Xavier Tomas

• M.D, PhD
• Consultant at Hospital Clínic de Barcelona

Background: Protracted febrile myalgia (PFM) is a rare but severe form of myalgia mainly occurring in pediatric patients with familial Mediterranean fever (FMF). PFM imaging and histopathological data remain scarce. Objectives: A comprehensive clinical, imaging, and histopathological characterization of PFM was performed by retrospectively analyzin...

Multiple myeloma (MM) remains incurable, with poor outcomes in heavily pre-treated patients with plasmacytomas. Chimeric antigen receptor (CAR) T-cell therapy has emerged as a promising treatment option; however, outcomes after such therapy in patients with soft-tissue plasmacytomas and other bone lesions remain poorly understood. Data regarding th...

Calf muscle injuries are common among athletes and occupational populations, with highly variable recovery times that are challenging to be predicted at the initial clinical evaluation. Specifically, in distal gastrocnemius muscle injuries, an ultrasound-based severity classification has shown to be useful for estimating the recovery time. Accordin...

Background and Objective Traditionally, literature on thoracic ultrasound has focused on the study of pleural and pulmonary pathology. However, given the superficial location of thoracic wall structures, ultrasound proves to be an excellent technique for their examination. This study aims to evaluate the clinical utility of thoracic ultrasound in d...

Myosteatosis has emerged as an important concept in muscle health as it is associated with an increased risk of adverse health outcomes, a higher rate of complications, and increased mortality associated with ageing, chronic systemic and neuromuscular diseases, cancer, metabolic syndromes, degenerative events, and trauma. Myosteatosis involves ecto...

Background Total knee arthroplasty (TKA) is an effective surgical procedure for managing advanced osteoarthritis of the knee, significantly reducing pain and improving function. However, some patients experience complications leading to revision surgery, often caused by periprosthetic joint infection (PJI) in early failures and adverse local tissue...

Background Contraceptive arm implants, such as Implanon NXT®/Nexplanon®, are reversible methods of birth control that have gained global popularity, with over 20 million worldwide users. While palpable implants can be easily removed, deep or non-palpable implants pose complications during extraction, often requiring open surgery. This ultrasound-gu...

Contraceptive arm implants provide long-acting contraception through a subdermal rod. The device is intended to be placed on the medial side of the non-dominant upper arm. There are two main types of implants: etonogestrel (ENG)-releasing devices, such as Implanon NXT®/Nexplanon®, and levonorgestrel (LNG)-releasing devices, including Sino-implant I...

Historically, musculoskeletal (MSK) tumors, which include both bone and soft tissue tumors, have been managed as distinct entities. The incidence of metastases, particularly bone metastasis, in patients with MSK tumors can result in the emergence of significant complications such as pain, impairment of vital anatomical structures, or pathological f...

Background Gastric cancer (GC) is the fifth most common cancer globally and the third leading cause of cancer-related deaths. While it predominantly metastasizes to the liver, peritoneum, and lungs, bone metastasis (BM) is a rare but severe complication. BM occurs in 1–20% of GC cases and is associated with a poor prognosis. Typically, BM in GC pre...

This study analyzes the individual UF2, from the medieval necropolis (9th-10th century) of the Antiguos Juzga-dossite in Barcelona. To complete the study, age and sex were estimated, and macroscopic and radiologicalanalysis of the observed lesions was carried out. The results indicated a 39-40-year-old man with injuries tothe skull, neck, left fore...

The paleopathological literature notably lacks the description and analysis of distal humeral fractures and their associated complications. The objectives of this study were (1) to evaluate a distal humerus fracture associated with cubitus valgus observed in the articulated right elbow of an adult male buried in the Santa Caterina Friary site in Ba...

MRI plays a crucial role in assessment of patients with muscle injuries. The healing process of these injuries has been studied in depth from the pathophysiologic and histologic points of view and divided into destruction, repair, and remodeling phases, but the MRI findings of these phases have not been fully described, to our knowledge. On the bas...

This research presents a comprehensive analysis of traumatic lesions observed in the skeletal remains from funerary unit 221, which belongs to a guild buried at the exterior buttresses of Santa Caterina friary's church wall. The aim is to investigate whether this guild was subjected to harsher working conditions during the transition from the medie...

Teaching Point: Costal chondroid tumors can mimic abdominal masses and, when located in the right hypochondrium, may suggest hepatic origin. Computed tomography is essential to determine their origin and nature and to guide appropriate treatment.

