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This manuscript delineates the pathway from in-house research on Artificial Intelligence (AI) to the development of a medical device, addressing critical phases including conceptualization, development, validation, and regulatory compliance. Key stages in the transformation process involve identifying clinical needs, data management, model training, and rigorous validation to ensure AI models are both robust and clinically relevant. Continuous post-deployment surveillance is essential to maintain performance and adapt to changes in clinical practice. The regulatory landscape is complex, encompassing stringent certification processes under the EU Medical Device Regulation (MDR) and the upcoming EU AI Act, which imposes additional compliance requirements aimed at mitigating AI-specific risks. Ethical considerations such as, emphasizing transparency, patient privacy, and equitable access to AI technologies, are paramount. The manuscript underscores the importance of interdisciplinary collaboration, between healthcare institutions and industry partners, and navigation of commercialization and market entry of AI devices. This overview provides a strategic framework for radiologists and healthcare leaders to effectively integrate AI into clinical practice, while adhering to regulatory and ethical standards, ultimately enhancing patient care and operational efficiency., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

With varying prevalence and manifestations depending on the underlying disease, thoracic involvement is one of the major factors determining morbidity and mortality in patients with rheumatic diseases (RDs). The most frequent pulmonary complication is interstitial lung disease (ILD), but other thoracic manifestations can also be present. Often, the only way to depict these extra-articular manifestations of disease is through imaging. Making an early diagnosis and thus aiding in the appropriate management requires radiologists to possess a comprehensive understanding of the typical imaging findings and the accompanying clinical context. In this review, the common features of thoracic involvement in RD are systematically described, with illustrations and explanatory drawings. ILD patterns, rheumatoid nodules, bronchial involvement, esophageal involvement, and pleural and pericardial disease are among the features discussed., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2024.)

Many studies and systematic reviews have been published about MRI of the knee and its structures, discussing detailed anatomy, imaging findings, and correlations between imaging and clinical findings. This paper includes evidence-based recommendations for a general radiologist regarding choice of imaging sequences and reporting basic MRI examinations of the knee. We recommend using clinicians' terminology when it is applicable to the imaging findings, for example, when reporting meniscal, ligament and tendon, or cartilage pathology. The intent is to standardise reporting language and to make reports less equivocal. The aim of the paper is to improve the usefulness of the MRI report by understanding the strengths and limitations of the MRI exam with regard to clinical correlation. We hope the implementation of these recommendations into radiological practice will increase diagnostic accuracy and consistency by avoiding pitfalls and reducing overcalling of pathology on MRI of the knee. CLINICAL RELEVANCE STATEMENT: The recommendations presented here are meant to aid general radiologists in planning and assessing studies to evaluate acute and chronic knee findings by advocating the use of unequivocal terminology and discussing the strengths and limitations of MRI examination of the knee. KEY POINTS: • On MRI, the knee should be examined and assessed in three orthogonal imaging planes. • The basic general protocol must yield T2-weighted fluid-sensitive and T1-weighted images. • The radiological assessment should include evaluation of ligamentous structures, cartilage, bony structures and bone marrow, soft tissues, bursae, alignment, and incidental findings., (© 2024. The Author(s).)

Objective: This study aimed to investigate the agreement of patient-assessed and researcher/physician-assessed measurements of the difference in range of motion between the unaffected and affected shoulders in 55 patients undergoing arthroscopic surgery for a unilateral shoulder condition., Methods: The investigation included 55 patients (17 women and 38 men; median age=53 years; range=26-74) with a symptomatic unilateral shoulder condition and a surgically treatable diagnosis. Images of a model/researcher performing active shoulder abduction, flexion, external rotation, and internal rotation were created. Each image was paired with a degree diagram or a level system (for internal rotation) on the back for the patient to accurately self-evaluate and record. Each patient was instructed to attentively examine the figures and perform the movements with the same posture as depicted. On the day of surgery, prior to the procedure, 2 independent researchers who were not involved in the patient's care used a standard goniometer to assess the same active movements that the patient had previously self-assessed. For agreement analyses, the intraclass correlation coefficient and Bland-Altman plots were calculated for continuous data (abduction, flexion, and external rotation), and Cohen's weighted kappa was calculated for ordinal categorical data (internal rotation)., Results: The intraclass correlation coefficient for abduction, flexion, and external rotation was 0.93 (excellent) 95% CI (0.87, 0.96), 0.89 (good) 95% CI (0.81, 0.94), and 0.72 (moderate) 95% CI (0.52, 0.84), respectively. Cohen's kappa for internal rotation (measured as reaching levels on the back) was 0.63 (moderate)., Conclusion: We believe that patient-assessed measurements of abduction (intraclass correlation coefficient 0.93) and flexion (intraclass correlation coefficient 0.89) can be used as a valid substitute (for measurements by a clinician or researcher). Patient-assessed measurements for external rotation (intraclass correlation coefficient 0.72) and internal rotation (kappa 0.63) are in moderate agreement and should be used more cautiously as substitutes., Level of Evidence: Level II, Diagnostic Study.

