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Diagnostics
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Interdisciplinary Approaches to Musculoskeletal Disorders: From Imaging to Management
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Interdisciplinary Approaches to Musculoskeletal Disorders: From Imaging to Management

A Special Issue of Diagnostics (ISSN 2075-4418) belonging to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 November 2026 | Viewed by 2344

Editors

Dr. Ralf Henkelmann

E-Mail Website
Guest Editor
Department of Orthopedics, Trauma and Plastic Surgery, Leipzig University, Liebigstraße 20, Leipzig, Germany
Interests: orthopedics; osteoarthritis; musculoskeletal disorders; musculoskeletal imaging; ar-throscopy; tissue engineering; cartilage therapy
Dr. Jeanette Henkelmann

E-Mail Website
Guest Editor Assistant
Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstraße 20, Leipzig, Germany
Interests: diagnostic radiology; computed tomography; magnetic resonance imaging; medical imaging; musculoskeletal disorders; musculoskeletal imaging

Special Issue Information

Dear Colleagues,

Musculoskeletal disorders constitute one of the leading global causes of pain, functional impairment, and disability. Although advances in medical imaging have substantially enhanced the detection and characterization of musculoskeletal pathology, the role of imaging in contemporary clinical care extends well beyond diagnostic classification. Imaging findings now play a central role in risk stratification, therapeutic decision-making, and surgical planning across multiple medical and surgical disciplines.

As Guest Editors representing musculoskeletal radiology and joint surgery, we focus on imaging that directly informs clinical decision-making. We believe that sustainable progress in musculoskeletal medicine arises when radiological expertise and clinical judgment are tightly integrated to improve patient care.

We invite submissions to the Diagnostics Special Issue “Interdisciplinary Approaches to Musculoskeletal Disorders: From Imaging to Management.” This issue welcomes high-quality original research and reviews that explicitly link musculoskeletal imaging with clinical management, therapeutic strategy, or surgical planning.

Particular interest is given to studies demonstrating how imaging findings—quantitative or qualitative—contribute to diagnostic accuracy, prognostic assessment, treatment selection, or outcome prediction. Contributions may address advanced or conventional imaging approaches, provided their clinical relevance and interdisciplinary integration are clearly articulated.

By uniting radiological precision with clinical expertise, this Special Issue highlights imaging as a decisive, patient-centered tool rather than an isolated diagnostic endpoint. We look forward to your impactful contributions.

Dr. Ralf Henkelmann
Guest Editor

Dr. Jeanette Henkelmann
Guest Editor Assistant

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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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 imaging
  • interdisciplinary management
  • clinical decision-making
  • quantitative imaging
  • imaging biomarkers
  • alignment and positioning
  • artificial intelligence
  • surgical planning

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Published Papers (4 papers)