Progressive population aging and improved healthcare have led to a significant increase in patients with hip arthroplasty (HA). In this patient group, the proportion of those who require a new arthroplasty (prosthetic replacement or secondary revision of the hip), has also increased. For this subgroup of patients in whom surgical prosthetic replace...

The aim of this study is to analyze the porotic skeletal lesions of bone remains from the funerary unit (UF) 221 of the Santa Caterina convent site in Barcelona, which is divided into secondary burials (Medieval, 13th-14th century) and primary burials (Modern, early 16th century), in order to evaluate the health state of these individuals. A previ...

Diabetic foot complications are increasingly prevalent in the world, leading to significant morbidity and driving up associated health care costs. Complex pathophysiology and suboptimal specificity of current imaging modalities have made diagnosis challenging, mainly in the evaluation of superimposed foot infection to underlying arthropathy or othe...

Background Because MRI has shown great accuracy in assessing acute muscle injuries, identification of risk factors for reinjury before return to play (RTP) in professional athletes during the healing process could be very relevant. We assessed the value of MRI findings prior to RTP as predictors of reinjury. Methods Retrospective observational stu...

Postoperative imaging of the hip used to be dominated by radiographs, computed tomography, and occasionally nuclear medicine studies, given that most surgeries were arthroplasties or, less commonly, core decompressions. The indications and procedures performed have expanded well beyond arthroplasties and now include labral procedures (resections, r...

The differential diagnosis of bone tumors in the talus is broad and includes both benign and malignant conditions. Metastases, although very rare, are one of these conditions. The typical nonspecific clinical and radiological presentations of metastases are a diagnostic challenge, and a high level of suspicion is needed in order to perform an adequ...

Background and Aims Continuous peripheral nerve blocks (cPNB) are widely used and have potential benefits for providing pain relief for several days. Successful insertion of cPNBs and avoidance of their dislocation can represent a challenge.Dislocation of cPNBs can result in failure of the block and is poorly described in the literature. The rate o...

Green hair is due to insoluble copper deposits in the hair of blonde people. Although it is most frequently due to an increase in the copper content of algaecides in swimming pools, other causes have been recognized. Herewith, we present a case of a blonde girl who had previously commercially highlighted her hair and the hair had turned green follo...

Objectives To perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton’s neuroma) and provide clinical indications. Methods We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who revi...

Objectives Interventional procedures around the knee are widely adopted for treating different musculoskeletal conditions. A panel of experts from the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the existing literature to assess the evidence on image-guided musculoskeletal interve...

Objectives Clarity regarding accuracy and effectiveness for interventional procedures around the foot and ankle is lacking. Consequently, a board of 53 members of the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the published literature to evaluate the evidence on image-guided musc...

Objectives Image-guided musculoskeletal interventional procedures around the hip are widely used in daily clinical practice. The need for clarity concerning the actual added value of imaging guidance and types of medications to be offered led the Ultrasound and the Interventional Subcommittees of the European Society of Musculoskeletal Radiology (E...

Presentamos el caso de una paciente mujer de 34 años de edad que presentó ruptura de ligamento de Cooper de la mama izquierda a raíz de movimiento brusco de torsión de tronco. Dicha patología es poco frecuente y es importante considerarla en los posibles diagnósticos diferenciales de una lesión pectoral. En la literatura no se encuentran casos repo...

Purpose: To compare the diagnostic accuracy of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) involving two region of interest (ROI) sizes with 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to differentiate diabetic foot osteomyelitis (DFO) from Charcot...

Objective The differentiation between delayed aseptic and septic complications of total hip arthroplasty is crucial to allow appropriate surgical planning and timely antimicrobial treatment. The aim of this study was to investigate the utility of multidetector computed tomography (CT) findings to diagnose aseptic mechanical loosening, granulomatous...

Whole-body magnetic resonance imaging (WB-MRI) is a powerful tool increasingly used to assess oncologic and nononcologic diseases. WB-MRI provides information about diffuse multifocal pathologies with excellent anatomical definition through high soft tissue contrast and spatial resolution as well as valuable functional information from diffusion-we...

Background: Infection after total hip arthroplasty remains a diagnostic challenge. We assessed the accuracy of computed tomography (CT)-guided joint aspiration combined with CT findings for prediction of septic hip prosthesis before revision surgery. Methods: A total of 96 patients (64.6% men; mean age, 68 years) scheduled for elective revision...

Introduction Short tau inversion recovery (STIR) sequences in whole body MRI (WB‐MRI) are usually used for detecting muscle edema (ME) in inflammatory myopathies. We evaluated b‐value 800 diffusion weighted imaging (b800 DWI). Methods Two radiologists independently and a consensus reader retrospectively re‐examined 60 patients with inflammatory my...