This statement from the European Society of Thoracic imaging (ESTI) explains and summarises the essentials for understanding and implementing Artificial intelligence (AI) in clinical practice in thoracic radiology departments. This document discusses the current AI scientific evidence in thoracic imaging, its potential clinical utility, implementation and costs, training requirements and validation, its' effect on the training of new radiologists, post-implementation issues, and medico-legal and ethical issues. All these issues have to be addressed and overcome, for AI to become implemented clinically in thoracic radiology. KEY POINTS: • Assessing the datasets used for training and validation of the AI system is essential. • A departmental strategy and business plan which includes continuing quality assurance of AI system and a sustainable financial plan is important for successful implementation. • Awareness of the negative effect on training of new radiologists is vital., (© 2023. The Author(s).)

This document from the European Society of Thoracic Imaging (ESTI) and the European Society of Radiology (ESR) discusses the role of imaging in the long-term follow-up of COVID-19 patients, to define which patients may benefit from imaging, and what imaging modalities and protocols should be used. Insights into imaging features encountered on computed tomography (CT) scans and potential pitfalls are discussed and possible areas for future review and research are also included. KEY POINTS: • Post-COVID-19 pneumonia changes are mainly consistent with prior organizing pneumonia and are likely to disappear within 12 months of recovery from the acute infection in the majority of patients. • At present, with the longest series of follow-up examinations reported not exceeding 12 months, the development of persistent or progressive fibrosis in at least some individuals cannot yet be excluded. • Residual ground glass opacification may be associated with persisting bronchial dilatation and distortion, and might be termed "fibrotic-like changes" probably consistent with prior organizing pneumonia., (© 2021. The Author(s).)

Background: A significant proportion of patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) later experience graft failure. Some studies suggest an association between a steep posterior tibial slope (PTS) and graft failure., Purpose: To examine the PTS in a large cohort of patients about to undergo ACLR and to determine whether a steep PTS is associated with later revision surgery., Study Design: Case-control study; Level of evidence, 3., Methods: A retrospective review of a cohort undergoing isolated ACLR between 2002 and 2012 (with 8-19 years of follow-up) was conducted. Preoperative sagittal radiographs of knees in full extension were used for measurements of the PTS. There were 2 independent examiners who performed repeated measurements to assess the reliability of the method. Statistical analyses were performed to compare the PTS in the groups with and without later revision surgery., Results: A total of 728 patients, with a mean age of 28 years at the time of surgery, were included. Overall, 10% (n = 76) underwent revision surgery during the observation period. The group of injured knees had a significantly steeper PTS compared with the group of uninjured knees (9.5° vs 8.7°, respectively; P < .05). The mean PTS in the no revision group was 9.5° compared with 9.3° in the revision group (not significant). Dichotomized testing of revision rates related to PTS cutoff values of ≥10°, ≥12°, ≥14°, ≥16°, and ≥18° showed no association of PTS steepness (not significant) to graft failure. Patients with revision were younger than the ones without (mean age, 24 ± 8 vs 29 ± 10 years, respectively) and had a shorter time from injury to ACLR (mean, 14 ± 27 vs 24 ± 44 months, respectively) as well as a smaller graft size (8.2 vs 8.4 mm, respectively; P = .040)., Conclusion: The current study did not find any association between a steep PTS measured on lateral knee radiographs and revision ACL surgery. However, a steeper PTS was seen in the group of injured knees compared with the group of uninjured (contralateral) knees. Independent of the PTS, younger patients, those with a shorter time from injury to surgery, and those with a smaller graft size were found to undergo revision surgery more often.

