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Diagnostics
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Recent Advances in Diagnosis and Management of Musculoskeletal Disorders
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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 4613

Special Issue Editors

Dr. Antonio Jesús Láinez-Ramos-Bossini

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; artificial intelligence; evidence-based medicine; precision medicine
Dr. Fernando Ruiz Santiago

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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

15 pages, 1648 KiB  
Article
Changes in the Relationship Between Gray Matter, Functional Parameters, and Quality of Life in Patients with a Post-Stroke Spastic Upper Limb After Single-Event Multilevel Surgery: Six-Month Results from a Randomized Trial
by Patricia Hurtado-Olmo, Pedro Hernández-Cortés, Ángela González-Santos, Lourdes Zuñiga-Gómez, Laura Del Olmo-Iruela and Andrés Catena
Diagnostics 2025, 15(8), 1020; https://doi.org/10.3390/diagnostics15081020 - 16 Apr 2025
Viewed by 321
Abstract
Introduction: Advanced magnetic resonance imaging (MRI) techniques in neuroplasticity evaluations provide important information on stroke disease and the underlying mechanisms of neuronal recovery. It has been observed that gray matter density or volume in brain regions closely related to motor function can be [...] Read more.
Introduction: Advanced magnetic resonance imaging (MRI) techniques in neuroplasticity evaluations provide important information on stroke disease and the underlying mechanisms of neuronal recovery. It has been observed that gray matter density or volume in brain regions closely related to motor function can be a valuable indicator of the response to treatment. Objective: To compare structural MRI-evaluated gray matter volume changes in patients with post-stroke upper limb spasticity for >1 year between those undergoing surgery and those treated with botulinum toxin A (BoNT-A) and to relate these findings to upper limb function and quality of life outcomes. Materials and Methods: Design. A two-arm controlled and randomized clinical trial in patients with post-stroke upper limb spasticity. Participants. Thirty post-stroke patients with spastic upper limbs. Intervention. Participants were randomly assigned (1:1 allocation ratio) for surgery (experimental group) or treatment with BoNT-A (control group). Main outcome measures. The functional parameters were analyzed with Fugl-Meyer, Zancolli, Keenan, House, Ashworth, pain visual analogue, and hospital anxiety and depression scales. Quality of life was evaluated using SF-36 and Newcastle stroke-specific quality of life scales. The carer burden questionnaire was also applied. Clinical examinations and MRI scans were performed at baseline and at six months post-intervention. Correlations between brain volume/thickness and predictors of interest were examined across evaluations and groups. Results: Five patients were excluded due to the presence of intracranial implants. Eleven patients were excluded from analyses since they were late dropouts. Changes were observed in the experimental group but not in the control group. Between baseline and six months, gray matter volume was augmented at the hippocampus and gyrus rectus and cortical thickness was increased at the frontal pole, occipital gyrus, and insular cortex, indicating anatomical changes in key areas related to motor and behavioral adaptation These changes were significantly related to subjective pain, Ashworth spasticity scale, and Newcastle quality of life scores, and marginally related to the carer burden score. Conclusions: The structural analysis of gray matter by MRI revealed differences in patients with post-stroke sequelae undergoing different therapies. Gray matter volume and cortical thickness measurements showed significant improvements in the surgery group but not in the BoNT-A group. Volume was increased in areas associated with motor and sensory functions, suggesting a neuroprotective or regenerative effect of upper limb surgery. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Management of Musculoskeletal Disorders)
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16 pages, 8952 KiB  
Article
Non-Invasive and Quantitative Evaluation for Disuse Muscle Atrophy Caused by Immobilization After Limb Fracture Based on Surface Electromyography Analysis
by Lvgang Shi, Yuyin Hong, Shun Zhang, Hao Jin, Shengming Wang and Gang Feng
Diagnostics 2024, 14(23), 2695; https://doi.org/10.3390/diagnostics14232695 - 29 Nov 2024
Viewed by 683
Abstract
Background: The clinical evaluation for disuse muscle atrophy usually depends on qualitative rating indicators with subjective judgments of doctors and some invasive measurement methods such as needle electromyography. Surface electromyography, as a non-invasive method, has been widely used in the detection of muscular [...] Read more.
Background: The clinical evaluation for disuse muscle atrophy usually depends on qualitative rating indicators with subjective judgments of doctors and some invasive measurement methods such as needle electromyography. Surface electromyography, as a non-invasive method, has been widely used in the detection of muscular and neurological diseases in recent years. In this paper, we explore how to evaluate disuse muscle atrophy based on surface electromyography; Methods: Firstly, we conducted rat experiments using hind-limb suspension to create a model of disuse muscle atrophy. Five groups of rats were suspended for 0, 3, 7, 14, and 21 days, respectively. We induced leg electromyography of rats through electrical stimulation and used fluorescence staining to obtain the fiber-type composition of rats’ leg muscles. We obtained the best-fitting frequency bands of power spectrum density of surface electromyography for type I and type II fibers in rats’ leg muscles by changing the frequency band boundaries. Secondly, we conducted tests on the human body and collected the electromyography of the atrophied muscles of the subjects over a period of 21 days. The changes in muscle fiber composition were evaluated using the frequency bands of power spectrum density obtained from rat experiments. The method was to evaluate the changes in type I fibers by the changes in the area of the best-fitting frequency band of type I fibers and to evaluate the changes in type II fibers by the changes in the area of the best-fitting frequency band of type II fibers. Results: The results of rat experiments showed that type I fibers best fit the frequency band of 20–330 Hz and type II fibers best fit the frequency band of 176–500 Hz. The results of human testing showed that the atrophy of the two types of fibers was consistent with the changes in the areas of the corresponding best-fitting frequency bands. Conclusions: The test results demonstrate the feasibility of using surface electromyography to evaluate muscle fiber-type composition and subsequently assess muscle atrophy. Further research may contribute to the diagnosis and treatment of disuse muscle atrophy. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Management of Musculoskeletal Disorders)
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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
Cited by 1 | Viewed by 813
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
(This article belongs to the Special Issue Recent Advances in Diagnosis and Management of Musculoskeletal Disorders)
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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 1172
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
(This article belongs to the Special Issue Recent Advances in Diagnosis and Management of Musculoskeletal Disorders)
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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
Cited by 1 | Viewed by 1070
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
(This article belongs to the Special Issue Recent Advances in Diagnosis and Management of Musculoskeletal Disorders)
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