Publications by authors named "Filip Vanhoenacker"

116 Publications

Giant Tug Lesion of the Soleus.

J Belg Soc Radiol 2021 Feb 15;105(1). Epub 2021 Feb 15.

AZ Sint-Maarten, Mechelen/Faculty of Medicine and Pharmacy, University of Brussels, Brussels, BE.

A giant soleus tug lesion is a benign pseudo-tumoral excrescence at the attachment of the soleus muscle at the posterior upper third of the tibia.
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http://dx.doi.org/10.5334/jbsr.2381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894369PMC
February 2021

Idiopathic Tumoral Calcinosis.

J Belg Soc Radiol 2021 Feb 9;105(1). Epub 2021 Feb 9.

AZ Sint-Maarten and University (Hospital) Antwerp/Ghent, BE.

The imaging clues to differentiate idiopathic tumoral calcinosis from other calcified soft tissue lesions include: pseudotumoral appearance with mass effect, bone erosion with intra-osseous protrusion of calcification, lobulated morphology, and peri-articular location on the extensor side.
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http://dx.doi.org/10.5334/jbsr.2341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880005PMC
February 2021

The Lisbon Agreement on Femoroacetabular Impingement Imaging-part 3: imaging techniques.

Eur Radiol 2021 Jan 7. Epub 2021 Jan 7.

Department of Radiology, Hospital de la Ribera, Valencia, Spain.

Objectives: Imaging diagnosis of femoroacetabular impingement (FAI) remains controversial due to a lack of high-level evidence, leading to significant variability in patient management. Optimizing protocols and technical details is essential in FAI imaging, although challenging in clinical practice. The purpose of this agreement is to establish expert-based statements on FAI imaging, using formal consensus techniques driven by relevant literature review. Recommendations on the selection and use of imaging techniques for FAI assessment, as well as guidance on relevant radiographic and MRI classifications, are provided.

Methods: The Delphi method was used to assess agreement and derive consensus among 30 panel members (musculoskeletal radiologists and orthopedic surgeons). Forty-four questions were agreed on and classified into five major topics and recent relevant literature was circulated, in order to produce answering statements. The level of evidence was assessed for all statements and panel members scored their level of agreement with each statement during 4 Delphi rounds. Either "group consensus," "group agreement," or "no agreement" was achieved.

Results: Forty-seven statements were generated and group consensus was reached for 45. Twenty-two statements pertaining to "Imaging techniques" were generated. Eight statements on "Radiographic assessment" and 12 statements on "MRI evaluation" gained consensus. No agreement was reached for the 2 "Ultrasound" related statements.

Conclusion: The first international consensus on FAI imaging was developed. Researchers and clinicians working with FAI and hip-related pain may use these recommendations to guide, develop, and implement comprehensive, evidence-based imaging protocols and classifications.

Key Points: • Radiographic evaluation is recommended for the initial assessment of FAI, while MRI with a dedicated protocol is the gold standard imaging technique for the comprehensive evaluation of this condition. • The MRI protocol for FAI evaluation should include unilateral small FOV with radial imaging, femoral torsion assessment, and a fluid sensitive sequence covering the whole pelvis. • The definite role of other imaging methods in FAI, such as ultrasound or CT, is still not well defined.
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http://dx.doi.org/10.1007/s00330-020-07501-5DOI Listing
January 2021

The Lisbon Agreement on femoroacetabular impingement imaging-part 2: general issues, parameters, and reporting.

Eur Radiol 2021 Jan 7. Epub 2021 Jan 7.

Department of Radiology, Hospital de la Ribera, Valencia, Spain.

Objectives: Imaging assessment for the clinical management of femoroacetabular impingement (FAI) is controversial because of a paucity of evidence-based guidance and notable variability among practitioners. Hence, expert consensus is needed because standardised imaging assessment is critical for clinical practice and research. We aimed to establish expert-based statements on FAI imaging by using formal methods of consensus building.

Methods: The Delphi method was used to formally derive consensus among 30 panel members from 13 countries. Forty-four questions were agreed upon, and relevant seminal literature was circulated and classified in major topics to produce answering statements. The level of evidence was noted for all statements, and panel members were asked to score their level of agreement (0-10). This is the second part of a three-part consensus series and focuses on 'General issues' and 'Parameters and reporting'.

