The role of Artificial intelligence in the assessment of the spine and spinal cord.

Artificial intelligence (AI) application development is underway in all areas of radiology where many promising tools are focused on the spine and spinal cord. In the past decade, multiple spine AI algorithms have been created based on radiographs, computed tomography, and magnetic resonance imaging. These algorithms have wide-ranging purposes including automatic labeling of vertebral levels, automated description of disc degenerative changes, detection and classification of spine trauma, identification of osseous lesions, and the assessment of cord pathology. The overarching goals for these algorithms include improved patient throughput, reducing radiologist workload burden, and improving diagnostic accuracy. There are several pre-requisite tasks required in order to achieve these goals, such as automatic image segmentation, facilitating image acquisition and postprocessing. In this narrative review, we discuss some of the important imaging AI solutions that have been developed for the assessment of the spine and spinal cord. We focus on their practical applications and briefly discuss some key requirements for the successful integration of these tools into practice. The potential impact of AI in the imaging assessment of the spine and cord is vast and promises to provide broad reaching improvements for clinicians, radiologists, and patients alike.

VIDEO: Dynamic Ultrasound Evaluation for Soft-Tissue Injuries of the Extremities: Hand, Wrist, and Ankle.

OBJECTIVE. The purpose of this article is to show the sonographic anatomy of the extremities relevant to various ligamentous, tendinous, and articular injuries occurring in the hand, wrist, and ankle. A brief discussion and depiction of the specific elements relevant to the pathophysiologic mechanism of these entities is followed by demonstrations of the dynamic ultrasound techniques that can be used to diagnose these injuries. The schematics and video clips illustrate the normal and pathologic features of these injuries. The first two videos discuss soft-tissue injuries to the hand and wrist, and the third addresses ankle injuries. CONCLUSION. After clinical assessment, dynamic ultrasound examination is a useful tool for diagnosing and assessing the degree of severity of several soft-tissue injuries to the extremities, some of which can be detected only during active movement. Familiarity with these specific dynamic techniques will enhance the value of the ultrasound examination.

Supraspinatus Myotendinous Junction Injuries: MRI Findings and Prevalence.

OBJECTIVE: The purpose of this study is to describe the MRI findings and evaluate the prevalence of supraspinatus myotendinous injuries. MATERIALS AND METHODS: Among 1001 consecutive shoulders that underwent either conventional MRI or MR arthrography between January and December 2016, 843 shoulders were included. All MR images were retrospectively analyzed for identification and classification into the appropriate grade of acute or chronic rotator cuff myotendinous injuries. Other MRI findings, such as the presence of rotator cuff tendon insertional tears, and clinical information were also evaluated. RESULTS: At MRI, 0.47% (4/843) of shoulders had supraspinatus myotendinous injuries involving the anterior muscular bundle exclusively. Chronic grade III (n = 2), acute grade III (n = 1), and acute grade II (n = 1) injuries were identified in three men and one woman (mean age, 44 years) with a clinical history of trauma (n = 2) or of progressive shoulder pain (n = 2). A concurrent supraspinatus insertional tendon tear with either partial (n = 1) or full (n = 1) thickness was present in half the cases. Loss of tension of the myotendinous junction in grade III myotendinous junction injuries led to severe atrophy and fatty infiltration of the anterior supraspinatus. CONCLUSION: Supraspinatus myotendinous junction injuries are uncommon at MRI. These lesions invariably involve the anterior bundle of the supraspinatus muscle and may occur with a concomitant insertional tendon tear. High-grade chronic injuries lead to selective atrophy and fatty infiltration of the anterior supraspinatus muscle.

A practical guide for planning pelvic bone percutaneous interventions (biopsy, tumour ablation and cementoplasty).

Percutaneous approaches for pelvic bone procedures (bone biopsies, tumour ablation and cementoplasty) are multiple and less well systematised than for the spine or extremities. Among the different imaging techniques that can be used for guidance, computed tomography (CT) scan is the modality of choice because of the complex pelvic anatomy. In specific cases, such as cementoplasty where real-time evaluation is a determinant, a combination of CT and fluoroscopy is highly recommended. The objective of this article is to propose a systematic approach for image-guided pelvic bone procedures, as well as to provide some technical tips. We illustrate the article with multiple examples, and diagrams of the approaches and important structures to avoid to perform these procedures safely. TEACHING POINTS: • Pelvic bone procedures are safe to perform if anatomical landmarks are recognised. • The safest approach varies depending on the pelvic level. • CT is the modality of choice for guiding pelvic percutaneous procedures. • Fluoroscopy is recommended when real-time monitoring is mandatory. • MRI can also be used for guiding pelvic percutaneous procedures.