Recent Advances in Diagnosis and Management of Musculoskeletal Disorders

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1836

Special Issue Editors


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Guest Editor
1. Department of Musculoskeletal Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
2. Advanced Imaging Group (TeCe22), Instituto Biosanitario de Granada (ibs.GRANADA), 18016 Granada, Spain
Interests: musculoskeletal radiology; artificial intelligence; evidence-based medicine; precision medicine

E-Mail Website
Guest Editor
1. Department of Musculoskeletal Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
2. Advanced Imaging Group (TeCe22), Instituto Biosanitario de Granada (ibs.GRANADA), 18016 Granada, Spain
Interests: musculoskeletal radiology; diagnosis; interventional procedures; spine

Special Issue Information

Dear Colleagues,

This Special Issue aims to provide updated knowledge and novel insights on the diagnosis and management of musculoskeletal disorders. Recent advances in this field, including a wide variety of diagnostic methods and procedures, warrant the need for up-to-date information and high-quality studies to enrich evidence-based decision making. We encourage the submission of original studies, systematic reviews, and meta-analyses on this topic, encompassing any musculoskeletal disorder, including skeletal, muscle, and soft-tissue pathologies. New paradigms such as artificial intelligence-assisted diagnostic methods, novel imaging techniques, and cutting-edge surgical or interventional techniques are particularly welcome. 

Dr. Antonio Jesús Láinez-Ramos-Bossini
Dr. Fernando Ruiz Santiago
Guest Editors

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Keywords

  • musculoskeletal disorder
  • radiology
  • interventional procedure
  • surgery
  • artificial intelligence

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Published Papers (3 papers)