Results: Forty-seven statements were generated and group consensus was reached for 45. Twenty-five statements pertaining to 'General issues' (9 addressing diagnosis, differential diagnosis, and postoperative imaging) and 'Parameters and reporting' (16 addressing femoral/acetabular parameters) were produced.

Conclusions: The available evidence was reviewed critically, recommended criteria for diagnostic imaging highlighted, and the roles/values of different imaging parameters assessed. Radiographic evaluation (AP pelvis and a Dunn 45° view) is the cornerstone of hip-imaging assessment and the minimum imaging study that should be performed when evaluating adult patients for FAI. In most cases, cross-sectional imaging is warranted because MRI is the 'gold standard' imaging modality for the comprehensive evaluation, differential diagnosis assessment, and FAI surgical planning.

Key Points: • Diagnostic imaging for FAI is not standardised due to scarce evidence-based guidance on which imaging modalities and diagnostic criteria/parameters should be used. • Radiographic evaluation is the cornerstone of hip assessment and the minimum study that should be performed when assessing suspected FAI. Cross-sectional imaging is justified in most cases because MRI is the 'gold standard' modality for comprehensive FAI evaluation. • For acetabular morphology, coverage (Wiberg's angle and acetabular index) and version (crossover, posterior wall, and ischial spine signs) should be assessed routinely. On the femoral side, the head-neck junction morphology (α° and offset), neck morphology (NSA), and torsion should be assessed.
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http://dx.doi.org/10.1007/s00330-020-07432-1DOI Listing
January 2021

Muscle Herniation: An Often-Missed Pseudotumor.

J Belg Soc Radiol 2020 Nov 13;104(1):62. Epub 2020 Nov 13.

AZ Sint-Maarten, BE.

Dynamic ultrasound and knowledge of a clinical history of a soft-tissue lump that increases in volume upon muscle contraction or weight-bearing are crucial in the diagnosis of muscle herniation.
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http://dx.doi.org/10.5334/jbsr.2294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664583PMC
November 2020

Fibrous Dysplasia, Paget's Disease of Bone, and Other Uncommon Sclerotic Bone Lesions of the Craniofacial Bones.

Semin Musculoskelet Radiol 2020 Oct 9;24(5):570-578. Epub 2020 Oct 9.

Department of Radiology, Antwerp University Hospital and Antwerp University, Edegem, Belgium.

Imaging studies of the brain, head and neck, sinuses, and dental computed tomography are among the most frequently performed procedures in radiologic departments. Systematic evaluation in the bone window may reveal common and uncommon sclerotic osseous abnormalities of the craniofacial skeleton.Most of these findings are incidental and unrelated to the initial clinical indications. Sporadically symptoms may arise due to lesional mass effect with compression on adjacent structures and neuroforaminal encroachment, resulting in proptosis, vision, or hearing loss. Other symptoms include craniofacial deformity, mandibular occlusion deformity, and local pain.This article reviews the most common disorders characterized by an increased bone density involving the craniofacial bones including fibrous dysplasia, Paget's disease of bone, meningioma with associated hyperostosis, and osteoma. Finally, typical examples of rarer sclerosing bone dysplasias are discussed as well.Emphasis is placed on imaging features and the differential diagnosis.
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http://dx.doi.org/10.1055/s-0039-3400292DOI Listing
October 2020

Imaging of Mixed and Radiopaque Jaw Lesions.

Semin Musculoskelet Radiol 2020 Oct 9;24(5):558-569. Epub 2020 Oct 9.

Department of Radiology, GZA Hospitals, Antwerp, Belgium.

Radiopaque lesions and lesions of mixed density are less frequent than radiolucent lesions of the jawbones. They comprise a spectrum of odontogenic and non-odontogenic lesions. The latter group includes inherited and developmental disorders, osteomyelitis, and benign and malignant primary bone tumors and metastases. Most odontogenic radiopaque or mixed lesions are either related to the apex or more rarely to the crown of the tooth, although there are exceptions to this rule. Some lesions, such as a torus mandibularis and torus palatinus, have a characteristic location, whereas others show no relationship to the dentition. This article describes the most characteristic and prevalent radiopaque and mixed lesions of the jaws and their imaging characteristics. Paget's disease, fibrous dysplasia, and rare sclerotic bone diseases of the maxillofacial bones are discussed elsewhere in this issue. Careful correlation of clinical presentation, panoramic radiographs, cone beam computed tomography, and histopathology are the cornerstones for appropriate lesion characterization.
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http://dx.doi.org/10.1055/s-0039-3402766DOI Listing
October 2020

Imaging of Radiolucent Jaw Lesions.

