Root resorption corresponds to the progressive loss of mineralized dental tissues and may occur in a physiological, pathological, or idiopathic manner. This resorption can affect both the internal and external surfaces of the tooth, presenting different etiological mechanisms, radiographic patterns, and therapeutic implications. Early diagnosis is crucial for the prognosis of the dental element and for defining the most appropriate clinical approach; however, diagnosis often occurs sporadically during routine clinical and radiographic examinations, making a favorable prognosis more difficult. Conventional radiographs, such as periapical and panoramic images, are widely used as initial evaluation methods; nevertheless, because they are two-dimensional examinations, they present important limitations, including structural overlap, distortions, and low sensitivity for early lesions, with computed tomography being the most satisfactory examination for diagnosing this condition. This study is characterized as a narrative literature review, conducted through a systematized survey of scientific literature in the PubMed, Scopus, and Web of Science databases, using the descriptors “Tooth Resorption,” “Root Resorption,” “Radiography,” and “Diagnosis,” combined with Boolean operators; articles published in the last five years, available in full text and directly addressing the use of radiographic methods in the diagnosis of internal and external root resorptions were included, while duplicate studies, isolated case reports, and publications lacking methodological rigor were excluded. The selection process occurred in stages, including the reading of titles and abstracts and the critical analysis of full texts. The results demonstrate that Cone Beam Computed Tomography presents greater sensitivity and specificity compared to conventional radiographs, enabling detailed three-dimensional visualization, better differentiation between types of resorption, and volumetric analysis of root loss, leading to the conclusion that CBCT is a fundamental tool for the diagnosis and monitoring of root resorptions, especially in complex cases involving recovery and orthodontic movement.

Conventional radiographs and bone mineral density are commonly used to predict cage subsidence, though their accuracy can be limited by factors several factors. MRI-based Vertebral Bone Quality (VBQ) and Endplate Bone Quality (EBQ) offer a more detailed assessment of bone quality and subsidence risk. This study aims to evaluate the accuracy of MRI-based VBQ and EBQ in predicting cage subsidence in anterior cervical spine surgery patients. A comprehensive search was conducted across databases including PubMed, Europe PMC, ScienceDirect, and Google Scholar using keywords such as "Magnetic Resonance Imaging", "MRI", "Vertebral Bone Quality", "Endplate Bone Quality", "Cage Subsidence", "Anterior Cervical Spine Surgery", "ACDF", "ACCF", combined with Boolean operators "AND" and "OR" up to November 2024. The risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2), with the primary outcome focusing on VBQ and EBQ values, and secondary outcomes examining the AUC, sensitivity, and specificity of VBQ and EBQ. Nine retrospective cohort studies involving 911 patients were included. Pooled analysis showed that high VBQ and EBQ scores were significantly associated with increased subsidence risk (OR 2.63, 95% CI: 1.51-4.60, p = 0.0007). Pooled sensitivity and specificity for VBQ were 78.9% (95% CI: 72.5%-85.3%) and 85.7% (95% CI: 82.2%-93.1%), respectively, with an AUC of 0.865. EBQ demonstrated pooled sensitivity of 81.8% and specificity of 88.7%, with an AUC of 0.890. The cutoff values for VBQ and EBQ ranged from 2.68-3.445 and 1.973-4.7, respectively. MRI-based VBQ and EBQ scores demonstrate strong diagnostic accuracy for predicting cage subsidence in anterior cervical spine surgery. These scores could aid in preoperative risk assessment, though further research should aim to standardize MRI protocols and validate cutoff values across diverse populations.