Background: Neuromyelitis optica is an inflammatory syndrome of the central nervous system, associated with anti-aquaporin-4 IgG antibodies. It is associated with severe neurological symptoms and risk of permanent neurological disability. The diagnosis can be established on the basis of clinical core characteristics of neuromyelitis optica, together with serological testing for anti-aquaporin-4 IgG antibodies and magnetic resonance imaging of the central nervous system., Case Presentation: We describe the case of a young woman presenting with obstipation, persistent nausea, vomiting and hiccups. The initial diagnostic workup confirmed obstipation, but did not find any underlying gastrointestinal pathology that could explain her persistent symptoms. Her condition deteriorated, she was unable to eat or drink without inducing vomiting, and eventually she received parenteral nutrition. Further diagnostic workup included magnetic resonance imaging of the brain, which revealed a T2-hyperintense lesion in the medulla oblongata, more specifically in the area postrema. Neurological and neuroradiological assessment led to a tentative clinical diagnosis of neuromyelitis optica spectrum disorder with a well-described, but rare, presentation: the area postrema syndrome. The diagnosis was confirmed by serological testing for anti-aquaporin-4 IgG antibodies. She was successfully treated with methylprednisolone with complete remission of symptoms. Patients with neuromyelitis optica spectrum disorders frequently experience relapses of the disease if untreated, and she was therefore treated with rituximab to prevent future relapses., Interpretation: This case is a reminder that common gastrointestinal symptoms may be caused by diseases of the central nervous system.

Background: Dyspnoea and syncope are common causes of admission to hospitals. Pulmonary embolism is often a differential diagnosis, and by examining the clinical history the clinician searches for known predisposing factors. This case report highlights the importance of Klinefelter's syndrome as a predisposing factor for venous thromboembolism. The syndrome is caused by an extra X chromosome in men, among whom the prevalence is estimated to be 1:500-1:1000. Probably only 25 % of men with the syndrome are diagnosed., Case Presentation: A man in his forties was admitted to hospital due to dyspnoea and syncope. CT showed submassive pulmonary embolism. The course illustrates the challenges of pulmonary embolism and its association with Klinefelter's syndrome., Interpretation: Several studies have shown an increased incidence of venous thromboembolism in patients with Klinefelter's syndrome. Klinefelter's patients have a higher pre-test likelihood of venous thromboembolism than other patients, similar to patients with hereditary thrombophilia. Klinefelter's syndrome is a persistent risk factor for recurrent thromboembolism. Thus, Klinefelter's syndrome impacts both the diagnosis and treatment of thromboembolic disease.

This document from the European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI) aims to present the main imaging features, and the role of CT scan in the early diagnosis of COVID-19, describing, in particular, the typical findings which make it possible to identify the disease and distinguish it from bacterial causes of infection, and to define which category of patients may benefit from CT imaging. The precautions that must be taken when performing scans to protect radiologists and technologists from infection will be described. The organisational measures that can be taken within radiology departments in order to cope with the influx of patients, while continuing to manage other emergency and time-sensitive activity (e.g. oncology, other infectious diseases etc.), will be discussed. KEY POINTS: • Bilateral ground glass opacities are typical CT manifestations of COVID-19. • Crazy paving and organising pneumonia pattern are seen at a later stage. • Extensive consolidation is associated with a poor prognosis.