Semin Musculoskelet Radiol 2020 Oct 9;24(5):549-557. Epub 2020 Oct 9.

Department of Radiology, GZA Sint-Augustinus, Antwerp, Belgium.

Radiolucent lesions in the jaw bones comprise a whole spectrum of odontogenic and nonodontogenic lesions. Although the imaging appearance is not always specific, careful radiologic analysis may contribute to characterization of these lesions. A useful approach is to first analyze the absence or presence of a relationship of the lesion to the teeth. The relation may be either near the tooth apex or crown of the tooth. Other lesions may or may not show any specific anatomical location. After analysis of the primary location of the lesion, additional criteria that may help in further imaging characterization are lesion demarcation and morphology, involvement of the cortex and periosteum, and soft tissue changes. This article describes the most characteristic and prevalent radiolucent lesions of the jaws at each location. In routine clinical practice, cone beam computed tomography is sufficient for appropriate lesion characterization, although magnetic resonance imaging may be useful in selected cases.
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http://dx.doi.org/10.1055/s-0040-1705118DOI Listing
October 2020

World Health Organization Classification of Odontogenic Tumors and Imaging Approach of Jaw Lesions.

Semin Musculoskelet Radiol 2020 Oct 9;24(5):535-548. Epub 2020 Oct 9.

Department of Radiology, Antwerp University Hospital and Antwerp University, Edegem, Belgium.

Tumors of the jaws represent a heterogeneous group of lesions that are classified histologically in the World Health Organization Classification of Odontogenic Tumors (2017). This article provides an update of the current nomenclature. The main role of imaging is to describe the precise location and extent of these lesions. Although characterization of imaging is often difficult due to overlapping characteristics, imaging is helpful to define which lesions should be referred for histologic examination and subsequent treatment planning. Location and density are the cardinal criteria for potential characterization on imaging. Radiologically, lesions may be radiolucent, radiopaque, or of mixed density. Additional criteria include lesion demarcation, morphology, cortical breakthrough, periosteal reaction, and adjacent soft tissue changes. Final lesion characterization is only definitive after interdisciplinary discussion and radiopathologic correlation. Correct diagnosis is obtained by a combination of the patient's age, lesion location, and clinical and radiologic presentation. It is important that all physicians use a uniform nomenclature.
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http://dx.doi.org/10.1055/s-0040-1710357DOI Listing
October 2020

Cone Beam Computed Tomography Imaging in Dental Implants: A Primer for Clinical Radiologists.

Semin Musculoskelet Radiol 2020 Oct 9;24(5):499-509. Epub 2020 Oct 9.

Department of Radiology, GZA Hospitals, Antwerp, Belgium.

With the introduction of cone beam computed tomography (CBCT) into dentistry in the 1990s, radiologists have become more frequently involved in dental implant planning. This article describes the information that should be included in a radiology report to achieve a successful implantation. The justification to use CBCT during the preoperative planning phase is based on the need to evaluate patient-specific anatomy in detail (general condition of the jaw, bone quantity, and bone quality), the application of more advanced surgical techniques (maxillary sinus augmentation procedure, zygomatic implants), and the integrated presurgical planning and virtual patient approach. Postoperatively, CBCT is used when implant retrieval is anticipated and two-dimensional radiographs have not provided sufficient information, for evaluation of graft healing, or to assess complications, mostly related to neurovascular trauma.
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http://dx.doi.org/10.1055/s-0040-1701496DOI Listing
October 2020

Imaging Anatomy of the Jaw and Dentition with Cone Beam Computed Tomography.

Semin Musculoskelet Radiol 2020 Oct 9;24(5):488-498. Epub 2020 Oct 9.

Department of Radiology, GZA Hospitals, Antwerp, Belgium.