Mapping textures of polar ice cores using 3D laboratory X-ray microscopy

To predict cartilage tumor malignancy from radiographic images combined with readily available non-imaging information based on a vision-language foundation model. This single-institution study assembled a dataset of 3336 radiographs from 455 patients with enchondroma or chondrosarcoma that was assembled from two sources: (1) patients with histopathology-confirmed diagnoses of enchondroma or chondrosarcoma, and (2) patients with imaging-stable enchondroma without biopsy, confirmed through long-term imaging follow-up. An adapted vision-language foundation model based on the pre-trained CLIP (Contrastive Language-Image Pretraining) architecture was fine-tuned with our proposed Medical Knowledge Adapters and evaluated using 10-fold patient-level cross-validation to predict cartilage tumor malignancy from plain radiographs and demographic information. Using radiographs alone, the model achieved an Areas Under the receiver operating characteristic Curve (AUC) of 0.91 ± 0.04. Incorporating demographics improved the AUC to 0.94 ± 0.02. Subgroup analysis demonstrated robust generalizability across tumor grades with an AUC of 0.91 ± 0.07 in distinguishing atypical cartilaginous tumors (ACT) previously known as low grade chondrosarcomas, and 0.95 ± 0.02 in differentiating high-grade chondrosarcomas from enchondromas. Within the clinically challenging extremity subgroup (enchondroma vs ACT/LGCS), the model achieved an AUC of 0.79 ± 0.14, reflecting diagnostic difficulty observed in clinical practice. This foundation model-based approach demonstrates strong performance using accessible data sources, offering a non-invasive, cost-efficient, and scalable solution for cartilage tumor assessment in musculoskeletal oncology.

Small bowel obstruction (SBO) is a common surgical emergency that can lead to significant morbidity, mortality, and healthcare costs, particularly when diagnosis is delayed. In rural and resource-limited emergency settings, advanced imaging techniques like computed tomography (CT) may not be readily available. As a result, clinicians often rely on physical examinations and plain radiographs which can be unreliable. Point-of-care ultrasound (POCUS) provides a rapid, radiation-free and cost-effective diagnostic alternative that can be performed directly at the bedside. We conducted a systematic review of published literature evaluating the diagnostic accuracy and clinical utility of POCUS in identifying SBO on the following databases PubMed, Web of Science,Cochrane Library and Google Scholar databases from January 2000 to December 2024. Studies were screened and selected based on the inclusion and exclusion criteria adhering to PRISMA 2020 guidelines. The sensitivity of POCUS for SBO ranged from 85.0 to 100%, while specificity ranged from 54.0 to 100%. Diagnostic accuracy remained high across a broad range of expertise overcoming operator dependence. Examination durations are approximately 10-11min, which is markedly shorter than 45-min to 3-h by CT. POCUS presents as a practical, scalable and cost-saving tool for diagnosing SBO in rural emergency care, addressing significant gaps where CT is not available and also facilitates faster diagnosis by timely identification of specific features. Future efforts should focus on developing validated algorithms for resource-limited settings allowing immediate care management.

Explainable deep learning-based multiclass classification of foot radiographs into normal, plantar fasciitis, and flatfoot.

Backgound: The incidence of pediatric urinary stones increased 4% per year during 1984-2008. Hematuria (Gross or microscopic) is seen in 30% to 55% of all pediatric urolithiasis. Nearly, 25-50% of pediatric ureteral stones need surgical intervention like ureteroscopy. Patients and Methods: In 2020, a prospective clinical study was done over a six months period (June to December) at the department of urology in Mosul Medical City. All children 14 years of age and below of both genders who presented with ureteric stones unpredictable for spontaneous passage were studied while cases with urologic comorbidities that necessitate open surgery were excluded. Abdomino-pelvic ultrasonography, plain abdominal radiography (KUB) and either intravenous urography (IVU) or computed tomography urogram (CTU) were done for all patients to identify stone characteristics (size, diameter, density and impaction) or ureteral state (dilatation or stricture). Results: seventeen cases of semirigid ureteroscopic Ho:YAG laser lithotripsy procedures were performed. Their average age was (5.64) years, male to female ratio was 12:5. Abdominal pain and fever were the commonest presenting symptoms (76.4%). The overall stone clearance following one session of ureteroscopic laser lithotripsy was 88.2% i.e. clearance was achieved in 15 out of 17 procedures (88.2%) whereas the remaining 2 out of 17 (11.8%); needed retreatment; one case required 2nd session ureteroscopy while the other had stone migration up to renal pelvis which was treated by stenting and later on by SWL. On comparing the stone free rates in relation to their sites in the ureter or to their diameters the P-values were not significant. The post-operative complications were faced in 4 cases only (23.5%), fever in 3 cases (17.6%), while retrograde stone migration was in 1 case (5.9%). Conclusion: Semi rigid ureteroscopic Ho:YAG laser lithotripsy is safe and effective in treating pediatric age group complaing from ureteral stones of different characteristics with a high clearance rate in single session procedures.

