Muscle Imaging: Beyond the Basics
03 August 2017 (online)
The field of musculoskeletal radiology continues to evolve in new and exciting directions. Only a generation ago, when few alternatives to conventional radiography and tomography were available, our field was referred to simply as “bone radiology.” With the widespread adoption of cross-sectional imaging, our field was rebranded as musculoskeletal radiology, and we have matured greatly in our understanding of both bones and internal derangements of joints. Insofar as scholarly work on muscle has lagged behind, our goal with this issue is to put the muscle back in musculoskeletal radiology.
“Infobesity” and “infoxication” refer to information overload that results in difficulty understanding an issue and making effective decisions. During our past 2 decades of practicing musculoskeletal radiology, we have been fortunate to witness many improvements in imaging techniques and diagnostic prowess. However, one of the underlying tectonic changes affecting us during this time often is taken for granted: the medical information explosion.
For physicians as lifelong learners, one of the driving forces behind this seismic shift has been PubMed, which ushered in the current era of free widespread access to the U.S. National Library of Medicine database. With ∼ 27 million references to journal articles in the life sciences, PubMed citations are now added at a rate of > 800,000 each year and come from > 5,600 worldwide journals in 40 languages! Even when searching specific terms, such as “skeletal muscle AND imaging,” there is deluge of 6,284 articles on humans in the English-language literature during just the past 5 years.
If the diagnosis is “information overload”, do we need a treatment? Phrases such as “information glut” and “data smog” have evolved to describe the unintended negative effects of information overload. For example, assuming people can process only about seven quanta of information at a time, social science research concludes that excess information can cause stress that degrades job satisfaction, delays decision making, and can even be associated with poorer decisions. Indeed, recent work in medicine indicates that diagnostic errors may be reduced by avoiding information overload. As radiologists, this should come as no surprise. We are familiar with the lack of clarity that may result from data with a low signal-to-noise ratio, as it were.
If the diagnosis is “information overload”, what is the treatment? One strategy for information management is a better filter. That is where Seminars in Musculoskeletal Radiology plays a vital role in distilling the essence of what we need to know to be at the top of our game.
In this issue, we go beyond the basics with nine articles by subspecialty scholars selected for their practical solutions to everyday challenges in busy clinical practices. These authors are recognized worldwide for their exceptional expertise in muscle imaging.
The first three articles focus on MRI of the upper extremity, from the shoulder (proximally) to the hand (distally).
The next three articles address more distal musculotendinous disorders, from the torso and pelvis (proximally) to the lower leg (distally).
The final three articles fill in pieces of the puzzle where musculoskeletal radiologists commonly add additional value for challenging patients, including on issues related to muscle ischemia, myositis, and sonographically guided interventions.
We trust that readers of this issue will find it filled with high-yield insights that go beyond basics and yet are highly practical clinically. This issue is just what the doctor ordered for infobesity—high-signal pearls of wisdom from trusted experts who have done the hard work of filtering out the noise.