as a journal, the arrival of new imaging modalities, and above all, the introduction of magnetic resonance imaging, resulted in a paradigm shift: In addition to visualizing osseous structures, now the detailed depiction of soft tissue structures became part of routine clinical imaging and had a major impact on understanding pathophysiology and patient treatment. This article analyzes the patterns of innovation that were essential for the transformation of musculoskeletal radiology. Furthermore, state-of-the-art joint imaging is described through 9 key concepts, including both cutting-edge clinical applications as well as topics at the forefront of musculoskeletal research. Eventually, emerging trends are outlined that will likely shape musculoskeletal radiology in the next decades. The past 50 years have transformed imaging of the joints. Whereas musculoskeletal imaging consisted predominantly of conventional radiography when Investigative Radiology was founded as a journal, the arrival of new imaging modalities, and above all, the introduction of magnetic resonance imaging, resulted in a paradigm shift: In addition to visualizing osseous structures, now the detailed depiction of soft tissue structures became part of routine clinical imaging and had a major impact on understanding pathophysiology and patient treatment. This article analyzes the patterns of innovation that were essential for the transformation of musculoskeletal radiology. Furthermore, state-of-the-art joint imaging is described through 9 key concepts, including both cutting-edge clinical applications as well as topics at the forefront of musculoskeletal research. Eventually, emerging trends are outlined that will likely shape musculoskeletal radiology in the next decades.

The Lisbon Agreement on Femoroacetabular Impingement Imaging—part 1: overview

“…Conjointly, radiographs and MRI are the standard imaging modalities used for diagnosing hip pathomorphology and planning treatment [13][14][15][16][17].…”

7 T Musculoskeletal MRI

“…17 Magnetic resonance images acquired at 1.5 Tor 3 Tallow the radiologist to visualize internal derangements of the knee in a similar way as is possible during open surgery or even autopsy. 18 Ex vivo histological studies and magnified views from arthroscopy allowed us to learn about the microanatomical structure of the menisci and the articular cartilage. However, current clinical MRI techniques fail to provide an equally reliable depiction of the musculoskeletal anatomy in vivo at the same resolution.…”

“… 17 Magnetic resonance images acquired at 1.5 T or 3 T allow the radiologist to visualize internal derangements of the knee in a similar way as is possible during open surgery or even autopsy. 18 …”

“…The joint most commonly evaluated with MRI is the knee: noncontrast 1.5 T and 3 T MRI have replaced diagnostic knee arthroscopy, which was still performed in large numbers at the beginning of this century in patients with unclear symptoms 17 . Magnetic resonance images acquired at 1.5 T or 3 T allow the radiologist to visualize internal derangements of the knee in a similar way as is possible during open surgery or even autopsy 18 …”

Imaging Methodology for Hip Preservation: Techniques, Parameters, and Thresholds

“…Presently, XR and MRI are the standard imaging modalities used for diagnosing hip impingement/instability, planning treatment, and outcome assessment. 7,8 Adequate preoperative characterization and assessment of the osseous morphology is of paramount importance to ensure optimal surgical outcomes for such populations. As an initial diagnostic clinical approach, anteroposterior (AP) pelvis and lateral hip radiographs 4 have traditionally been used and will continue to be (►Fig.…”