Magnetic resonance imaging (MRI) is considered the most sensitive and specific imaging technique for the detection of muscle diseases related to myopathies. Since 2008, the use of whole-body MRI (WBMRI) to evaluate myopathies has improved due to technical advances such as rolling table platform and parallel imaging, which enable rapid assessment of...

Blunt injuries to the chest wall are an important chapter on emergency room (ER) departments, being the third most common injuries in trauma patients which ominous complications could appear. This article describes different types of traumatic events affecting the chest wall, which maybe misdiagnosed with conventional X-ray. Special emphasis has be...

Background Dermatomyositis represents one of the major forms among the inflammatory myopathies (IIM). Although the muscle biopsy remains the definitive test, MRI has been used to detect unique patterns of muscle involvement. To date, no studies have compared MRI with muscle pathology in naïve DM. Objectives To compare the pattern of muscle MRI wit...

Purpose: A reduction in femoral offset may decrease muscle tension and lead to spacer dislocations even though proximal femur, musculature and acetabulum remain intact. In this study, we aimed to determine whether postoperative lateral femoral offset (LFO) and modified vertical femoral offset (MVFO) values affect the risk of dislocation of a hip s...

Purpose: The aim of this study was to measure the cortical thickness and bone density of the different parts of the bicipital tuberosity, to evaluate the importance of these variables on resistance to pulling out of distal biceps tendon reinsertion implants. Methods: Sixteen cadaveric arms were used for this study. A multiple detector computed t...

Introduction: Hypertrophy of the tensor fascia lata muscle (HTFLM) is a rare complication after total hip arthroplasty (THA) and is a potential source of pain, palpable mass, or both. Materials and methods: We retrospectively analyzed 1285 primary THAs and 482 THA revisions (THAR) performed at our center from 2008 to 2014. Among these, five pati...

Purpose: To compare radiography with multidetector computed tomography (MDCT) in the evaluation of graft integration following acetabular reconstruction for failed total hip arthroplasty (THA). Methods: Records of 5 men and 6 women aged 60 to 78 (mean, 71.8) years who underwent acetabular reconstruction using structural allografts for severe ace...

Aim: To evaluate the impact of the angioscintigrapy of the three phase bone scan as screening method to rule out infection of the hip and knee prosthesis prior to performing the (99m)Tc-HMPAO leukocyte scintigraphy. Material and methods: A total of 120 (70 women, 50 men; mean age 71±11years) with clinical suspicion of hip (n=63) or knee (n=57) i...

Resumen Objetivo Analizar la utilidad de la fase angiogammagráfica de la gammagrafía ósea en 3 fases como posible método de cribado en el diagnóstico de infección de prótesis de cadera y de rodilla, previa a la realización de la gammagrafía con leucocitos marcados. Material y métodos Se analizaron prospectivamente 120 pacientes (70 mujeres y 50 h...

To evaluate the impact of the angioscintigrapy of the three phase bone scan as screening method to rule out infection of the hip and knee prosthesis prior to performing the (99m)Tc-HMPAO leukocyte scintigraphy. A total of 120 (70 women, 50 men; mean age 71±11years) with clinical suspicion of hip (n=63) or knee (n=57) infection of the prosthesis and...

Dear Sir,Following the recent publication of our study on whole-body 18F-FDG PET/CT and MRI of the spine in the diagnosis of haematogenous spondylodiscitis [1], we would like to reply to the comments by Soussan [2].Dr. Soussan questions the low specificity of MRI regarding the MRI criteria for infection described in the “Materials and methods” sect...

Purpose To prospectively compare 18F-FDG PET/CT and MRI in the diagnosis of haematogenous spondylodiscitis Methods The study included 26 patients (12 women, 14 men; mean age 59 ± 17 years) with clinical symptoms of infection of the spine. Patients who had had prior spinal surgery or any type of antibiotic therapy in the previous 3 months were ex...

Mycobacterium marinum is an atypical mycobacterium that usually causes a solitary nodule on the hand ("fish tank granuloma") or less commonly, secondary erythematous channels and nodules spread along lymphatic drainage of the extremity, mimicking sporothricoid skin lesions of nodular lymphangitis. This report presents a case of this rare entity, a...

The main goal of this paper is to describe and discuss pathological lesions observed in a Roman skeleton (between 2 nd and 3 rd century AD) from the north‐east region of the Iberian Peninsula (St Nicasi 18–24 site. Gavà, Barcelona), which may be compatible with treponematosis. Most of the skeleton, with the exception of the neurocranium, was recove...

