Diagnostics

16 pages, 1352 KB

Open AccessArticle

Subscapularis Partial Thickness Tears by Yoo and Rhee Classification: Identifying MRI Predictors for Type IIB, Requiring Surgical Repair

by Yoonsang Lee, Seul Ki Lee and Jee-Young Kim

Diagnostics 2025, 15(21), 2670; https://doi.org/10.3390/diagnostics15212670 (registering DOI) - 22 Oct 2025

Abstract

Objectives: This study aimed to assess the significance of a novel subclassification for partial thickness tears of the subscapularis tendon (SSC) by Yoo and Rhee and to identify key MRI findings predictive of the newly adopted surgical indicator (Yoo type IIB). Methods [...] Read more.

Objectives: This study aimed to assess the significance of a novel subclassification for partial thickness tears of the subscapularis tendon (SSC) by Yoo and Rhee and to identify key MRI findings predictive of the newly adopted surgical indicator (Yoo type IIB). Methods: Between June 2021 and January 2024, 190 patients undergoing preoperative MRI and arthroscopic rotator cuff repair were enrolled. Patients with arthroscopically confirmed Lafosse type 1 tears (n = 148) who underwent debridement were included. Preoperative MRIs were retrospectively evaluated for SSC tear according to Yoo and Rhee classification, muscle atrophy, fatty infiltration, lesser tuberosity cyst, and long head of the biceps (LHBT) pathologies. Patients were divided into the control (Yoo type I + IIA) and study (Yoo type IIB) groups, and significant associations of MRI findings between the groups were investigated. Results: Among Lafosse type 1 patients, the control group (Yoo type I [n = 70] and Yoo type IIA [n = 41]; n = 111; mean age, 61.8 years ± 9.6, 48 men), and the study group (Yoo type IIB, n = 32; mean age, 66.2 years ± 7.8, 16 men) showed significant differences in age (p = 0.017), but not in gender (p = 0.634). Preoperative MRI findings, including muscle atrophy (p < 0.001), fatty infiltration (p < 0.001), lesser tuberosity cyst (p = 0.033), and LHBT pathologies (full thickness tear, p = 0.040; partial thickness tear, p < 0.001; tendinosis, p = 0.003; subluxation, p < 0.001), differed significantly between the groups. Multivariate analysis identified muscle atrophy (odds ratio [OR] = 33.83, p = 0.008) and LHBT subluxation (OR = 22.83, p < 0.001) as independent predictors for Yoo type IIB. Conclusions: In partial thickness tears of SSC, significant MRI differences were found between the Yoo and Rhee classifications. Notably, muscle atrophy and LHBT subluxation were valuable indicators for predicting Yoo type IIB as a surgical indication. Full article

(This article belongs to the Special Issue Musculoskeletal Imaging in Clinical Practice: From Detection to Decision-Making)

12 pages, 694 KB

Open AccessArticle

Hand Osteoarthritis in the Elderly: The Prevalence of Articular Cartilage Defects in Radiographically Normal and Affected Joints

by Reiji Nishimura, Tohru Hashimoto, Takeshi Fukuda, Tohru Yano, Kazuhiro Maeda, Masataka Okabe and Takeshi Miyawaki

Diagnostics 2025, 15(21), 2669; https://doi.org/10.3390/diagnostics15212669 (registering DOI) - 22 Oct 2025

Abstract

Background: Hand osteoarthritis (OA) is a highly prevalent disease that significantly impairs quality of life among many patients. The direct evaluation of cartilage defects associated with OA in vivo is challenging, and indirect assessments using X-ray images are commonly employed. The aim [...] Read more.

