RSNA preview: Musculoskeletal radiology evolves from anatomic to functional imaging

Highlights of the 2008 RSNA meeting suggest the field of musculoskeletal radiology is moving away from purely descriptive imaging studies and more into quantitative ones. Research is advancing the understanding of tissue function and underlying anomalies as well as image-guided treatment options.

One of the unifying themes this year is an emphasis on tissue characterization, said MSK subcommittee chair Dr. David A. Rubin. Musculoskeletal imaging used to focus mostly on surface diagnoses of fractures or tears. But now, radiologists will find more abstract presentations that delve deep into the structure and biology of peripheral nerves, muscles, tendons, or different types of MSK tumors.

"Like the rest of radiology, there is a shift toward more quantitative as well as qualitative studies," Rubin told Diagnostic Imaging. "There are more diseases where there's actually something we will be measuring, some sort of parameter that better describes how a tendon or a nerve is working rather than simply what it looks like."

Scientific abstracts at RSNA 2008 promise groundbreaking presentations on several topics:

• MR diffusion tensor imaging for the assessment of degenerative spine disease or disabling peripheral nerve disorders
• Diffusion-weighted MRI for characterization of soft-tissue tumors or detection of painful postoperative infections
• Sonoelastography for diagnosis of softening heel, elbow, and shoulder tendons and for diagnosis of heel, elbow, and shoulder tendon tears
• Image-guided interventions for pain management
• Whole-body imaging for screening of multiple myeloma and other bone-crushing neoplasms and for the assessment of tumor behavior and response to treatment
• New 3D imaging techniques for analysis of osteoporosis
• Use of "smartphones" for offsite diagnosis of fractures

A number of these scientific developments may never pan out beyond the lab. A fair number of them, however, offer useful insight that many radiologists, general or specialist, would want to bring back to their daily practice, Rubin said.

These studies have been born out of the daring desire to delve into the deeper causes of many conditions as well as the need to create new image-guided treatments, according to the Mallinckrodt Institute of Radiology's MSK imaging section chief.

"We are seeing much more of a maturation of the field of MSK radiology," Rubin said.

For more information from the Diagnostic Imaging archives:

Percutaneous osteoplasty proves as hip as surgeryCT, MR-guided injections promise pain relief for sacroiliac joint lesionsImaging techniques fine-tune upper extremity MSK diagnosesMR diffusion tensor imaging identifies and categorizes cervical spine trauma