Jejunal melanoma: An unusual cause of intussusception

This study explores the role of hyphenated and hybrid techniques in modern dental diagnostics by integrating chemical analysis, medical imaging, and artificial intelligence to achieve early and accurate detection of dental diseases. It highlights the limitations of conventional visual examination and radiography, which often fail to identify biochemical and histological changes in their early stages, leading to delayed treatment and poor outcomes. By combining AI-based imaging—especially convolutional neural networks applied to dental radiographs—with advanced analytical methods such as GC-MS, FIA-UV-Vis, and RP-HPLC, these approaches enable the detection of subtle biomarkers in saliva, metabolic changes, and structural abnormalities that are otherwise overlooked. The research demonstrates that such integrated systems enhance diagnostic precision, reduce human error, accelerate clinical decision-making, and improve patient care. Ultimately, the study concludes that the combination of AI-assisted imaging and GC-MS offers the most comprehensive and effective framework for early detection and management of oral diseases, and recommends adopting this modern diagnostic model in dental colleges, particularly in Iraq, to advance preventive and therapeutic dentistry. This work is a narrative review supported by analytical observations of available diagnostic technologies in Iraqi institutions, aiming to propose a modern framework for dental diagnostics. This study aims to: • Review the role of AI and hybrid analytical techniques in dental diagnosis. • Evaluate the efficiency of hyphenated techniques in detecting chemical and histological abnormalities. • Compare conventional diagnostic methods with hybrid approaches. • Highlight the potential of these techniques in early detection of oral diseases.

The aim of the study was to investigate whether the ventriculoperitoneal (VP) shunt valve setting can be reliably assessed using maximum intensity projection (MIP) reconstructions from non-contrast, full-dose head CT scans, and how this method performs in comparison to conventional lateral skull radiographs. This retrospective study included 41adult patients (mean age59 ± 25years) with Codman Certas programmable VP shunt valves who underwent lateral skull X‑ray and asame-day, non-contrast head CT scan between January and July 2024. From the CT data, MIP reconstructions of the valve region were generated. Three neuroradiologists, blinded to each other's assessments, independently rated valve settings and image quality using a5-point Likert scale. Mean reconstruction time was recorded. Radiation dose data were extracted from institutional dose-monitoring software. Valve settings were identifiable in all 44 CT/X-ray image pairs, with 95% agreement between MIP andX-ray readings. MIP reconstructions were successfully generated (median CTDIvol 35.34 mGy (30.42; 40.32); mean reconstruction time70 s). Image quality was rated lower for MIP (median 2 [IQR 2]) than for X‑ray (median 4 [IQR 1]; p < 0.001). In 45% of cases scanned with photon-counting CT, MIP quality was significantly higher (median 3 vs.1; p < 0.001). Inter-reader reliability was good for MIPs (ICC = 0.82) and excellent for X‑rays (ICC = 0.97). MIP reconstructions from non-contrast head CT allow reliable VP shunt valve setting assessment and may reduce the need for additional radiographs, especially when advanced CT systems are used.

Introduction: Sternoclavicular joint injuries are rare and potentially life-threatening injuries due to their proximity to vital mediastinal structures. In adolescents, skeletal immaturity can add complexity to the injury due to potential involvement of the physis. A physeal fracture with displacement can appear as a dislocation on imaging, also known as pseudo-dislocation. Additionally, this anatomic area is difficult to visualize with plain radiographs, which can result in misdiagnosis and delayed treatment. Case Report: We present a case of a 15-year-old male athlete who presented to the emergency department with severe right clavicular pain four hours after sustaining a football injury. Plain radiographs obtained at an outside facility as well as repeat plain radiographs at our facility showed no evidence of fracture or dislocation. The patient’s degree of pain and physical exam findings prompted further imaging with computed tomography (CT), ultimately revealing a physeal fracture of the medial right clavicle with posterior and superior displacement. Conclusion: Sternoclavicular joint injuries in skeletally immature patients are complex and require immediate diagnosis and intervention. Plain radiographs are often unreliable in recognizing these injuries and, in our case, the physeal fracture with displacement was not radiographically apparent on two separate occasions. Advanced imaging with CT revealed the diagnosis, highlighting the importance of a detailed physical exam and for physicians to maintain a high index of clinicalsuspicion when evaluating adolescents with high-impact trauma, even in the setting of negative plain radiographs.

