Semin Musculoskelet Radiol 2019; 23(03): 195-196
DOI: 10.1055/s-0039-1688713
Preface
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hip and Advanced MSK Imaging: A Voyage to the Unknown

Vasco V. Mascarenhas
1   MSK Imaging Unit (UIME), Imaging Center, Hospital da Luz, Lisbon, Portugal
,
Alberto Vieira
2   São João University Hospital, Porto Medical School - FMUP, Porto, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
04 June 2019 (online)

The current issue, on the topic “Hip and Advanced Musculoskeletal Imaging,” relates to the theme of the European Society of Musculoskeletal Radiology (ESSR) meeting in Lisbon, Portugal (June 26–29, 2019). The ESSR promotes research activities, educational programs, and a multitude of endeavors that support the advancement of musculoskeletal (MSK) imaging worldwide (www.essr.org).

Hip joint imaging has been a personal enthusiasm of ours in both research and clinical practice.[1] [2] It is our pleasure to present an issue on these topics with high-quality contributions from MSK radiologists and orthopaedic surgeons. These articles offer both an overview of current clinical perspectives and state-of-the-art imaging and also in-depth information of paramount significance for daily activities.

MSK radiology is a broad and substantially innovative specialty of imaging dedicated to understanding new pathologies, developing imaging techniques, and improving clinical practice/applications. Hip and advanced MSK imaging is presently in the spotlight, boosted by both new technical developments that deliver precise anatomical images and novel clinical conditions discovered in the past 2 decades,[3] such as the recognition of femoroacetabular impingement (FAI) as a cause of early-onset osteoarthritis.[4]

Identifying the clinical utility of such technologies in an era of rising health care costs is a significant challenge for MSK radiologists. Worldwide populations are continuing to age steadily. Therefore, the impact of hip-preserving surgery (HPS) and osteoarthritis on public health will be ongoing.[5] [6] Accordingly, precise knowledge of the full scope of hip pathology, from diagnosis and differentials to prognosis and treatment, is essential to fully address present-day clinical concerns. In fact, clinicians currently rely on state-of-the-art imaging to treat their patients adequately.

This issue presents 14 review articles on hip and advanced MSK imaging including a thorough assessment of hip pathology along with the exploration of novelties in the emerging field of artificial intelligence (AI). Literature/imaging reviews in tandem with the authors' personal experience will help readers put practical possibilities and limitations into perspective.

The first four articles focus on general topics pertaining to a practical approach of the hip and pelvis: sports, arthritis, intervention, and oncology reviews.

The next five articles focus on “hip” hip topics, from birth to developmental deterioration of the joint. With the acceptance of FAI and HPS ∼ 2 decades ago, a significant number of radiologists, orthopaedic surgeons, and sports physicians have implemented this concept in routine clinical practice.[5] [7] However, concerns have been raised about overdiagnosis and overtreatment of this entity.[7] Imaging and clinical evaluation are now established as the cornerstone in the evaluation of patients with suspected FAI.[8] These reviews look at the current state of FAI and HPS, both from a strict evidence-based point of view and also from the perspectives of radiologists and orthopaedic surgeons.

The final four articles address current concepts on some of the most advanced imaging techniques of MSK, from metal artifact reduction to whole-body MR imaging. Additionally, an overview of AI and specific MSK advancements that have driven recent enthusiasm offers a review of the current literature and examines the most likely ways that AI will shape MSK radiology in the coming years. AI will certainly expand opportunities for radiologists to participate in patient care both via improvements in imaging and extraction of useful data, and possibly also by optimizing the everyday workflow.[9]

Looking ahead, we hope this issue will become a valuable resource for your clinical work by deepening your knowledge of pathologic conditions of the hip along with a critical view of emerging technologies.

 
  • References

  • 1 Mascarenhas VV, Rego P, Dantas P. , et al. Hip shape is symmetric, non-dependent on limb dominance and gender-specific: implications for femoroacetabular impingement. A 3D CT analysis in asymptomatic subjects. Eur Radiol 2018; 28 (04) 1609-1624
  • 2 Mascarenhas VV, Rego P, Dantas P. , et al. Can we discriminate symptomatic hip patients from asymptomatic volunteers based on anatomic predictors? A 3-dimensional magnetic resonance study on cam, pincer, and spinopelvic parameters. Am J Sports Med 2018; 46 (13) 3097-3110
  • 3 Sutter R, Stoel BC, Buck FM. , et al. Internal derangements of joints—past, present, and future. Invest Radiol 2015; 50 (09) 601-614
  • 4 Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 2008; 466 (02) 264-272
  • 5 Sutter R, Pfirrmann CWA. Update on femoroacetabular impingement: what is new, and how should we assess it?. Semin Musculoskelet Radiol 2017; 21 (05) 518-528
  • 6 Mascarenhas VV, Rego P, Dantas P, Gaspar A, Soldado F, Consciência JG. Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects. Eur Radiol 2017; 27 (05) 2011-2023
  • 7 Mascarenhas VV, Rego P, Dantas P. , et al. Imaging prevalence of femoroacetabular impingement in symptomatic patients, athletes, and asymptomatic individuals: a systematic review. Eur J Radiol 2016; 85 (01) 73-95
  • 8 Mascarenhas VV, Caetano A. Imaging the young adult hip in the future. Ann Joint 2018; 3: 47-47
  • 9 Syed AB, Zoga AC. Artificial intelligence in radiology: current technology and future directions. Semin Musculoskelet Radiol 2018; 22 (05) 540-545