Innovative Procedures

As this is being transcribed New Year's has just past. And if any of us had watched the various cable TV news shows, we would have heard the various authorities prognosticating about what the New Year will hold. The problem about prognostication is that there isn't an insignificant risk that you will be wrong. People will always remember when you are wrong rather than right. That being said, I will prognosticate. The future of bone radiology is bright. The field has rapidly evolved and progressed and has become a much closer collaborative adjunct to clinicians. In fact, one thing that has recently impressed me is how much young orthopedic surgeons in practice, having gotten used to working with good bone radiologists in the universities, desire that contact in a private practice setting. This is unique and relatively new to the field of musculoskeletal imaging.

I believe that the two most important areas of musculoskeletal imaging for the future will be functional imaging and image-guided procedures. Functional imaging has already been presented to you the reader in some detail in several recent issues of Seminars in Musculoskeletal Radiology. The current issue, edited by John Carrino, covers interventional musculoskeletal procedures. Not only is it appropriate to cover this topic in this time of evolution of musculoskeletal radiology but this journal has come full circle-the Volume 1 winter 1997 issue of Seminars in Musculoskeletal Radiology, guest-edited by Jean-Denis Laredo, concerned musculoskeletal procedures.

Both David and I have known John for many years. John is an excellent bone radiologist and is one individual in this country who has been “pushing the envelope” on musculoskeletal procedures. This issue is quite different than the issue published several years previously and so its title is different. The first word in the title is “innovative.” In fact the procedures covered are quite innovative. The first article covers bone augmentation; probably the musculoskeletal interventional procedure most in vogue. The second article covers intradiscal therapies, whose popularity has waxed and waned through the years but is currently on the upside with intense clinical interest. The third article covers thermal ablation of bone tumors. This, in combination with cryoablation, is often used in many institutions for nonresectable tumors, especially with metastatic disease. The next article covers the treatment of vascular anomalies, and the last article is probably the most innovative of the lot, covering magnetic resonance-guided musculoskeletal procedures, a topic that Dr. Carrino has extensive experience with at the Brigham and Women's Hospital in Boston.

So if I had to give my New Year's predictions for 2006 knowing that this issue will go to press halfway through the year, these innovative procedures will likely become less innovative over time as they become more widely accepted and performed. Musculoskeletal radiology divisions will not be considered totally functional unless they have strong procedural components. And we will see more development of specific procedural personnel in musculoskeletal imaging, some of whom will be coming from an osteoradiology background and some from an interventional radiology background. As with all predictions there's a good chance that I am wrong, and next time you see me you can chide me and point that out. That by no means diminishes the work that John Carrino and his colleagues have done, which stands alone by its excellence regardless of whether my predictions are correct or not.