ABSTRACT This study aims to identify lesions confined to the internal structures of bones. A radiographic analysis was performed on 219 archaeological, historical period skeletons from southern Finland. Although the study examines nearly all preserved skeletal elements using plain radiographs, it does not incorporate computed tomography. Notably, 17 individuals (7.8%) were preliminarily diagnosed with neoplastic lesions. The 7.8% prevalence of neoplasia includes benign lesions, malignant lesions, and some lesions where there was uncertainty as to whether they were neoplasia or other diagnoses. We observed lesions that are not detectable on the bone surface. In addition, we identified lesions that had been previously overlooked in the macroscopic analysis, or initially interpreted as taphonomic alterations. However, upon re‐evaluation with X‐ray imaging, these are now considered indicative of tumors. In previous macroscopic analyses, only benign neoplastic lesions were identified. These findings highlight the significance of comprehensive radiological examination of skeletal remains in advancing the understanding of the historical prevalence and development of bone neoplastic formations.

The challenges found to self-assemble crystalline octahedral M6L4 metal-organic cages (MOCs) with the tridentate 2,4,6-tris(4-pyridyl)benzene (TPB) ligand and Pd2+ are due to the dihedral angle θ ∼ 36° between the pyridines and the central benzene ring (Hpyridine···Hbenzene repulsion), the end-capping group, and the presence of suitable templating guests. Although it has recently been reported that the TPB M6L4 cage (Pd6(TPB)4) can be formed in the solution state by only using the ethylenediamine (en) cis protecting group and Pd2+, its solid-state synthesis, 3D X-ray structure, and host-guest chemistry have not been reported. Here, using mechanochemistry by neat grinding (NG) TPB and (en)-Pd(NO3)2, we report the solid-state synthesis of Pd6(TPB)4, its solid-state structure, and its ability to include aromatic guests in aqueous media. In solution, the self-assembly of TPB and Pd2+ with a templating guest (i.e., 3-phenylpropanoic acid) (G1) formed crystals of Pd6(TPB)4, suitable for single-crystal X-ray diffraction (SC-XRD). Density functional theory (DFT) calculations specific to the solid state showed different high binding energy (Eb) values for Pd6(TPB)4 and the isostructural tris-pyridyl triazine (TPT)-based MOC (Pd6(TPT)4). The higher stability of the Pd6(TPT)4 structure with respect to Pd6(TPB)4 may be related to its higher Eb and density, a direct consequence of the higher degree of planarity of TPT, suggesting the importance of enthalpic/entropic contributions for the stability of these M6L4 structures in the solid state. The Pd6(TPB)4 cage has an electron-rich hydrophobic cavity (∼450 Å3) that is stable in water and in acidic conditions and can include four G1 in one M6L4, as shown by titration experiments and using a guest model X-ray structure. In the solution state, 1H NMR data show that G1 guest exchange/inclusion in Pd6(TPB)4 occurs in the fast exchange regime. Hollow Pd6(TPB)4 is a strong candidate to be used in functional applications such as molecular recognition, guest stabilization, or unusual reactivity.

In children and adolescents, osteochondritis dissecans (OCD) represents an important differential diagnosis of chronic joint pain. Because the disease typically begins with nonspecific symptoms, imaging plays apivotal role in establishing the diagnosis. Early-stage lesions, if identified correctly, can heal completely, whereas unstable lesions usually require surgical treatment. Conventional radiography remains the cornerstone of initial diagnostic evaluation. Magnetic resonance imaging (MRI) is currently the most important imaging technique for evaluating OCD lesions. It enables early detection of subchondral signal alterations, detailed morphological assessment of the lesion, evaluation of stability through direct and indirect signs of instability, and follow-up under conservative or postoperative treatment. Radiologists play acentral role in the early detection and characterization of OCD, providing clinicians with critical information for further management. OCD should always be considered in cases of unexplained joint pain in children, adolescents, and young adults. Conventional radiographs should be performed as the initial diagnostic evaluation. However, only MRI enables reliable early detection and accurately differentiates stable and unstable disease. In children, both sides should be examined when appropriate, since OCD frequently affects both joints.