Introduction: Psoas abscess associated with hip arthroplasty infection is a rare entity. The aim of this report was to review our experience. Material and methods: Patients with computerized tomography (CT) diagnosis of psoas abscess associated with a hip arthroplasty infection from 2004 to 2009 were retrospectively reviewed. Demographics, micro...

Purpose The aims of this study were to assess the healing rate of repair of chronically torn meniscal tear with MR-arthrography and to evaluate the relationship between the clinical and the radiographic outcomes and the impact of the meniscal section on healing. Methods MR-arthrography was performed at a median of 10.5 months (range 6–55) after...

PURPOSE/AIM - Review the spectrum of musculoskeletal soft tissue infections (MSTIs) - Recognize the key findings on image to make an early diagnosis - Identify the signs of severity - Describe clinical and radiological characteristic findings of some of the causative organisms - Discuss the value of new imaging techniques such as diffusion–weighted...

This study aimed to prospectively evaluate the usefulness of PET/CT using F-FDG in comparison to bone scan and Ga in the diagnosis of spondylodiskitis. This prospective study included 34 patients (15 women and 19 men) aged 59 (18) years with clinical symptoms of spondylodiskitis. Whole-body PET/CT and bone scan combined with planar and SPECT/CT Ga...

Una donna di 63 anni si presenta con dolore alla caviglia sinistra da circa 3 mesi. Riferisce una lesione traumatica in tale sede circa 6 mesi prima. Vengono eseguite radiografie e RM.

Objective: The purpose of this review is to describe the gross anatomic and MRI appearance of the quadratus femoris muscle and the MRI appearance of common lesions of the quadratus femoris. Conclusion: Lesions of the quadratus femoris have been implicated as a cause of hip pain. It therefore is important to be familiar with the anatomy of the qu...

The pathogenesis of prosthesis loosening is not well understood. The aim of our study was to sonicate components of joint prostheses removed due to aseptic loosening, culture the sonicate fluid, and to correlate these results with the degree of radiological osteolysis. From January 2008 to June 2009 all consecutive patients who underwent a revision...

To assess the prevalence, imaging appearance, and clinical significance, of bone marrow MR signal changes in a group of human immunodeficiency virus (HIV)-infected patients with lipodystrophy syndrome. Twenty-eight HIV-infected patients with lipodystrophy syndrome treated with highly active antiretroviral therapy, and 12 HIV-negative controls under...

To determine the accuracy of guided computed tomography aspiration in the detection of septic hip prosthesis before surgery. Sixty-three patients (35 women and 28 men; age range, 29-86 years; mean age, 71 years) with clinically suspected septic hip prosthesis were prospectively studied with independent review board (IRB) approval. Volume and microb...

A 63-year-old woman presented with a 3-month history of left ankle pain. She recalled a traumatic ankle sprain 6 months before. Plain-film radiographs and MRI were obtained. The name “osteochondral lesion” mainly describes a posttraumatic lesion involving an area of hyaline cartilage at an articular surface and its underlying subchondral bone. This...

The aim of this study was to evaluate whether anterior cruciate ligament (ACL) reconstruction using the double bundle technique (DB) improves stability in the knee compared with the single bundle technique (SB) with the femoral tunnel in a more horizontal position (2 or 10 o'clock). We conducted a randomized, prospective study. Forty patients were...

Uno de los principales retos en el tratamiento del dolor de la articulación sacroilíaca (AS) es llegar a un adecuado diagnóstico. Las técnicas por imagen han ganado un gran protagonismo en este aspecto. La tomografía computarizada (TC) y la resonancia magnética (RM) presentan igual eficacia en la detección de cambios estructurales en artrosis y art...

One of the most challenging aspects of treating the sacroiliac joint (SIJ) pain is the complexity of diagnosis. Imaging methods have gained importance for the diagnosis of SIJ diseases. CT and MR exams had equal efficacy superior to radiography in staging structural changes in the SIJ due to osteoarthritis or sacroiliitis. The diagnosis of spondylo...

Alumina ceramic-on-ceramic total hip arthroplasty (THA) has been widely used due to its advantages such as low wear, scratch resistance, wettable surface and relatively low biological reactivity of the wear particles. Nevertheless, this material in THA still persists to be one of the major concerns about the risk of fracture, due to its brittleness...

Bone fracture is a well known possible late complication of radiation treatment. Little has been written about fractures of long bones after irradiation. We present a case of femur bone necrosis secondary to postoperative radiation for a soft tissue sarcoma of the thigh 20 years earlier. Fixation of the diaphyseal fracture and radiological evolutio...