The Role of Imaging in Femoroacetabular Impingement: History, Current Practices, and Future Applications

CT in musculoskeletal imaging: still helpful and for what?

Computed tomography (CT) is a common modality employed for musculoskeletal imaging. Conventional CT techniques are useful for the assessment of trauma in detection, characterization and surgical planning of complex fractures. CT arthrography can depict internal derangement lesions and impact medical decision making of orthopedic providers. In oncology, CT can have a role in the characterization of bone tumors and may elucidate soft tissue mineralization patterns. Several advances in CT technology have led to a variety of acquisition techniques with distinct clinical applications. These include four-dimensional CT, which allows examination of joints during motion; cone-beam CT, which allows examination during physiological weight-bearing conditions; dual-energy CT, which allows material decomposition useful in musculoskeletal deposition disorders (e.g., gout) and bone marrow edema detection; and photon-counting CT, which provides increased spatial resolution, decreased radiation, and material decomposition compared to standard multi-detector CT systems due to its ability to directly translate X-ray photon energies into electrical signals. Advanced acquisition techniques provide higher spatial resolution scans capable of enhanced bony microarchitecture and bone mineral density assessment. Together, these CT acquisition techniques will continue to play a substantial role in the practices of orthopedics, rheumatology, metabolic bone, oncology, and interventional radiology.

Acetabular Retroversion: Dysplasia in Disguise that Leads to Early Arthritis of the Hip

We aimed to assess the prevalence of acetabular retroversion (AR) in patients undergoing total hip replacement (THA) based on age. We retrospectively compared preoperative anteroposterior pelvic radiographs of patients younger than 40 years of age who underwent THA with the age- and body mass index-matched control of 40 years and older patients. Retroversion was determined based on the presence of cross-over sign, ischial spine sign, posterior wall sign, and elephant's ear sign with data stratified based on presence of dysplasia.