Plain abdominal radiography is a widely used imaging modality for diagnosing neonatal necrotizing enterocolitis (NEC), but the characteristic features of stage I NEC are often subtle, making early diagnosis challenging. This study explores the application of deep learning (DL) models to assist in the early diagnosis of stage I NEC. This retrospective study included 380 and 300 neonates who underwent abdominal radiography at two centers between June 2016 and December 2023. Neonates were grouped based on a diagnosis of stage I NEC. DL features were extracted from the radiographs using the DenseNet121 model, based on which radiomics models were constructed using logistic regression (LR) and random forest (RF) algorithms. Performance was evaluated through receiver operating characteristic (ROC) curves. Both the training and external validation cohorts were used to assess model accuracy in distinguishing stage I NEC. Additionally, a direct comparison with human expert diagnostic performance was conducted. In the training cohort, 25 DL features were selected for model development. The area under the ROC curve (AUC) for LR and RF models was 0.972 (95% CI: 0.956-0.988) and 0.961 (95% CI: 0.942-0.980), respectively. In the external validation cohort, the models demonstrated AUCs of 0.964 (95% CI: 0.943-0.986) and 0.951 (95% CI: 0.925-0.976), respectively. These models evidently outperformed human experts in diagnostic performance. The DL model based on plain abdominal radiography effectively identified stage I NEC in neonates. This approach offers a non-invasive method to enhance early NEC diagnosis and support clinical decision-making. QuestionDeep learning (DL) models applied to plain abdominal radiography can enhance the early diagnosis of stage I neonatal necrotizing enterocolitis (NEC). FindingsIn this retrospective study involving 680 neonates from two centers, DL-based radiomics models achieved much higher accuracy for diagnosing stage I NEC than human radiologists. Clinical relevanceDL models based on plain abdominal radiography have the ability to significantly improve the early identification of stage I NEC, offering a non-invasive tool to support radiologists in early diagnosis.

Femoral head fractures resulting from hip dislocations are rare injuries resulting from high-velocity trauma. Garrett Pipkin, in 1957, classified these fractures into four types. All varieties are associated with hip dislocations, which are attended to as emergencies. Few cases of isolated femoral head fractures without hip dislocation have been published in the literature; we describe one such atypical variant. A 38-year-old male presented with a history of pain and swelling in his right knee following a traffic accident. After 48 hours of bed rest on ambulating, the patient had mild right hip discomfort, but hip examination was essentially normal. Radiology was repeated with plain radiographs and non-contrast computed tomography (NCCT), followed by contrast-enhanced magnetic resonance imaging (MRI) pelvis with bilateral hips. He had a fracture of the head of the femur and acetabular lip with concentric joint. Without hip dislocation, this was an unusual presentation of Pipkin Type IV fracture of the femoral head &amp; posterior acetabular lip. It was managed with open reduction and lag screw fixation of supra-foveal femoral head fracture approaching through the acetabular bony rim avulsion, which was later fixed with lag screw and spring plates. The patient recovered well. This was an unusual presentation of Pipkin type IV fracture without hip dislocation and can be missed due to a subtle presentation, not yet described in the literature. A high degree of suspicion and advanced radiology helped in the appropriate management of the case.

Rationale:Subcutaneous extensor tendon rupture caused by Kienböck disease is rare. Only 22 cases have been reported in the English literature since 1986.Patient concerns:A 74-year-old male experienced numbness of his right hand for several years and was unable to extend his right middle and ring finger 2 months before consultation.Diagnoses:Physical examination revealed no pain in his right wrist, but was unable to extend the middle and ring fingers. He also had numbness of the thumb, index, middle, and radial side of the ring finger. Plain radiography and computed tomography revealed osteoarthritis of the wrist and segmental lunate bone. Ultrasonography revealed disruption of the extensor tendon, indicating that the lunate bone volar fragment did not interfere with the flexor tendons and median nerve. Magnetic resonance imaging suggested extensor tendon rupture. Nerve conduction studies showed delayed distal motor latencies of the abductor pollicis brevis muscle. We diagnosed subcutaneous rupture of the extensor tendons of the middle and ring fingers caused by stage Ⅳ Kienböck disease complicated by carpal tunnel syndrome.Interventions:A 2-portal endoscopic carpal tunnel release was performed under general anesthesia. A dorsal curved incision was made. The dorsal fragment of the lunate punctured the capsule, and the extensor digitorum communis (EDC) tendon of the middle, ring, and little fingers, and the extensor indicis proprius tendons were ruptured. The dorsal fragment of the lunate bone was removed and the EDC tendon of the middle finger was transferred to that of the index finger. The combined EDC tendons of the ring and little fingers were transferred to the extensor digitorum minimi tendon.Outcomes:The numbness and extension restriction of the middle and ring fingers had improved at 2 years postoperatively. Dorsal and volar flexion were up to 60°.Lessons:Dorsal lunate bone fragments associated with advanced Kienböck disease can cause extensor tendon rupture. When ultrasonography confirms that the volar fragment of the lunate bone does not impinge upon the median nerve or flexor tendons, surgical intervention on the volar fragment may be unnecessary. Computed tomography, magnetic resonance imaging, and ultrasonography are valuable for accurate assessment and preoperative planning.

