Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology, Second Edition

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

Deadline for manuscript submissions: 31 December 2025 | Viewed by 1799

Special Issue Editor


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Guest Editor
1. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
2. Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
3. Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
Interests: muscuoloskeletal ultrasound; pain management research; meta-analysis
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Special Issue Information

Dear Colleagues,

The use of clinical symptoms and physical findings for the diagnosis of musculoskeletal disorders is often unreliable. Advances in ultrasound technology have enabled the delineation of the reciprocal anatomy of affected regions, thereby enhancing identification of the underlying pathology. There are many advantages of using ultrasound to explore musculoskeletal pain, including the lack of radiation, real-time imaging, non-invasive evaluation of vascularity, and the ability to perform dynamic studies. Recently, the development of elastography has improved the qualitative and quantitative evaluation of the mechanical properties of tendons and muscles, providing better diagnostic accuracy and follow-up of musculoskeletal disorders. Furthermore, compared with magnetic resonance imaging, ultrasound is better for identifying the origins of peripheral and axial musculoskeletal pain.

Once the cause of pain is correctly diagnosed, the intervention instrument can also be directed through ultrasound guidance, increasing the rate of treatment success. Several systematic reviews and meta-analyses have pointed out that ultrasound guidance leads to more effective treatment of musculoskeletal pain than landmark guidance. Since pain severely hampers quality of life and is treated as the fifth vital sign, determining ultrasound can assist in the management of pain has emerged as one of the most important issues for pain physicians. Therefore, this Special Issue will provide a collection of narrative or systematic reviews, basic research, and clinical studies that employ ultrasound to identify the origin and associations of musculoskeletal pain as well as to guide interventions. Since nerve entrapment is a common etiology of musculoskeletal pain, we also welcome articles investigating ultrasound-guided treatment for peripheral nerve entrapment syndrome.

Potential topics include, but are not limited to, the following:

  • Association of ultrasound diagnosed musculoskeletal painful disorders with pathologies obtained from other imaging modalities;
  • Accuracy of ultrasound imaging in the diagnosis of musculoskeletal pain compared with surgical and radiological findings;
  • Education/training of musculoskeletal ultrasound in the diagnosis of musculoskeletal painful syndrome;
  • Comparative effectiveness of ultrasound-guided treatments for musculoskeletal painful syndrome;
  • Use of ultrasound elastography for diagnosis and follow up of musculoskeletal pain.

Dr. Ke-Vin Chang
Guest Editor

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Keywords

  • diagnosis
  • ultrasound
  • pain
  • muscle
  • tendon
  • nerve
  • rehabiltation

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Published Papers (2 papers)