Knowledge of dental, maxillary, and mandibular anatomy and the use of correct nomenclature is critical in the evaluation of a mandibulofacial and/or maxillofacial imaging data set. The use of the correct diagnostic imaging tool tailored to the patient's needs is of equal importance. This article highlights imaging anatomy and cross-sectional imaging modalities mainly focusing on cone beam computed tomography of the mandibulofacial and maxillofacial region.
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http://dx.doi.org/10.1055/s-0040-1701494DOI Listing
October 2020

Facial and Dental Imaging.

Semin Musculoskelet Radiol 2020 10 9;24(5):477-478. Epub 2020 Oct 9.

Department of Radiology, AZ Sint-Maarten Mechelen, Belgium, Antwerp University Hospital, Faculty of Medicine and Health Sciences, Universities of Antwerp and Ghent, Belgium.

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http://dx.doi.org/10.1055/s-0040-1715886DOI Listing
October 2020

History Page: Editorial Notes.

Semin Musculoskelet Radiol 2020 06 28;24(3):331. Epub 2020 Sep 28.

Medical University of Vienna, General Hospital of Vienna, Vienna, Austria.

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http://dx.doi.org/10.1055/s-0040-1701498DOI Listing
June 2020

History Page: Leaders in MSK Radiology Chr. M. F. Sinding-Larsen, 1866-1930.

Semin Musculoskelet Radiol 2020 Jun 28;24(3):332-334. Epub 2020 Sep 28.

Radiology, Unilabs Radiology, Oslo, Norway.

This history page in the series "Leaders in MSK radiology" is dedicated to the memory and achievements of the Norwegian physician Christian Magnus Falsen Sinding-Larsen who's name is connected to the medical eponym Sinding-Larsen-Johansson disease.
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http://dx.doi.org/10.1055/s-0040-1701497DOI Listing
June 2020

Present Status of Musculoskeletal Radiology in Europe: International Survey by the European Society of Musculoskeletal Radiology.

Semin Musculoskelet Radiol 2020 Jun 28;24(3):323-330. Epub 2020 Sep 28.

Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany.

No official data exist on the status of musculoskeletal (MSK) radiology in Europe. The Committee for National Societies conducted an international survey to understand the status of training, subspecialization, and local practice among the European Society of Musculoskeletal Radiology (ESSR) partner societies. This article reports the results of that survey. An online questionnaire was distributed to all 26 European national associations that act as official partner societies of the ESSR. The 24 questions were subdivided into six sections: society structure, relationship with the national radiological society, subspecialization, present radiology practice, MSK interventional procedures, and MSK ultrasound. The findings of our study show a lack of standardized training and/or accreditation methods in the field of MSK radiology at a national level. The European diploma in musculoskeletal radiology is directed to partly overcome this problem; however, this certification is still underrecognized. Using certification methods, a more homogeneous European landscape could be created in the future with a view to subspecialist training. MSK ultrasound and MSK interventional procedures should be performed by a health professional with a solid knowledge of the relevant imaging modalities and sufficient training in MSK radiology. Recognition of MSK radiology as an official subspecialty would make the field more attractive for younger colleagues as well as attracting the brightest and best, an important key to further development of both clinical and academic radiology. KEY POINTS: · Standardized training and/or accreditation methods in the field of MSK radiology is lacking at a national level.. · With certification methods, such as the European diploma in musculoskeletal radiology, a more homogeneous European landscape could be created in the future with a view to subspecialist training.. · Recognition of MSK radiology as an official subspecialty would make the field more attractive for younger colleagues as well as attracting the brightest and best, an important key to further development of both clinical and academic radiology..
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http://dx.doi.org/10.1055/s-0040-1713119DOI Listing
June 2020

Giant Frontal Paranasal Mucocele: Case Report and Review of the Literature.

J Belg Soc Radiol 2020 Sep 11;104(1):48. Epub 2020 Sep 11.

AZ Sint-Maarten and University (Hospital) Antwerp/Ghent, BE.