Resource Utilization and Surgical Risk in Pediatric Pneumatosis Intestinalis.

Accurate preoperative implant sizing is a critical component of successful total knee arthroplasty (TKA). Artificial intelligence (AI) has emerged as a promising tool for enhancing preoperative planning. This is achieved through predictive modelling based on different input modalities, including computed tomography (CT), plain radiographs and patient demographic data. Despite growing interest, the comparative performance of these models remains unclear. This systematic review aims to evaluate and compare the predictive accuracy of AI-based models for TKA component sizing across different input modalities. A systematic literature search was conducted in PubMed, Scopus, Embase and Cochrane Central following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies included original research that developed or validated AI models for predicting component sizes in TKA planning and reported measurable performance outcomes. Methodological quality and risk of bias were assessed using the PROBAST tool. Qualitative synthesis was performed with stratification by planning modality. Thirteen studies encompassing 37,002 patients met the inclusion criteria. AI models were developed using three-dimensional (3D) imaging (n = 4), two-dimensional (2D) radiographs (n = 4), demographic data (n = 2) or mixed inputs (n = 2). For femoral component prediction, the highest exact size accuracy was achieved by x-ray-based models (86.70%), followed by mixed-input (86.27%), CT/MRI-based (79.98%) and demographic models (45.72%). Accuracy within ±1 size remained high across modalities: CT/MRI (97.67%), x-ray (96.35%) and demographic (92.35%). For tibial components, exact size prediction was similarly high in mixed-input (85.29%), CT/MRI-based (83.98%) and x-ray-based models (83.57%), while demographic models lagged (52.25%). Prediction within ±1 size exceeded 94% for all modalities, with CT-based models achieving the highest accuracy (98.49%). AI models using 2D and 3D imaging achieve high accuracy in TKA component sizing, with 3D imaging performing best for tibial components. Demographic-only models are less accurate, whereas multimodal approaches may optimize predictive precision in surgical planning. Level III.

Purpose Precise quantification of angular deformity at the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joint is paramount in congenital polydactyly surgery. It dictates the surgical center point and informs the necessity for corrective osteotomy. Conventional radiography (x-ray), while standard, suffers from inherent limitations in visualizing cartilage and soft tissue, compromising surgical planning. This study evaluates the clinical feasibility and superiority of a three-dimensional fat suppression rapid phase shifting gradient echo (3D-FS-FSPGR) magnetic resonance imaging (MRI) sequence for overcoming these limitations and achieving accurate preoperative angular assessment. Methods Pediatric patients presenting with congenital polydactyly of the hands or feet underwent preoperative imaging with both standard x-ray and the 3D-FS-FSPGR MRI sequence. Evaluation focused on characterizing angular deformities at the affected joints. Direct comparative analysis assessed the visualization of osseous alignment, cartilage architecture, joint bifurcation planes, and surrounding soft tissues, alongside the accuracy of angular measurements derived from each modality. Results Compared to x-ray, the 3D-FS-FSPGR MRI sequence demonstrated superior visualization of cartilage morphology, joint capsule anatomy, soft tissue, and articular surfaces at the MCP/MTP joints. This anatomical delineation translated to more accurate and reliable quantification of angular deformities. Crucially, significant discrepancies in measured joint angles were observed between MRI and x-ray. These differences are pronounced in cases where the morphology of the cartilage affects joint alignment and the complex branching planes. Conclusion Conventional x-ray assessment in congenital polydactyly is limited in visualizing soft tissue and cartilage structures. The 3D-FS-FSPGR MRI sequence offers superior characterization of cartilaginous and soft tissue components, enabling more precise measurement of joint angular deformities. Its integration into the preoperative evaluation protocol demonstrates substantial clinical feasibility and tangible potential to optimize surgical site and reduce the incidence of postoperative deformities and functional impairment, thereby improving the long-term functional and aesthetic outcomes for these children.