Holger Pettersson – författare

During the last decade the therapeutic approach to musculoskeletal tumors has changed dramatically, from ablative surgery with ampu­ tation ofthe limb to reconstructive surgery with transplantation of bone and vessels combined with radio-and chemotherapy. This has changed the demands on radiologists and pathologists to a considerable degree. At the same time there has been a manifold increase in the diagnostic possibilities offered by modern radiology, with several new modalities affording a potential for morphologic depiction and tissue character­ ization that was unattainable a decade ago. Today, the definitive diagnostic work-up and treatment of patients with musculoskeletal tumors is most often done in tumor centers, by groups that ideally should be composed of an orthopedic surgeon, radiotherapist, oncologist, radiologist, pathologist and cytologist. It is necessary for all the members of this team to be well versed in the surgi­ cal and other treatment principles, in the pathologic concepts, and in the radiologic interpretation of musculoskeletal tumors. Moreover, it is important that the modern diagnostic approach to musculoskeletal tumors is well known also at the referring center, be it a private practi­ tioner's office or a large hospital. This will avoid unnecessary biopsies, and repetition of radiologic and other diagnostic procedures that have already been performed at the referring center.

A thorough knowledge of normal radiological anatomy is necessary for detection and evaluation of pathological changes. In pediatric radiology, normal anatomy and normal proportions of anatomical structures may differ considerably from the adult, and may vary during growth. Therefore, in pediatric radiology there is a multitude of measurements, that in the individual patient is important, but that for the radiologist is not meaningful or even possible to keep in mind. This holds true both for the experienced pediatric radiologist, and for those who practise pediatric radiology only occasionally. This volume is written for both categories. In the literature, normal values are calculated and presented in many different ways, that are not always easy to compare, or easy to use in daily work. Therefore, we have revised and recalculated the data given by authors, in order to present the statistical upper and lower normal limits as between plus and minus two standard deviations (± 2SD). This means that about 2% of a normal population will be assessed as abnormally large and around 2% abnormally small with respect to the parameter assessed. In this way, the presentation throughout the book is uniform, and hopefully easy to use. All figures have been redrawn and computed in an attempt to make them as clear as possible.

Musculoskeletal studies account for an important proportion of the daily clinical practice of most radiologists. For many years following Rontgen's discovery of x-rays in 1895, these studies were confined to plain films and conventional tomography, which substantially limited the contribution of radiology in achieving better diagnosis and treatment of ortho­ pedic pathologic conditions. The advent of digital radiography, ultrasound, computer tomography and especially magnetic resonance imaging has greatly enhanced the potential of radiologic imaging in this field. Among the benefits to accrue from these techniques are the detailed visualization of soft tissue anatomy and pathologic changes, progress in the noninvasive study of joint pathology, and improved staging of primary bone tumors. The need for an update of our knowledge in orthopedic imaging is therefore immense. The editors, Dr. A. M. Davies and Prof. H. Pettersson, have been able to acquire the collabo­ ration of a number of international leaders in bone and soft tissue imaging for the produc­ tion of this book, which took an exceptionally brief period from the date of conception to printing. Accordingly, readers will find in this work the latest developments in techniques and radiologic interpretation. The up-to-date nature of the information provided, and the expertise which it embodies, will undoubtedly be of great help in daily clinical practice, not only to general radiologists and orthopedic surgeons but also to musculoskeletal radiolo­ gists working in subspecialties. I am very grateful to the editors and to the authors for their excellent contributions.