Giant mucocele is a rare expansile lesion that may mimic other locally aggressive lesions of the cranial vault. Giant frontal mucoceles with massive osteolytic destruction mimicking an aggressive lesion are rare compared to smaller mucoceles. This article reports a giant mucocele of the frontal sinus and reviews the literature. Important imaging clues pointing toward the diagnosis of a mucocele on computed tomography (CT) and magnetic resonance imaging (MRI) are a well-defined expansile mass, an intimate relationship with the frontal sinus, subtle peripheral rim enhancement, and slow progression on serial imaging. The density on CT and signal on MRI may vary along with the lesion content. The potential role of diffusion-weighted imaging should be elaborated in future reports.
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http://dx.doi.org/10.5334/jbsr.2117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485410PMC
September 2020

Meniscal Ossicle Mimicking a Radial Meniscal Tear.

J Belg Soc Radiol 2020 Jun 26;104(1):33. Epub 2020 Jun 26.

AZ Sint-Maarten, BE.

A meniscal ossicle may be misdiagnosed as a tear of the posterior horn of the medial meniscus or an intra-articular loose body.
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http://dx.doi.org/10.5334/jbsr.2125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319072PMC
June 2020

Acrophyseal growth arrest in a long-term survivor of acute lymphoblastic leukemia.

Skeletal Radiol 2020 Dec 20;49(12):2095-2099. Epub 2020 Jun 20.

Department of Radiology, General Hospital Sint-Maarten, Mechelen, Universities of Antwerp and Ghent, Antwerp, Belgium.

Growth arrest at the secondary growth plate, also known as the acrophysis, is a rare phenomenon with only very few known published case reports. We report on a case of formation of ghost secondary ossification centers at the acrophyses of the knee joint in a 14-year-old female, who survived early childhood acute lymphoblastic leukemia. The patient suffered from severe side effects from both disease and subsequent treatment strategies with a 10-month immobilization period as a consequence at the age of 3 years. The ghost secondary ossification centers were encountered on radiographs and MRI 10 years later, when she presented for evaluation of chronic pain in her left knee related to sports activities, due to a meniscal cyst. Awareness of this phenomenon is nevertheless important, because it seems that endochondral bone growth recovery at the acrophyses might be different from recovery in physes, because we found no concomitant sequelae of growth arrest in the metaphyses.
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http://dx.doi.org/10.1007/s00256-020-03513-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652800PMC
December 2020

Correction: Glomangiomyoma of the Knee: A Rare Juxtasynovial Presentation.

J Belg Soc Radiol 2020 Jun 1;104(1):26. Epub 2020 Jun 1.

Sint-Lucas Hospital Ghent, BE.

[This corrects the article DOI: 10.5334/jbsr.2051.].
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http://dx.doi.org/10.5334/jbsr.2166DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274200PMC
June 2020

Aggressive fibromatosis of the upper arm: an unusual cause of radial nerve paresis.

Acta Neurol Belg 2020 Aug 25;120(4):947-949. Epub 2020 May 25.

Department of Radiology, AZ Sint-Maarten Mechelen, Liersesteenweg 435, 2800, Mechelen, Belgium.

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http://dx.doi.org/10.1007/s13760-020-01386-3DOI Listing
August 2020

The Lisbon Agreement on Femoroacetabular Impingement Imaging-part 1: overview.

Eur Radiol 2020 Oct 17;30(10):5281-5297. Epub 2020 Jul 17.

Musculoskeletal Imaging Unit, Imaging Center, Radiology Department, Hospital da Luz, Grupo Luz Saúde, Av. Lusiada 100, 1500-650, Lisbon, Portugal.

Objectives: Imaging assessment for the clinical management of femoroacetabular impingement (FAI) syndrome remains controversial because of a paucity of evidence-based guidance and notable variability in clinical practice, ultimately requiring expert consensus. The purpose of this agreement is to establish expert-based statements on FAI imaging, using formal techniques of consensus building.

Methods: A validated Delphi method and peer-reviewed literature were used to formally derive consensus among 30 panel members (21 musculoskeletal radiologists and 9 orthopaedic surgeons) from 13 countries. Forty-four questions were agreed on, and recent relevant seminal literature was circulated and classified in five major topics ('General issues', 'Parameters and reporting', 'Radiographic assessment', 'MRI' and 'Ultrasound') in order to produce answering statements. The level of evidence was noted for all statements, and panel members were asked to score their level of agreement with each statement (0 to 10) during iterative rounds. Either 'consensus', 'agreement' or 'no agreement' was achieved.

