Application of Imaging Modalities to Musculoskeletal Soft Tissues

• Modalities– Magnetic resonance.– Ultrasound.– Computed tomography (CT).– Positron emission tomography CT.

• Tissues– Spine and intervertebral discs. – Joints, ligaments, menisci, synovium, and tendons.– Muscles and entheses (where tendons and ligaments join bone).

• Applications– Identification of at-risk populations.– Early detection of disease.– Conclusive diagnosis of disease or injury.– Evaluation of tissue repair or regeneration.

Musculoskeletal Soft Tissue Imaging Research Gaps

• Standardization of methods– Among protocols and between technicians using same protocols.

– Interpretation of results.

• Correlation between signs and symptoms– Intervertebral disc images and back pain.

– Hip and knee images and osteoarthritis pain.

– Muscle images and physical functioning (e.g., strength, fatigue).

• Collection of images during movement– Back pain.

– Muscular dystrophy.

• Visualization of tissues, cells, and cell processes– Ligaments, menisci, entheses.

– Stem cells.

– Inflammation.

The Future of Musculoskeletal Soft Tissue Imaging

• Examine multiple tissues that compose joints– Muscle atrophy and symptomatic back pain—not just intervertebral disc.– Soft tissue pathology and osteoarthritis symptoms—not just cartilage.

• Measure functional indices to quantify disease severity– Intervertebral disc degeneration.– Muscular dystrophy.

• Understand cell processes– Stem cell propagation, migration, and differentiation.– Tissue regeneration.

• Evaluate therapies– Conventional pharmacologic, surgical, and physical therapies.– Engineered tissue constructs.– Stem cells or other regenerative strategies.