Team handball is a fast high-scoring indoor contact sport with > 20 million registered players who are organized in > 150 federations worldwide. The combination of complex and unique biomechanics of handball throwing, permitted body tackles and blocks, and illegal fouls contribute to team handball ranging among the four athletic sports that carry the highest risks of injury. The categories include a broad range of acute and overuse injuries that most commonly occur in the shoulder, knee, and ankle. In concert with sports medicine, physicians, surgeons, physical therapists, and radiologists consult in the care of handball players through the appropriate use and expert interpretations of radiography, ultrasonography, CT, and MRI studies to facilitate diagnosis, characterization, and healing of a broad spectrum of acute, complex, concomitant, chronic, and overuse injuries. This article is based on published data and the author team's cumulative experience in playing and caring for handball players in Denmark, Sweden, Norway, Germany, Switzerland, and Spain. The article reviews and illustrates the spectrum of common handball injuries and highlights the contributions of sports imaging for diagnosis and management., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: The Segond fracture is an avulsion of the anterolateral tibia that can be found in patients with an anterior cruciate ligament (ACL) tear. It is currently unclear if the Segond fracture needs treatment or if it heals spontaneously and if it is associated with an increased risk of failure after ACL reconstruction., Purpose: To identify the incidence and spontaneous healing rate of Segond fractures in a consecutive cohort of patients undergoing ACL reconstruction and to examine the predictive value of the Segond fracture on the risk of undergoing revision surgery., Study Design: Cohort study; Level of evidence, 3., Methods: A retrospective review of a cohort undergoing isolated ACL reconstruction between 2002 and 2016 was performed. Radiographs from the time of injury and preoperative radiographs were evaluated for Segond fractures and healed Segond fractures. Descriptive data were extracted from an internal quality database. Statistical analyses were performed to investigate risk of revision surgery and to compare across subgroups of patients., Results: A total of 1364 patients were included in the study. The incidence of Segond fractures was 7.4%. In addition, 10.4% of patients displayed signs of healed Segond fractures. In total, 15.2% of patients had either 1 or both findings. The overall healing response of the fracture was 35.6%. Those with Segond fractures were older ( P = .014) and had a shorter interval from injury to surgery ( P = .003) as compared with the rest of the cohort. The incidence of Segond fractures was significantly higher in those injured during downhill skiing as compared with other injury mechanisms ( P = .04). The Segond fracture did not represent an increased risk of undergoing revision when compared with the control group (not significant)., Conclusion: The incidence of conventional Segond fractures in patients with ACL injury was found to be in accordance with former studies. Accounting for the high incidence of healed Segond fractures, a much higher incidence (15%) was seen. Although the spontaneous healing rate from initial radiographs to preoperative imaging was only 36%, the presence of Segond fractures did not represent a higher risk of undergoing revision surgery.