Results: Forty-seven statements were generated, and group consensus was reached for 45 (95.7%). Seventeen of these statements were selected as most important for dissemination in advance. There was no agreement for the two statements pertaining to 'Ultrasound'.

Conclusion: Radiographic evaluation is the cornerstone of hip evaluation. An anteroposterior pelvis radiograph and a Dunn 45° view are recommended for the initial assessment of FAI although MRI with a dedicated protocol is the gold standard imaging technique in this setting. The resulting consensus can serve as a tool to reduce variability in clinical practices and guide further research for the clinical management of FAI.

Key Points: • FAI imaging literature is extensive although often of low level of evidence. • Radiographic evaluation with a reproducible technique is the cornerstone of hip imaging assessment. • MRI with a dedicated protocol is the gold standard imaging technique for FAI assessment.
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http://dx.doi.org/10.1007/s00330-020-06822-9DOI Listing
October 2020

Glomangiomyoma of the Knee: A Rare Juxtasynovial Presentation: Juxtasynovial glomangiomyoma in the joint capsule is a rare location for glomus tumors that should be considered in the differential diagnosis of hypervascular synovial-based tumors.

J Belg Soc Radiol 2020 Mar 3;104(1):12. Epub 2020 Mar 3.

Sint-Lucas Hospital Ghent, BE.

Glomus tumors are benign tumors typically located in the subcutis or deep dermis of the subungual region of the fingers. Histologically, glomus tumors are divided into three subtypes, in descending order of frequency: solid glomus tumor, glomangioma and glomangiomyoma. We report a case of a symptomatic intracapsular juxtasynovial glomangiomyoma of the knee. To the best of our knowledge, this location of this uncommon histological subtype of glomus tumor has not been reported previously. Although the final diagnosis is made by histopathology, the radiologist should consider this rare lesion in the differential of highly vascularised synovial-based masses.
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http://dx.doi.org/10.5334/jbsr.2051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059490PMC
March 2020

Radiographic/MR Imaging Correlation of Soft Tissues.

Magn Reson Imaging Clin N Am 2019 Nov;27(4):769-789

Department of Radiology, AZ Sint-Maarten Mechelen, University Hospital Antwerp, Liersesteenweg 435, Mechelen 2800, Belgium.

MR imaging is nowadays regarded as the preferred imaging modality for evaluation of soft tissue lesions. As plain radiographs are often the first step in evaluation of musculoskeletal disorders, identification of subtle soft tissue signs may be helpful to select patients who need to be referred for subsequent MR imaging. Although not very sensitive, certain plain film findings, such as intralesional calcification or gas, may allow one to make to a more specific tissue diagnosis and may obviate the need for invasive diagnostic procedures and potential harmful treatment.
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http://dx.doi.org/10.1016/j.mric.2019.07.007DOI Listing
November 2019

Hand and Wrist: A Kaleidoscopic View of Accessory Ossicles, Variants, Coalitions, and Others.

Semin Musculoskelet Radiol 2019 Oct 25;23(5):511-522. Epub 2019 Sep 25.

Department of Radiology and Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

Accessory bones, variants, and coalitions are not uncommon at the hand-wrist region. They are often overlooked because they are usually asymptomatic and found incidentally on imaging. However, they may sometimes present as a (painful) swelling or mimic a (sequel of a) fracture. Other symptoms may be attributed to impingement and exercise-related pain. Thorough knowledge of the anatomy, systematic imaging analysis, and the awareness of their existence are the clues to a correct identification. Plain radiography and magnetic resonance imaging (MRI) play a pivotal role in the correct diagnosis. In general, signal intensity on MRI is similar to the normal bony structures. However, concomitant bone marrow edema may indicate the presence of impingement. Therefore, MRI sequences with fat suppression should be included in case of symptomatic findings. This article provides a kaleidoscopic overview of some of the prevalent bony anomalies of the hand-wrist region and their potential pathogenic nature.
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http://dx.doi.org/10.1055/s-0039-1693974DOI Listing
October 2019

Diagnosis of peripheral bone and prosthetic joint infections: overview on the consensus documents by the EANM, EBJIS, and ESR (with ESCMID endorsement).

Eur Radiol 2019 Dec 27;29(12):6425-6438. Epub 2019 Jun 27.

Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Objectives: Peripheral bone infection (PBI) and prosthetic joint infection (PJI) are two different infectious conditions of the musculoskeletal system. They have in common to be quite challenging to be diagnosed and no clear diagnostic flowchart has been established. Thus, a conjoined initiative on these two topics has been initiated by the European Society of Radiology (ESR), the European Association of Nuclear Medicine (EANM), the European Bone and Joint Infection Society (EBJIS), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). The purpose of this work is to provide an overview on the two consensus documents on PBI and PJI that originated by the conjoined work of the ESR, EANM, and EBJIS (with ESCMID endorsement).

Methods And Results: After literature search, a list of 18 statements for PBI and 25 statements for PJI were drafted in consensus on the most debated diagnostic challenges on these two topics, with emphasis on imaging.

Conclusions: Overall, white blood cell scintigraphy and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities for the diagnosis of PBI and PJI. However, the choice of which advanced diagnostic modality to use first depends on several factors, such as the benefit for the patient, local experience of imaging specialists, costs, and availability. Since robust, comparative studies among most tests do not exist, the proposed flowcharts are based not only on existing literature but also on the opinion of multiple experts involved on these topics.

Key Points: • For peripheral bone infection and prosthetic joint infection, white blood cell and magnetic resonance imaging have individually demonstrated the highest diagnostic performance over other imaging modalities. • Two evidence- and expert-based diagnostic flowcharts involving variable combination of laboratory tests, biopsy methods, and radiological and nuclear medicine imaging modalities are proposed by a multi-society expert panel. • Clinical application of these flowcharts depends on several factors, such as the benefit for the patient, local experience, costs, and availability.
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http://dx.doi.org/10.1007/s00330-019-06326-1DOI Listing
December 2019

Intravascular Pneumocephalus: .

J Belg Soc Radiol 2019 May 9;103(1):29. Epub 2019 May 9.

AZ Sint-Maarten and University (Hospital) Antwerp/Ghent, BE.

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http://dx.doi.org/10.5334/jbsr.1795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509955PMC
May 2019

Juxta-Cortical Chondroma of the Phalanges: Is there a Role for Cone-Beam Computed Tomography in Diagnosis and Local Staging?: Main teaching point: Low-dose cone-beam computed tomography (CT) may be of additional value to radiographs and magnetic resonance imaging (MRI) in preoperative characterization and local staging of juxta-cortical chondroma.

J Belg Soc Radiol 2019 Apr 4;103(1):22. Epub 2019 Apr 4.

University Hospital Antwerp, Wilrijkstraat, Edegem, BE.

Juxta-cortical chondroma is a rare cartilaginous tumor originating from the periosteum. On conventional radiography, the lesion typically causes saucerization of the adjacent cortex with well-delineated sclerotic margins. Projection radiography may be less accurate than cross-sectional imaging to demonstrate the precise extent of pressure erosion and bone and soft tissue extent. Although magnetic resonance imaging (MRI) is the imaging technique of choice for further preoperative evaluation, cone-beam computed tomography (CT) may be of additional value. Due to its high spatial resolution, cone-beam CT may detect very tiny matrix calcifications and allows a more precise evaluation of the saucerized cortex at a low radiation dose.
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http://dx.doi.org/10.5334/jbsr.1657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450252PMC
April 2019

Imaging of Malignant Primitive Tumors of the Spine.

J Belg Soc Radiol 2018 Sep 6;102(1):56. Epub 2018 Sep 6.

Institut Kassab of Orthopaedics, TN.

Primary malignant tumors of the spine are rare and mainly include chordoma, chondrosarcoma, Ewing sarcoma or primitive neuroectodermal tumor, and osteosarcoma. The final diagnosis is based on the combination of patient age, topographic and histologic features of the tumor, and lesion pattern on computed tomography (CT) and magnetic resonance (MR) imaging. Imaging evaluation includes radiography, CT, bone scintigraphy, and MR imaging. CT is more useful than radiography for evaluating location of the lesion and analyzing bone destruction and matrix, whereas MR has unmatched ability to assess soft tissue extension. This pictorial review provides an overview of the most prevalent primitive malignant tumors of spine.
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http://dx.doi.org/10.5334/jbsr.1410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425224PMC
September 2018