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Musculoskeletal (MSK) disorders are the leading contributors to disability worldwide and are expected to increase, partly due to an aging population and rising incidence of obesity. 

To meet the upcoming challenges in MSK imaging, 900 specialists gathered at the annual meeting of the European Society of Skeletal Radiology (ESSR) on June 22 – 24 in the Euskalduna Conference Center, overlooking the River Nervión in Bilbao, Spain. The main topic of the congress was ankle and foot imaging, and speakers reviewed the most significant advances in the field from a multidisciplinary perspective.

ESSR 2023 delegates enjoying a break in sunny Bilbao 

Besides the traditional ultrasound course offered each year at the meeting, the program featured three workshops on spondyloarthritis, a group of arthritis conditions that affect bones in the spine and nearby joints, causing pain and inflammation. Sessions on Thursday June 22nd, the first day of the congress, also focused on artificial intelligence (AI), while subcommittees organized dedicated workshops. 

AI-boosted ultrasound systems in the limelight 

With barely 20 companies displaying their products in the main hall of the building, the technical exhibition was buzzing with activity, networking and new equipment. Some of the main manufacturers were present, and a quarter of the exhibitors were AI software developers, reflecting the growing interest of MSK radiologists in such solutions to ease workflow.

French company Gleamer presented its BoneView measurements and BoneView Bone Age solutions. Three other French companies – AZMed, Milvue and Incepto, a platform provider – were also present at the show, while Bulgaria-based SmartSoft Healthcare featured CoLumbo, its AI assistant software for the interpretation of lumbar spine MR scans. 

Austrian provider IB Lab showcased its animal-inspired ZOO portfolio that covers the leg, knee, hand, hip, spine and foot, and launched SQUIRREL, its newest tool to expedite and improve assessment and monitoring of scoliosis. The industry was also very much present in the scientific program, with two main manufacturers holding dedicated symposia featuring key opinion leaders in the field. 

Prof. Martinolli showing small nerves of the upper arm

On Friday, ESSR President Professor Carlo Martinolli, head of the imaging department at University Hospital Genoa, Italy, gave an impressive lecture on challenges in small nerves imaging. “Most of those nerves running in the arm and forearm are forgotten,” he said. “They are so tiny and so superficial that they’re very hard to see using conventional transducers.” 

Probe in hand, he showed a mesmerized audience how to image small nerves of the upper limb with a Philips EPIQ Elite advanced ultrasound system installed directly on stage. ESSR’s immediate past president Doctor Eva Llopis, a radiologist at the European Musculoskeletal Institute (IMSKE) in Valencia, Spain, shared her tips on how to efficiently use MRI and manage requests in MSK studies. 

“There’s an increased demand for MRI scans in any specialty and especially in MSK, but resources are limited both in equipment and technology,” she said. “Many factors such as increased average age and sports practice, particularly in older patients, are causing this growing demand. (We have to consider) the importance of activity combined with sarcopenia, a type of muscle loss that occurs with aging and / or immobility.” 

On Saturday, Prof. Martinolli also spoke about exploring elbow ligaments with the next generation high-frequency probes during a symposium organized by Italian manufacturer Esaote, who showcased its recently launched MyLab X-90 advanced ultrasound system.