Background: Hand osteoarthritis (OA) is a highly prevalent disease that significantly impairs quality of life among many patients. The direct evaluation of cartilage defects associated with OA in vivo is challenging, and indirect assessments using X-ray images are commonly employed. The aim of this study was to evaluate the relationship between X-ray images of finger joints and cartilage defects. Methods: This study included 42 hands from cadavers that were fixed with alcohol and formalin. After X-ray posteroanterior images of all the finger joints were taken, the extent of the cartilage defects was observed macroscopically. On X-ray images, OA was defined as a modified Kellgren–Lawrence scale score of 2 or higher. Histological examinations were performed on several joints with cartilage defects to confirm whether the macroscopic cartilage defects corresponded to the histological cartilage defects. Results: A total of 588 joints were evaluated. On X-ray images, OA was observed in 20.2% of the joints, and cartilage defects were present in 45.1%. Among joints with cartilage defects, the prevalence of joints without radiographic OA was 55.1%. On the other hand, 31.1% of joints without radiographic OA had cartilage defects. Cartilage defects were identified in all joints with radiographic OA. Conclusions: The use of X-ray images to evaluate OA is beneficial; however, when interpreting radiographic OA, it is important to note that early or partial OA may not be detectable. Additionally, when OA findings are present on X-ray images, cartilage defects are always present. Full article

(This article belongs to the Special Issue Advances and Challenges in the Diagnosis and Treatment of Rheumatic Diseases)

24 pages, 1137 KB

Open AccessSystematic Review

Bayesian Monte Carlo Simulation Based on Systematic Review for Personalized Risk Stratification of Contralateral Lymph Node Metastasis in Oral Squamous Cell Carcinoma

by Karthik N. Rao, M. P. Sreeram, Prajwal Dange, Andres Coca Pelaz, Cesare Piazza, Remco de Bree, Fernando Lopez, Orlando Guntinas-Lichius, Luiz Paulo Kowalski, Kevin T. Robbins, Primož Strojan, Carlos Suárez, Akihiro Homma, Robert Takes, Juan Pablo Rodrigo, Marc Hamoir, Avraham Eisbruch, Francisco Civantos, Anna Luíza Damaceno Araújo, Alessandra Rinaldo, Małgorzata Wierzbicka and Alfio Ferlito Show full author list Hide full author list

Diagnostics 2025, 15(21), 2668; https://doi.org/10.3390/diagnostics15212668 (registering DOI) - 22 Oct 2025

Abstract

Background: Contralateral lymph node metastasis (CLNM) in oral squamous cell carcinoma (OSCC) represents a major clinical challenge, in patients with a clinically contralateral node-negative neck. Individualized risk stratification is crucial to guide decisions on elective contralateral neck dissection. This study aimed to [...] Read more.

Background: Contralateral lymph node metastasis (CLNM) in oral squamous cell carcinoma (OSCC) represents a major clinical challenge, in patients with a clinically contralateral node-negative neck. Individualized risk stratification is crucial to guide decisions on elective contralateral neck dissection. This study aimed to synthesize existing evidence and apply Bayesian Monte Carlo Simulation (MCS) to estimate CLNM probability across various clinic-pathological scenarios. Methods: A systematic search of PubMed, PubMed Central, and Embase (2000–2024) identified 26 eligible studies. Effect sizes for seven key risk factors—midline-crossing tumours, extranodal extension (ENE), ≥2 ipsilateral lymph nodes, depth of invasion (DOI) >10 mm, perineural invasion and lymphovascular invasion (PNI-LVI), poor differentiation, and floor of mouth subsite—were computed and incorporated into a Bayesian logistic model. Using the No-U-Turn Sampler (NUTS) in RStan, 100,000 virtual patient profiles were simulated to generate posterior probabilities of CLNM. Results: The baseline CLNM risk for lateralized tumours without additional risk factors was 4.2%. Single risk factors increased probability substantially: midline-crossing tumours (31.7%), ENE (27.4%), and ≥2 ipsilateral nodes (24.9%). Combinations of risk factors amplified the risk non-linearly: the presence of a midline-crossing tumour, ENE, and ≥2 ipsilateral nodes yielded a 76.8% CLNM probability, and the presence of all seven risk factors increased it to 93.7%. Risk tiers were classified from minimal (<20%) to very high (>50%) to guide clinical decision-making. Conclusions: This MCS-based model reveals that CLNM risk increases multiplicatively with the presence of various high-risk features. The simulation supports bilateral neck management in high-risk patients and observation in low-risk cases. Prospective validation is needed to integrate this model into routine clinical practice and to guide patient-specific surgical planning. Full article

(This article belongs to the Special Issue Advances in Molecular Pathology and Imaging for Precision Diagnosis and Treatment of Tumors)