Background: The anatomic placement of anterior cruciate ligament (ACL) grafts is often assessed with postoperative imaging. In clinical practice, graft angles are measured to indicate anatomic placement on magnetic resonance imaging, whereas grid measurements are performed on computed tomography (CT). Recently, a study indicated that graft angle measurements could also be assessed on CT. No consensus has yet been reached on which measurement method is best suited to assess anatomic graft placement., Purpose: To compare the ability of grid measurements and angle measurements to identify anatomic versus nonanatomic tunnel placement on CT performed in patients undergoing ACL reconstruction., Study Design: Case series; Level of evidence, 4., Methods: A total of 100 knees undergoing primary reconstruction with a hamstring graft (HAM group), 91 undergoing reconstruction with a bone-patellar tendon-bone graft (BPTB group), and 117 undergoing revision ACL reconstruction (REV group) were assessed with CT. Grid measurements of the femoral and tibial tunnels and angle measurements of grafts were performed. Graft placement, rated as anatomic or nonanatomic, was assessed with both methods. Pearson chi-square, analysis of variance, Kruskal-Wallis, and weighted kappa tests were performed as appropriate., Results: The grid assessment classified 10% of the HAM group, 4% of the BPTB group, and 17% of the REV group as nonanatomic ( P < .001). The angle assessment classified 37% of the HAM group, 54% of the BPTB group, and 47% of the REV group as nonanatomic. The weighted kappa between angle measurements and grid measurements was low in all groups (HAM: 0.009; BPTB: 0.065; REV: 0.041)., Conclusion: The agreement between grid measurements and angle measurements was very low. The angle measurements seemed to overestimate nonanatomic tunnel placement. Grid measurements were better in identifying malpositioned grafts., Competing Interests: The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Background: to examine if PROTruding of the Anterior Medial Meniscus (PROTAMM) could be an indirect sign of PCL deficiency by comparing PROTAMM to passive posterior tibial sagging (PSS) for chronic PCL rupture on routine MRI., Methods: Patients with PCL reconstruction between 2011 and 2016 were included in a case control study. Primarily cases with combined ACL/PCL injury were excluded. Secondary exclusion criteria were bony fractures, medial meniscus pathology and poor quality MRIs. Three (blinded) observers reviewed the pre-operative MRIs according to a pre-defined protocol., Results: After applying the inclusion and primary exclusion criteria 16 patients were identified in the PCL rupture group. The control group consisted of 15 patients. After reviewing the MRIs, 6 were excluded due to secondary exclusion criteria. Mean PPS measured 4.8 mm (± 4.4 mm) in the PCL rupture group and 1.8 mm (±2.9 mm) in the control group, p = 0.05. Mean PROTAMM was 3.6 mm (±0.6 mm) in the PCL rupture group and 0.7 mm (±0.9 mm) in the control group, p = 0.004., Conclusion: We found a mean PROTAMM of 3.6 mm in patients with PCL rupture. We suggest that this sign, after knee injury in an otherwise normal medial meniscus, is a promising indirect sign of PCL deficiency compared to PPS. Implementation of this sign in clinical practice may improve the sensitivity of routine non-weight bearing MRI in identifying PCL deficient knees., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Patients with Alzheimer's disease (AD) have blood-brain barrier (BBB) dysfunction. Methods to study cells of the BBB in vivo would facilitate analyses of neurovascular damage in early AD. Thus, we conducted a pilot study to investigate if brain-derived endothelial cells (BDCECs) could be identified from a cell population of circulating endothelial cells (CECs). Peripheral blood was sampled from early AD patients (n = 9), patients with vascular diseases (myocardial infarction (n = 8) and ischemic stroke (n = 8)), and healthy controls (n = 8). We enumerated CD34 + /CD146 + /CD45 - cells (CECs) and Glucose transporter-1 (Glut1 + CECs (BDCECs)) by flow cytometry. We found that BDCECs formed a separate, aggregate cell population. Glut1 expression on BDCECs, measured by the median fluorescence intensity, was significantly decreased in patients with AD compared to both the healthy controls and patients with myocardial infarction ((p < .05, Kruskal-Wallis, Dunn's post hoc test). We found no significant differences in cell numbers. Our study shows that isolation of BDCECs offers a promising non-invasive tool to investigate cells derived from the BBB. Downregulation of Glut1 at the mild stages of AD suggests that agents that increase Glut1 levels may be therapeutic candidates to improve energy availability to the brain., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: The anterior cruciate ligament (ACL) is regularly reconstructed if knee joint function is impaired. Anatomic graft tunnel placement, often assessed with varying measurement methods, in the femur and tibia is considered important for an optimal clinical outcome. A consensus on the exact location of the femoral and tibial footprint centers is lacking., Purpose: To systematically review the literature regarding anatomic centers of the femoral and tibial ACL footprints and assess the mean, median, and percentiles of normal centers., Study Design: Systematic review., Methods: A systematic literature search was performed in the PubMed/Medline database in November 2015. Search terms were the following: "ACL" and "insertion anatomy" or "anatomic footprint" or "radiographic landmarks" or "quadrant methods" or "tunnel placement" or "cadaveric femoral" or "cadaveric tibial." English-language articles that reported the location of the ACL footprint according to the Bernard and Hertel grid in the femur and the Stäubli and Rauschning method in the tibia were included. Weighted means, weighted medians, and weighted 5th and 95th percentiles were calculated., Results: The initial search yielded 1393 articles. After applying the inclusion and exclusion criteria, 16 studies with measurements on cadaveric specimens or a healthy population were reviewed. The weighted mean of the femoral insertion center based on measurements in 218 knees was 29% in the deep-shallow (DS) direction and 35% in the high-low (HL) direction. The weighted median was 26% for DS and 34% for HL. The weighted 5th and 95th percentiles for DS were 24% and 37%, respectively, and for HL were 28% and 43%, respectively. The weighted mean of the tibial insertion center in the anterior-posterior direction based on measurements in 300 knees was 42%, and the weighted median was 44%; the 5th and 95th percentiles were 39% and 46%, respectively., Conclusion: Our results show slight differences between the weighted means and medians in the femoral and tibial insertion centers. We recommend the use of the 5th and 95th percentiles when considering postoperative placement to be "in or out of the anatomic range."

Many different diseases present as cavitary pulmonary nodules. The spectrum of diseases ranges from acute to chronic infections, chronic systemic diseases, and malignancies. To decide on the most likely or correct diagnosis may be challenging. Knowledge of common and uncommon radiological findings in correlation with relevant clinical history and findings is necessary to make the right diagnosis and recommend the correct follow-up or step forward. The aim of this pictorial review is to present a brief overview of CT findings of common cavitary lung diseases seen in adult patients.

The anterior and posterior cruciate ligaments are important stabilizers of the knee joint function. Although they are both similar in their native appearance, they possess slightly different properties and complement each other's function. The imaging findings differ between the anterior and posterior cruciate ligaments. While MRI is the main imaging modality, radiographs and CT have a role in pre- and post-operative imaging. The aim of this review is to present pre-and post-operative imaging findings of injured cruciate ligaments. A special emphasis will be placed on the potential pitfalls in cruciate ligament imaging.