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Research

13 pages, 3211 KiB  
Article
Sagittal Realignment Following Decompression for Lumbar Spinal Stenosis in Elderly Patients: A Comprehensive EOS Imaging Analysis
by Hyung-Youl Park, Ho-Young Jung, Geon-U Kim, Se-Heon Lee and Jun-Seok Lee
Diagnostics 2024, 14(21), 2380; https://doi.org/10.3390/diagnostics14212380 - 25 Oct 2024
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Abstract
Background/Objectives: This study investigated whether decompression surgery for lumbar spinal stenosis can effectively improve sagittal alignment in elderly patients. With the growing focus on sagittal balance in spinal surgery, this study aimed to evaluate post-decompression alignment changes and identify the factors influencing these [...] Read more.
Background/Objectives: This study investigated whether decompression surgery for lumbar spinal stenosis can effectively improve sagittal alignment in elderly patients. With the growing focus on sagittal balance in spinal surgery, this study aimed to evaluate post-decompression alignment changes and identify the factors influencing these changes using the EOS imaging system. Methods: A retrospective analysis was conducted on 49 elderly patients who underwent decompression surgery alone for lumbar spinal stenosis. Radiologic parameters, measured using the EOS system, and clinical outcomes were assessed preoperatively, at two weeks postoperatively, and at one year postoperatively. Patients were grouped based on the improvement of the sagittal vertical axis (SVA) by 25 mm or more. A multivariate analysis was performed to identify factors affecting sagittal alignment changes. Results: Significant sagittal alignment improvements were observed postoperatively, including a notable increase in thoracic kyphosis and a decrease in SVA observed at one year. Clinical outcomes, such as the Oswestry disability index (ODI) and EQ-5D, significantly improved at both two weeks and one year postoperatively compared to preoperative values (all p-values < 0.05). Multivariate analysis revealed that greater preoperative SVA and higher ODI were significant predictors of sagittal alignment changes (odds ratio [OR] for SVA = 1.014, OR for ODI = 1.034). Conclusions: Decompression surgery for lumbar spinal stenosis in elderly patients can result in significant improvements in sagittal alignment and clinical outcomes. The study suggests that decompression alone is a viable surgical option for elderly patients, particularly those with a greater preoperative sagittal imbalance and disability, even in the absence of major deformities. Full article
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10 pages, 2101 KiB  
Article
A Comparative Analysis of International Classification Systems to Predict the Risk of Collapse in Single-Level Osteoporotic Vertebral Fractures
by Antonio Jesús Láinez Ramos-Bossini, Paula María Jiménez Gutiérrez, David Luengo Gómez, Mario Rivera Izquierdo, José Manuel Benítez and Fernando Ruiz Santiago
Diagnostics 2024, 14(19), 2152; https://doi.org/10.3390/diagnostics14192152 - 27 Sep 2024
Viewed by 564
Abstract
Introduction: Various classifications for osteoporotic vertebral fractures (OVFs) have been introduced to enhance patient care and facilitate clinical communication. However, there is limited evidence of their effectiveness in predicting vertebral collapse, and very few studies have compared this association across different classification systems. [...] Read more.
Introduction: Various classifications for osteoporotic vertebral fractures (OVFs) have been introduced to enhance patient care and facilitate clinical communication. However, there is limited evidence of their effectiveness in predicting vertebral collapse, and very few studies have compared this association across different classification systems. This study aims to investigate the association between OVF categories, according to the most widely used classification systems, and vertebral collapse. Patients and Methods: A retrospective single-center study was conducted involving patients diagnosed with acute OVFs at the emergency department of a tertiary-level academic hospital with a minimum follow-up of 6 months. Vertebral fractures were independently classified by two radiologists according to several classification systems, including those proposed by Genant, Sugita, the German Society for Orthopedics and Trauma (DGOU), and the AO Spine. Associations between vertebral collapse and OVF classification systems were analyzed using bivariate and logistic regression analyses. Results: This study included 208 patients (82.7% females; mean age of 72.6 ± 9.2 years). The median follow-up time was 15 months, with L1 being the most common fracture site (47.6%). The most frequent OVF types observed, according to Genant’s morphological, Genant’s quantitative, Sugita ’s, DGOU’s, and AO Spine’s classifications, were biconcave (50%), grade 0.5 (47.6%), bow-shaped (61.5%), OF2 (74%), and A1 (61.5%), respectively. All classifications, except for Genant’s quantitative system, were significantly associated with vertebral collapse in bivariate analyses. Logistic regression analyses showed a significant association (p = 0.002) between the AO Spine classification and vertebral collapse, with 85.7% of A4 fractures developing collapse on follow-up. Conclusions: The AO Spine classification showed the highest predictive capacity for vertebral collapse. Specifically, A4 fracture types showed a very high risk of vertebral collapse, confirming the need for non-conservative management of these fractures. Further multicentric and prospective studies are warranted to confirm these findings. Full article
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9 pages, 2473 KiB  
Article
Reliability and Validity of Ultrasound in Identifying Anatomical Landmarks for Diagnosing A2 Pulley Ruptures: A Cadaveric Study
by Xeber Iruretagoiena, Volker Schöffl, Ramón Balius, Marc Blasi, Fernando Dávila, Xavier Sala-Blanch, Asier Dorronsoro and Javier de la Fuente
Diagnostics 2024, 14(19), 2149; https://doi.org/10.3390/diagnostics14192149 - 27 Sep 2024
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Abstract
Background/Objectives: Rock climbing is becoming more popular, leading to an increased focus on diagnosing and treating related injuries. Finger pulley and flexor tendon injuries are common among climbers, with the A2 pulley being the most frequently affected. High-resolution ultrasound (US) is the [...] Read more.
Background/Objectives: Rock climbing is becoming more popular, leading to an increased focus on diagnosing and treating related injuries. Finger pulley and flexor tendon injuries are common among climbers, with the A2 pulley being the most frequently affected. High-resolution ultrasound (US) is the preferred method for detecting pulley injuries. This study aimed to determine the reliability and validity of US in identifying anatomical landmarks for diagnosing A2 pulley ruptures. Methods: This study was cross-sectional, involving 36 fingers from 4 cadaver arms. A Canon Aplio i800 US machine was used to measure two anatomical landmarks: the midpoint of the proximal phalanx and the distal edge of the A2 pulley. For the first anatomical landmark, the length of the proximal phalanx (PP distance), and for the second landmark, the distance between the distal edges of the proximal phalanx and the A2 pulley (“A” distance), were measured. Measurements were performed by two sonographers and compared to a digital caliper measurement taken post-cadaver dissection. Observers were blinded during measurements to ensure unbiased results. Results: Overall PP distance measured by US (O1: 37.5 ± 5.3 mm, O2: 37.8 ± 5.4 mm) tended to be shorter than caliper measurements (O3: 39.5 ± 5.5 mm). The differences between sonographers were minimal, but larger when compared to caliper measurements. High reliability for PP distance measurement was observed, especially between sonographers, with an ICC average of 0.99 (0.98, 1.00). However, reliability was lower for the “A” distance, with significant differences between US and caliper measurements. Regarding validity, US measurements were valid when compared to caliper measurements for PP distance, but not as reliable for the “A” due to wider confidence intervals. While US can substitute caliper measurements for PP distance (LR, Y:O2, X:O3, −0.70 (−3.28–1.38), 0.98 (0.93 ± 1.04)), its validity for “A” distance is lower (LR, Y:O2, X:O3, −2.37 (−13.53–4.83), 1.02 (0.62–1.75)). Conclusions: US is a reliable and valid tool in identifying anatomical landmarks for diagnosing A2 pulley ruptures, particularly for detecting the midpoint of the proximal phalanx. This is important to differentiate between complete and partial A2 pulley tears. However, the measurement of the “A” distance requires further refinement. These findings support efforts to standardize US examination protocols and promote consensus in diagnostic methodology, though further research is needed to address the remaining challenges. Full article
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