14 pages, 730 KB

Open AccessReview

Venous Thromboembolism in Inherited Platelet Disorders: A Clinical Challenge

by Francesco Paciullo, Patrizia Rovere-Querini, Loredana Bury, Emanuela Falcinelli and Paolo Gresele

Diagnostics 2025, 15(21), 2667; https://doi.org/10.3390/diagnostics15212667 (registering DOI) - 22 Oct 2025

Abstract

Inherited platelet disorders (IPDs) are rare hematological conditions characterized by abnormal platelet function or number, predisposing patients to bleeding. Even if they apparently lower the risk of venous thromboembolism (VTE), this is not abolished in these patients, and may represent a potential cause [...] Read more.

Inherited platelet disorders (IPDs) are rare hematological conditions characterized by abnormal platelet function or number, predisposing patients to bleeding. Even if they apparently lower the risk of venous thromboembolism (VTE), this is not abolished in these patients, and may represent a potential cause of mortality. VTE prevention and treatment in these patients is particularly challenging due to the delicate balance between thrombosis and bleeding risks. Here, we summarize current evidence on the incidence, risk factors, and management strategies for VTE in IPD patients, with a focus on the perioperative setting. Full article

(This article belongs to the Special Issue Pathophysiologic Mechanisms, Diagnosis and Management of Venous Thromboembolism)

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6 pages, 3208 KB

Open AccessInteresting Images

Multimodality Imaging of Warthin’s Tumor: PET/CT, Scintigraphy, MRI, and CT

by Miju Cheon, Hyunkyung Yi and Injoong Kim

Diagnostics 2025, 15(21), 2666; https://doi.org/10.3390/diagnostics15212666 (registering DOI) - 22 Oct 2025

Abstract

Warthin’s tumor is a benign salivary gland neoplasm that can exhibit intense FDG uptake, potentially mimicking malignant lesions on oncologic imaging. We report a case of a 78-year-old man undergoing staging for suspected lung cancer, in whom a hypermetabolic lesion was incidentally detected [...] Read more.

Warthin’s tumor is a benign salivary gland neoplasm that can exhibit intense FDG uptake, potentially mimicking malignant lesions on oncologic imaging. We report a case of a 78-year-old man undergoing staging for suspected lung cancer, in whom a hypermetabolic lesion was incidentally detected in the left parotid gland on [¹⁸F]FDG PET/CT. Correlation with prior salivary scintigraphy, MRI, and CT supported the likelihood of Warthin’s tumor, which was subsequently confirmed by fine-needle aspiration cytology. This case illustrates how multimodality imaging can provide complementary diagnostic information that helps characterize the parotid lesion, but not replace cytologic confirmation. Recognition of characteristic imaging features, an understanding of each modality’s diagnostic strengths and limitations, and cytologic confirmation when indicated are essential to avoid misinterpretation and optimize patient management. Full article

(This article belongs to the Collection Advances in Cancer Imaging)

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14 pages, 8055 KB

Open AccessArticle

Interstitial Lung Disease Outcome Prediction Using Quantitative Densitometry Indices on Baseline Chest Computed Tomography

by Li-Ting Huang, Tang-Hsiu Huang, Chung-Ying Lin, Hao Ho, Yi-Shan Tsai, Chia-Ying Lin and Chien-Kuo Wang

Diagnostics 2025, 15(21), 2665; https://doi.org/10.3390/diagnostics15212665 (registering DOI) - 22 Oct 2025

Abstract

Background/Objectives: Accurate prognostication for interstitial lung disease (ILD) remains challenging, limiting clinicians’ ability to optimize patient management strategies. This study aimed to evaluate the prognostic value of baseline quantitative CT-derived indices, including total lung volume (TLVcm³), normal lung volume% (NLV%), [...] Read more.