The aim of anterior cruciate ligament (ACL) reconstruction is to restore normal function of the knee, but unfortunately abnormal kinematics and a predisposition to knee osteoarthritis occur in a significant percentage of patients. So there is an ongoing need to improve treatment options and long-term outcome of patients with a ruptured ACL. With the recent advancements in the field of ACL tissue engineering, the focus of treatment for ACL injuries is changing from resection and reconstruction toward repair and regeneration. Several new ACL repair methods were recently introduced as an alternative to traditional ACL reconstructive procedures. Radiologists must become familiar with these new surgical methods to interpret their appearance correctly on postoperative imaging studies. This article provides an overview of the latest advancements in ACL surgical methods and discusses the role of imaging to assess the postoperative ACL including both standard and advanced imaging methods., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Posterior cruciate ligament (PCL) ruptures are not common, but reconstruction is increasing because PCL-deficient knees are prone to develop osteoarthritis. Preoperative MRI may confirm a total or partial disruption of PCL fibers. An overstretched PCL is often mistaken for an intact PCL while the knee is functionally PCL deficient, resulting in false-negative MRI reports. Posterior translation of the medial condyle is a useful indirect sign on imaging. Preoperative stress radiographs are used to quantify the degree of PCL deficiency, and posterior translation determines whether to treat conservatively or with surgery. Early postoperative imaging is performed to evaluate tunnel placement and fixation devices. Late postoperative imaging is performed to assess graft rupture, arthrofibrosis, or tunnel widening. Pre- and postoperative imaging plays an important part in planning and treating functionally PCL-deficient knees and PCL ruptures., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Background: A non-anatomic placement of the femoral and tibial tunnels may affect outcome in anterior cruciate ligament (ACL) reconstructions. Tunnel placements are validated with varying imaging modalities. We compared measurements of tunnel placements between radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) in a clinical setting, assessed the reliability and aimed to decide on a possible "gold standard"., Methods: All patients who had undergone at least two of three modalities, radiographs, MRI and CT, after ACL reconstruction between January 2011 and June 2013 were included. Two radiologists measured tunnel placements according to a standardized protocol. Interobserver agreement was assessed with intraclass correlation coefficients (ICC), the intermodality differences with Bland-Atman plots. Radiation data for CT studies were collected., Results: Forty-six CTs, 45 radiographs and 30 MRIs were reviewed. Femoral inter-observer agreement for radiographs was ICC=0.64, for CT ICC=0.86 and for MRI ICC = 0.75. Tibial inter-observer agreement for radiographs was ICC=0.92, for CT-mip ICC=0.91, for CT and MRI ICC = 0.87. No intermodality differences between the femoral measurements were observed. In the tibia, there were differences between radiographs and CT (-3.9%), radiographs-MRI (-3.6%), CT-CT mip (3.2%) and CTmip-MRI (-3.1%). The effective radiation doses varied between 0.025 and 0.045 mSv, mean and median was 0.033 mSv., Conclusion: There were differences in the tibial measurements between summation and single slice images. Only 3D-CT depicted the femoral tunnel in both directions. CT was consistently reliable in both femoral and tibial measurements. Effective radiation dose from CT was lower than previously reported. CT can safely be used in routine clinical practice to evaluate tunnel placements after ACL reconstruction., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Reconstruction of the anterior cruciate ligament (ACL) is a well-established surgical procedure. However, post-operative imaging in the early phase is not routinely performed. The rationale for performing such imaging is to provide a baseline examination for future controls, to provide immediate feedback to surgeons regarding tunnel placement, and to assess placement of fixation devices. The purpose of this paper is to enable the reader to accurately read post-operative radiographs and CT scans after single-bundle ACL reconstruction.

Mucoid (myxoid) degeneration of the anterior cruciate ligament (ACL) is well documented and well known. Mucoid degeneration of the posterior cruciate ligament (PCL) has been reported, but is rare in comparison. The changes may be subtle and may be missed if one is not aware of the diagnosis. As in the ACL, degeneration may cause pain and discomfort. Recognition of the pathology and correct diagnosis is important for the patient and referring physician, as this may have an impact on the therapeutic strategy. We present a case of mucoid degeneration of both PCLs, which to the best of our knowledge has not been published before in the medical literature, as a probable cause of knee pain due to habitual kneeling.