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Review

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14 pages, 1980 KiB  
Review
Ultrasound in Adhesive Capsulitis: A Narrative Exploration from Static Imaging to Contrast-Enhanced, Dynamic and Sonoelastographic Insights
by Wei-Ting Wu, Ke-Vin Chang, Kamal Mezian, Vincenzo Ricci, Consuelo B. Gonzalez-Suarez and Levent Özçakar
Diagnostics 2025, 15(15), 1924; https://doi.org/10.3390/diagnostics15151924 - 31 Jul 2025
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Abstract
Adhesive capsulitis is a painful and progressive condition marked by significant limitations in shoulder mobility, particularly affecting external rotation. Although magnetic resonance imaging is regarded as the reference standard for assessing intra-articular structures, its high cost and limited availability present challenges in routine [...] Read more.
Adhesive capsulitis is a painful and progressive condition marked by significant limitations in shoulder mobility, particularly affecting external rotation. Although magnetic resonance imaging is regarded as the reference standard for assessing intra-articular structures, its high cost and limited availability present challenges in routine clinical use. In contrast, musculoskeletal ultrasound has emerged as an accessible, real-time, and cost-effective imaging modality for both the diagnosis and treatment guidance of adhesive capsulitis. This narrative review compiles and illustrates current evidence regarding the role of ultrasound, encompassing static B-mode imaging, dynamic motion analysis, contrast-enhanced techniques, and sonoelastography. Key sonographic features—such as thickening of the coracohumeral ligament, fibrosis in the axillary recess, and abnormal tendon kinematics—have been consistently associated with adhesive capsulitis and demonstrate favorable diagnostic performance. Advanced methods like contrast-enhanced ultrasound and elastography provide additional functional insights (enabling evaluation of capsular stiffness and vascular changes) which may aid in disease staging and prediction of treatment response. Despite these advantages, the clinical utility of ultrasound remains subject to operator expertise and technical variability. Limited visualization of intra-articular structures and the absence of standardized scanning protocols continue to pose challenges. Nevertheless, ongoing advances in its technology and utility standardization hold promise for the broader application of ultrasound in clinical practice. With continued research and validation, ultrasound is positioned to play an increasingly central role in the comprehensive assessment and management of adhesive capsulitis. Full article
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16 pages, 5818 KiB  
Case Report
Novel Sonoguided Digital Palpation and Ultrasound-Guided Hydrodissection of the Long Thoracic Nerve for Managing Serratus Anterior Muscle Pain Syndrome: A Case Report with Technical Details
by Nunung Nugroho, King Hei Stanley Lam, Theodore Tandiono, Teinny Suryadi, Anwar Suhaimi, Wahida Ratnawati, Daniel Chiung-Jui Su, Yonghyun Yoon and Kenneth Dean Reeves
Diagnostics 2025, 15(15), 1891; https://doi.org/10.3390/diagnostics15151891 - 28 Jul 2025
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Abstract
Background and Clinical Significance: Serratus Anterior Muscle Pain Syndrome (SAMPS) is an underdiagnosed cause of anterior chest wall pain, often attributed to myofascial trigger points of the serratus anterior muscle (SAM) or dysfunction of the Long Thoracic Nerve (LTN), leading to significant disability [...] Read more.
Background and Clinical Significance: Serratus Anterior Muscle Pain Syndrome (SAMPS) is an underdiagnosed cause of anterior chest wall pain, often attributed to myofascial trigger points of the serratus anterior muscle (SAM) or dysfunction of the Long Thoracic Nerve (LTN), leading to significant disability and affecting ipsilateral upper limb movement and quality of life. Current diagnosis relies on exclusion and physical examination, with limited treatment options beyond conservative approaches. This case report presents a novel approach to chronic SAMPS, successfully diagnosed using Sonoguided Digital Palpation (SDP) and treated with ultrasound-guided hydrodissection of the LTN using 5% dextrose in water (D5W) without local anesthetic (LA), in a patient where conventional treatments had failed. Case Presentation: A 72-year-old male presented with a three-year history of persistent left chest pain radiating to the upper back, exacerbated by activity and mimicking cardiac pain. His medical history included two percutaneous coronary interventions. Physical examination revealed tenderness along the anterior axillary line and a positive hyperirritable spot at the mid axillary line at the 5th rib level. SDP was used to visualize the serratus anterior fascia (SAF) and LTN, and to reproduce the patient’s concordant pain by palpating the LTN. Ultrasound-guided hydrodissection of the LTN was then performed using 20–30cc of D5W without LA to separate the nerve from the surrounding tissues, employing a “fascial unzipping” technique. The patient reported immediate pain relief post-procedure, with the pain reducing from 9/10 to 1/10 on the Numeric Rating Scale (NRS), and sustained relief and functional improvement at the 12-month follow-up. Conclusions: Sonoguided Digital Palpation (SDP) of the LTN can serve as a valuable diagnostic adjunct for visualizing and diagnosing SAMPS. Ultrasound-guided hydrodissection of the LTN with D5W without LA may provide a promising and safe treatment option for patients with chronic SAMPS refractory to conservative management, resulting in rapid and sustained pain relief. Further research, including controlled trials, is warranted to evaluate the long-term efficacy and generalizability of these findings and to compare D5W to other injectates. Full article
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