Background/Objectives: Accurate prognostication for interstitial lung disease (ILD) remains challenging, limiting clinicians’ ability to optimize patient management strategies. This study aimed to evaluate the prognostic value of baseline quantitative CT-derived indices, including total lung volume (TLVcm³), normal lung volume% (NLV%), and fibrotic lung volume% (FLV%), for predicting three-year mortality in interstitial lung disease (ILD) patients. Methods: A total of 101 ILD patients were retrospectively enrolled. Baseline CT-derived indices, including TLVcm³, NLV% (−950 to −700 HU), and FLV% (−600 to +50 HU), were measured on chest CT. Baseline forced vital capacity(FVC)% predicted and diffuse capacity of lungs for carbon monoxide (DLCO)% predicted were collected. Survival analysis used Kaplan–Meier’s curves and log-rank tests. Uni- and multivariate Cox’s proportional hazards regression were performed. Pearson’s correlation was used between CT-derived indices, FVC% predicted, and DLCO% predicted. Results: During 3-year follow-up, 30 of 101 patients (29.70%) died. Deceased patients had a significantly lower baseline NLV% (59.27% ± 7.61% vs. 65.02% ± 7.82%, p = 0.001) and a higher FLV% (17.64% ± 7.98% vs. 13.34% ± 7.48%, p = 0.011) compared with survivors. Multivariate analysis identified baseline NLV% (adjusted hazard ratio 0.88, 95% CI: 0.78–0.99, p = 0.034) and DLCO% predicted (adjusted hazard ratio 0.97, 95% CI: 0.95–0.99, p = 0.007) as independent predictors of three-year mortality. Patients with NLV% ≤ 64.15 and FLV% ≥ 14.12 showed significantly worse survival outcomes (21.78% vs. 7.92%, p < 0.001;19.80% (20/101) vs. 9.90% (10/101), p < 0.001). CT-derived indices moderately correlated with FVC% predicted and DLCO% predicted. Conclusions: Baseline FLV% ≥ 14.12 and NLV% ≤ 64.15 can effectively stratify and differentiate outcomes in ILD patients. Baseline NLV% has the potential as a prognostic indicator for 3-year survival in ILD. Full article

(This article belongs to the Section Clinical Diagnosis and Prognosis)

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8 pages, 7464 KB

Open AccessCase Report

The Chestnut and the Imperfect Crime: A Case Report of Femicide and Staged Road Accident

by Gennaro Baldino, Tindara Biondo, Cataldo Raffino, Marija Čaplinskienė, Stefano Vanin and Elvira Ventura Spagnolo

Diagnostics 2025, 15(21), 2664; https://doi.org/10.3390/diagnostics15212664 - 22 Oct 2025

Abstract

Introduction: Charred bodies represents a significant challenge for forensic pathologists due to the destructive effects of fire on human remains. Although most fire-related deaths are accidental, cases of suicide and homicide are not uncommon. Case Report: We report a peculiar case of a [...] Read more.

Introduction: Charred bodies represents a significant challenge for forensic pathologists due to the destructive effects of fire on human remains. Although most fire-related deaths are accidental, cases of suicide and homicide are not uncommon. Case Report: We report a peculiar case of a severely burned body discovered inside a torched vehicle. Under judicial investigation, a full autopsy was performed, including macroscopic and microscopic examination of key anatomical structures: the inspection of oral cavity revealed no soot deposits; a foreign object (a chestnut) was found anterior to the epiglottis, though not lodged within the glottis; no thermal injuries or soot were observed in the upper or lower airways. Histological analysis excluded thermal damage at the alveolar–capillary interface. Alveolar spaces appeared both hyperinflated and ectatic, likely due to septal rupture, suggestive of acute pulmonary emphysema and multiorgan congestion. Carboxyhemoglobin levels were below 5%, indicating a low level which did not support intravital inhalation of combustion gases. Based on the comprehensive medico-legal findings, the cause of death was attributed to an asphyxial mechanism. It was further demonstrated that the burning of the body occurred post-mortem. DNA extraction from two dental specimens enabled positive identification of the victim. Subsequent investigations confirmed the case to be a femicide. The perpetrator, following a domestic altercation over jealousy, suffocated his young wife and attempted to simulate accidental choking by placing a chestnut in her mouth. He then staged a vehicular fire to mimic a fatal accident. Conclusions: The case underlines that a multidisciplinary forensic approach is essential, and must integrate different methodologies and the analysis of both circumstantial evidence and scene investigation. Full article

(This article belongs to the Special Issue Diagnostic Methods in Forensic Pathology, Third Edition)

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Diagnostics, Volume 15, Issue 21 (November-1 2025) – 7 articles

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