Objective: During the ESSR 2011 Research Committee Meeting, the duration of intellectual property of a research proposal was discussed. A duration of 2 years from idea to publication was suggested. The purpose of this study was to evaluate how many ESSR 2008 and 2009 scientific abstracts were PubMed cited in print within 2 years of the congress., Materials and Methods: In September of 2011, two researchers independently performed a literature search using author names and title words of all ESSR 2008 and 2009 scientific abstracts published in Skeletal Radiology. In case of similarity or doubt, a senior reviewer made the final decision. Publication details were recorded and analyses were performed in Microsoft Excel (Microsoft, Redmond, WA, USA)., Results: Until September of 2011, 62 out of 137 ESSR 2008 and 2009 scientific abstracts (45%) were PubMed cited in print [2008: 34/73 (47%); 2009: 28/64 (44%)]. 54 out of 137 abstracts (39%) were PubMed cited in print within 2 years of the congress [2008: 30/73(41%); 2009: 23/64 (36%)] including eight out of 137 abstracts (6%), which were already published before the congress [2008: 4/73 (5%); 2009: 4/64 (6%)]. The top-ranking journal in absolute numbers of publications was Skeletal Radiology. The top publishing country was the United Kingdom. Study sample size and first author position between abstract and publication did not change in the majority., Conclusions: Thirty-nine percent of ESSR 2008 and 2009 scientific abstracts were published within 2 years of the congress including 6% that were already PubMed cited in print before the congress.

Background: Ultrasound has been the method of choice for antenatal fetal assessment for the past three decades; however, problems may arise in cases of oligohydramnion, unfavorable position of the fetus, and maternal obesity., Purpose: To compare ultrasound (US) and magnetic resonance imaging (MRI) for common fetal measurements at 19-30 weeks' gestation, and to assess the effect of high maternal body-mass index (BMI)., Material and Methods: 59 low-risk singleton pregnancies were enrolled in a prospective blinded cross-sectional study. In a first session, an experienced obstetrician used a high-resolution US technique and in a second session on the same day MRI was used to measure biparietal diameter (BPD), head circumference (HC), mean abdominal diameter (MAD), abdominal circumference (AC), and femur length (FL). Inter- and intraobserver and intermodality variability was determined using Bland-Altman plots. The effect of maternal BMI was assessed using Spearman's statistics., Results: A total of 45 women aged 19-43 years (median 29 years) attended both US and MRI at median 22 weeks' gestation. The mean differences between US and MRI were 1.6 mm for HC (95% confidence interval [CI] -1.0, 4.3 mm), 1 mm for AC (95% CI -0.2, 4.0 mm), 0.2 mm for MAD (95% CI -0.7, 1.2 mm), 2.2 mm for BPD (95% CI 1.7, 2.7 mm), and 4.6 mm for FL (95% CI 2.9, 6.4 mm). Maternal BMI did not affect the results (Spearman' rho 0.054-0.277; P=NS). The intraobserver agreement for all MRI measurements was acceptable, except for FL, while the interobserver agreement was poor., Conclusion: There was good agreement between US and MRI for common fetal measurements, but not for all (i.e., BPD and particularly FL). MRI had a poor interobserver agreement, underscoring the need for technical refinement and reference ranges specifically established for MRI.

Background: Ultrasound screening has been part of antenatal care for several decades, and warrants high expertise to meet the criteria for a worthwhile screening program. In particular, the rate of false positives should be low., Purpose: To examine time trends of pregnancy terminations for fetal abnormality after 12 weeks' gestation, and to assess the agreement between antenatal ultrasound and post-termination autopsy findings for the main pathologies leading to termination., Material and Methods: During the period 1988 to 2002, 198 pregnancies were terminated for fetal abnormality after 12 weeks' gestation. We reviewed the case notes for those 151 who were autopsied (male/female/undetermined ;= ;91/56/4). Annual rates of live births and stillbirths were retrieved from the Medical Birth Registry of Norway., Results: Antenatal ultrasound provided a correct diagnosis of the major abnormality in 149/151 cases (99%), based on post-termination autopsy findings. The annual rate of terminations after 12 weeks' gestation varied between 0.6 and 3.4 (mean 1.8) per 1000 live births, with a trend toward higher rates over the study period (P=0.001, chi-square test for linear-by-linear association)., Conclusion: The specificity of antenatal ultrasound for major abnormalities was high, as compared to postnatal autopsy findings. The mean annual rates of termination after 12 weeks' gestation tended to increase over the 14-year study period.