Trauma: Concepts and Approaches

I am pleased to present this very interesting issue to the readers of Seminars in Musculoskeletal Radiology. It is dedicated to trauma imaging and mainly focuses on concepts and approaches.

When the editors in chief, Professors Zanetti and White, invited me to serve as guest editor for this issue, I was delighted with the idea to organize an issue where the articles do not follow a typical structure. Rather than just describing anatomical abnormalities and their imaging appearance, this issue explains the underlying concepts and principles behind the approaches to different pathologies in musculoskeletal (MSK) trauma imaging.

A primary task was to find internationally renowned experts who could cover the individual topics in the intended way. The authors were selected based on their research as well as their educational and clinical experience. I looked for authors who would be both able and willing to prepare and present topics in a very structured manner.

The first article was written by Luke J. Higgins and his colleagues from the MSK section at Johns Hopkins University. Under the guidance of the head of the section, Prof. John A. Carrino, they have done a wonderful job in recent years introducing structured reporting and standardizing medical communication in their clinical routine. So they had enormous knowledge to offer for their article, which deals with miscommunication in acute MSK trauma cases. They not only answer questions about how to avoid miscommunication but also provide tools to improve communication and thus ultimately patient management.

Leonard E. Swischuk, professor of radiology at the University of Texas, wrote the second article, dedicated to pediatric MSK trauma imaging. He explains basic principles about pathologies and what to look for in children. Dr. Swischuk explains how those differ from adults. I recommend this very well-structured and concise article to all readers, not only to those who specialize in pediatric imaging. Knowing the principles in pediatric radiology and understanding the corresponding pathologies will improve the skills of every radiologist.

The third article, “Polytrauma: Optimal Imaging and Evaluation Algorithm,” was prepared by Lucas L. Geyer and his colleagues from Munich. The Munich group has a vast experience in trauma imaging, specifically imaging of multiple traumatic injuries. They studied the topic in depth and optimized workflows and imaging algorithms in their home department. I was very impressed with their highly standardized set-up when I had the chance to visit them recently. Their article reflects their significant experience and provides excellent recommendations for an optimal set-up in terms of infrastructure, computed tomography (CT) protocol, and standardized image reading.

Erika J. Ulbrich wrote the fourth article, dedicated to cervical spine imaging. She is a colleague of mine in Zurich and has spent many years researching cervical spine injuries. She has authored or coauthored several studies on this topic and has worked on a large Swiss-based multicenter study on whiplash injuries. As an expert in this field she did an amazing job in reviewing the present literature and providing a detailed overview on the pros and cons of the different imaging modalities and current guidelines/evidence regarding how and when to use them.

The fifth article also deals with spine imaging. Javier Pizones and his colleague Ernesto Castillo from Madrid, Spain, put together a very interesting article about the assessment of acute thoracolumbar fracture. Both authors have conducted and published several original studies on this topic, and I recommend those articles as additional reading beyond their excellent review in this issue. They describe typical pitfalls in multidetector CT imaging and the added value of emergency MRI especially for the evaluation of the posterior elements of the spine.

A very distinguished and well-illustrated overview on the diagnosis and therapy of acute hemorrhage in patients with pelvic fractures was written by Sebastian Kos and colleagues. I personally know Sebastian, who is not only an excellent fellowship-trained interventionist but also—by training, experience, and heart—an outstanding diagnostic radiologist. He and his colleagues provide background information about epidemiology and the classification of pelvic fractures/hemorrhage, list predictive diagnostic findings to identify patients who should undergo emergent catheter angiography, and discuss the main aspects of the latter.

The seventh article is also dedicated to interventional therapy in the pelvis, and I am delighted that two very renowned radiologists agreed to cover this topic, Richard H. Daffner and Robert L. Sciulli from the Allegheny General Hospital in Pittsburgh, Pennsylvania. Both authors are distinguished experts in their field, and their article, “CT-Guided Iliosacral Screw Placement,” is an outstanding report about their experience with this procedure, which they started > 10 years ago and can be performed in any radiology department.

The final article, “Frequently Missed Findings in Acute Ankle Injury,” was authored by Zaid Jibri and his colleagues from the University Hospital of Wales, Cardiff. The authors are experts in diagnostic radiology and have vast clinical experience. Their article is a reflection of their in-depth knowledge, and it is also richly illustrated. The authors recently published another review article about persistent ankle pain following a sprain in the journal Emergency Radiology. I can recommend their current work in the Seminars as well as their previous work as reading material due to the complementary information.

I wish to express my deepest thanks to all the authors and co-authors of this issue of Seminars in Musculoskeletal Radiology. Their well-structured work, concise writing, and timely submissions are highly appreciated. In addition, I would like to thank the editors in chief for offering me the opportunity to act as guest editor. They are not only outstanding MSK radiologists but also good friends for many years. Many thanks also to the production team, who all did a great job in ensuring a high-quality production. Overall, it was a tremendous experience and pleasure to put this issue together, as well as a considerable joy to work with the authors, co-authors, editors in chief, and the production team.