Pediatric Musculoskeletal Imaging

The imaging of pediatric musculoskeletal disease often presents a challenge to the practicing radiologist. Working with children, one needs to be familiar with the tremendous spectrum of normal and abnormal development that can be encountered throughout childhood, ranging from the tiny premature infant to the adult-sized teenager. Obtaining and interpreting diagnostic examinations in a young child especially often requires skills that are quite different from those needed for adults both for image acquisition and interpretation. For example, although magnetic resonance imaging (MRI) provides the most detailed and exquisite imaging of the musculoskeletal system, it may require sedation or even general anesthesia in the young child.

In this issue we focus on a diverse range of pediatric topics, presenting some common and more uncommonly encountered disorders. Two authors provide more specific recent information updating our use of two commonly used imaging modalities: nuclear medicine and MRI. Dr. Shammas summarizes our current understanding of the role of nuclear medicine including positron emission tomography/computerized tomography for evaluation of the pediatric musculoskeletal system, reviewing the commonly used radiopharmaceuticals and their applications. Dr. Chavhan and coworkers review the current status of 3-T MRI, highlighting some of the current added benefits and disadvantages that 3-T systems can bring to the imaging of children and what has been assessed to date.

The important role of imaging in the assessment of tumors is addressed by Dr. Navarro. He provides an overview of the imaging of benign soft tissue tumors, focusing on the growing role of sonography. Dr. Lobo-Mueller and colleagues in two pictorial articles provide an excellent overview of extremity vascular anomalies. This is still a very confusing topic for radiologists and in our literature. They present an excellent pictorial summary of these lesions both simple and complex, their classification, imaging findings, and the utility of intervention.

The increasing recognition of the genetic basis for many skeletal disorders and the alteration it is having on our basic understanding of musculoskeletal disorders is illustrated by the fine overview of SHOX-associated disorders by Dr. Gahunia and colleagues.

Dr. Ranson provides an update of pediatric musculoskeletal infections including a section that presents the imaging of the increasingly recognized community-acquired methicillin-resistant Staphylococcus aureus.

The authors are to be commended for their efforts. I would also like to express my gratitude to the contributing authors for their timely cooperation and excellent contributions.

It has been a privilege for me to work with all the authors and the fine team at Thieme. I would like to thank the editors for the privilege of serving as the guest editor for this issue.