The role of radiology is well established in the diagnosis and management of musculoskeletal (MSK) problems. These include a spectrum of imaging modalities that are invaluable in diagnosing and evaluating response to the treatment. The anatomical and structural changes of the disease can be well delineated on imaging. Imaging also plays a significant role in guided intervention for diagnostic and therapeutic purposes. Early diagnosis of a disease helps to decrease morbidity and mortality.
Radiology has undergone considerable technological advances over time, and especially in the recent past. Radiographs, Ultrasound, Computed Tomography (CT) scan, and Magnetic Resonance Imaging (MRI) are the most common modalities that are used for MSK problems. These are extensively used in trauma, general and specialist orthopaedics, sports injuries, rheumatological diseases, spine diseases, bone and soft tissue sarcomas, and imaging-guided intervention. The increase in strength of MRI has resulted in a shift from arthrogram to non-arthrographic imaging due to increased spatial and contrast resolution. The ability to delineate smaller anatomical structures with high-resolution ultrasound and higher strength has enabled clinicians to diagnose pathologies that were not possible before. Utilisation of MARS (metal artefact reduction software) has decreased the artefact from metal-work which has been a common problem in orthopaedic imaging. Molecular imaging and fusion are increasingly being used for the diagnosis and management of orthopaedic conditions. Newer CT techniques of Dual Energy CT Scan (DECT) have come up with wide applications ranging from aiding in the diagnosis of gout to the use of the technology for reduction of metal-related artefacts that can be a problem when imaging metalwork with standard CT scan. Artificial Intelligence (AI) is increasingly being used in radiology which enables to increase the workflow, decrease radiological errors, and inturn improve patient care.
With the availability of a spectrum of modalities of imaging, the optimisation of the imaging modality is tailored to the clinical question which in certain circumstances would need a discussion with the radiologist. It is crucial for orthopaedic surgeons and rheumatologists to have a basic understanding of the imaging modalities, their applications, and newer developments in this field. The same principle applies to radiologists, who need to have a basic understanding of MSK diseases and their management. This is helpful in constructing a useful radiology report, tailoring the report, and using terminology which is useful to the clinicians. A clinical correlation of the radiological findings is essential to optimise patient management.
In this special issue on MSK radiology, there are a plethora of articles focussing on imaging updates of various pathologies – both diagnostic and intervention by eminent radiologists and orthopaedic surgeons from around the world. These include articles on spondyloarthropathy by Dr. Rennie and his team from Leicester, arthritis by Prof Iwona Sudoł-Szopińska.1 Articles on infection from Dr. Wilfred Peh, Singapore, and sports by Dr. Choudur are worth looking at too. Tumours can be a difficult topic but these have been covered extensively too.2 Artificial intelligence in radiology is the latest trend which has been written by Dr. Kharat and colleagues from Pune. A spectrum of radiology articles including Fusion imaging (PET MR) in OA written by Prof Vaishya and colleagues is an interesting one too.3 Articles on intervention by Dr. Ankur Goyal and co-workers from AIIMS have also been included. Newer entities like Iyengar Bothcu confluence and the importance of inversion in radiology have also been included in this special issue. There is a superb article by Dr. Iyengar and colleagues on what orthopaedic surgeons expect from a radiology report.4 We would like to thank all the authors, editorial team, reviewers, sponsors, and last but not least Prof. Raju Vaishya for their help and contribution to this special issue on MSK Radiology.
Funding
None.
Declaration of competing interest
None.
Contributor Information
Rajesh Botchu, Email: rajesh.botchu@nhs.net.
Harun Gupta, Email: harun.gupta@nhs.net.
References
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