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15 pages, 1360 KB  
Article
Radiographic Projection Quality Score for the Knee (RPQS-Knee): Development and Reliability
by Peter Melcher, Ralf Henkelmann, Salim Youssef, Anton Brehmer, Timm Denecke and Jeanette Henkelmann
Diagnostics 2026, 16(17), 2703; https://doi.org/10.3390/diagnostics16172703 - 25 Aug 2026
Viewed by 279
Abstract
Background/Objectives: Accurate patient positioning is essential for diagnostic quality in conventional knee radiography. Although established anatomical landmarks are routinely used to judge projection quality, assessment remains qualitative and observer-dependent. We therefore developed and validated the Radiographic Projection Quality Score for the Knee (RPQS-Knee), [...] Read more.
Background/Objectives: Accurate patient positioning is essential for diagnostic quality in conventional knee radiography. Although established anatomical landmarks are routinely used to judge projection quality, assessment remains qualitative and observer-dependent. We therefore developed and validated the Radiographic Projection Quality Score for the Knee (RPQS-Knee), a standardized scoring system for objective projection quality assessment. Methods: The RPQS-Knee was derived from established radiographic positioning criteria, anatomical reference landmarks, and predefined geometrically based measurement thresholds. The final score was evaluated in 153 consecutive knee radiographic examinations, independently assessed by one radiologist and two orthopedic surgeons. Inter rater reliability was assessed using quadratically weighted Gwet’s AC2, intra rater reliability using weighted Cohen’s κ, and construct validity by correlation with separately assigned diagnostic adequacy ratings. Results: The RPQS-Knee comprises four projection-related criteria assessing fibular-head superimposition, tibial plateau alignment, and femoral-condyle congruency. Inter rater reliability was excellent for the total score (AC2 = 0.93; 95% CI, 0.92–0.95) and good to excellent for all individual items (AC2 = 0.76–0.85). Intra rater reliability ranged from κ = 0.59 to 0.81. RPQS-Knee subscores correlated strongly with diagnostic adequacy ratings (ρ = −0.69 and −0.78; both p < 0.001), providing evidence supporting construct validity. Conclusions: The RPQS-Knee translates established radiographic positioning criteria into a standardized, reproducible instrument for objective assessment of projection quality. Its excellent reliability and evidence supporting construct validity suggest that it may facilitate standardized quality assessment in clinical practice, quality assurance, and research. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to Musculoskeletal Disorders: From Imaging to Management)
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19 pages, 2002 KB  
Article
Intra- and Interobserver Reliability of the CT-Based Glenoid Arc-Angle Method Using Injured-Side and Contralateral Reference Circles: A Diagnostic Reliability Study
by Susanne Strasser, Johannes Dominikus Pallua, Anton Aschaber, Franz Kralinger, Dietmar Dammerer, Dietmar Krappinger, Rohit Arora and Clemens Hengg
Diagnostics 2026, 16(15), 2477; https://doi.org/10.3390/diagnostics16152477 - 6 Aug 2026
Viewed by 257
Abstract
Background/Objectives: This study aimed to compare the intraobserver and interobserver reliability and absolute agreement of the CT-based glenoid arc-angle method when the reference circle was constructed either directly on the injured glenoid or transferred from the healthy contralateral glenoid. The objective was [...] Read more.
Background/Objectives: This study aimed to compare the intraobserver and interobserver reliability and absolute agreement of the CT-based glenoid arc-angle method when the reference circle was constructed either directly on the injured glenoid or transferred from the healthy contralateral glenoid. The objective was to assess measurement reproducibility rather than anatomical validity, diagnostic accuracy, or clinical utility. Methods: Preoperative CT scans of 31 patients with anterior shoulder instability who underwent surgery were retrospectively analyzed. Three independent observers with different levels of experience performed measurements at two separate time points using two geometrical approaches. In the contralateral-reference method, the diameter of the best-fit circle was determined on the healthy contralateral glenoid and transferred to the injured side. In the injured-side method, the best-fit circle was determined directly on the injured glenoid. The defect angle and glenoid diameter were measured, and the defect angle was converted into an area-based percentage of glenoid bone loss. Intraobserver reliability was assessed across the two measurement sessions, whereas interobserver reliability was assessed across observer-specific means from the two sessions, using intraclass correlation coefficients with 95% confidence intervals. Absolute agreement, systematic bias, and measurement error between sessions were additionally evaluated using Bland–Altman analysis, the standard error of measurement, and the minimum detectable change. Results: The contralateral-reference method yielded numerically higher ICC point estimates for both measured parameters. For defect-angle measurements, the interobserver ICC based on observer-specific two-session mean estimates was 0.890 with the contralateral-reference method (95% CI: 0.811–0.942) and 0.603 with the injured-side method (95% CI: 0.399–0.767). For glenoid-diameter measurements, the corresponding interobserver ICCs were 0.900 (95% CI: 0.660–0.961) and 0.812 (95% CI: 0.672–0.900), respectively. Several confidence intervals crossed conventional reliability category boundaries and partially overlapped between methods; therefore, these findings represent numerical differences in point estimates rather than statistically established superiority. Conclusions: Within this cohort, the contralateral-reference method yielded numerically higher ICC point estimates, smaller session-related biases, and lower measurement-error estimates than the injured-side method. These descriptive findings do not establish statistically significant superiority, diagnostic accuracy, clinical utility, or treatment thresholds. The results are limited by the relatively small retrospective cohort of 31 surgically treated patients and the absence of anatomical or clinical outcome validation. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to Musculoskeletal Disorders: From Imaging to Management)
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14 pages, 2034 KB  
Article
Longitudinal Multiparametric Quantitative MRI Evaluation of Graft Maturity Following Anterior Cruciate Ligament Reconstruction: A One-Year Prospective Observational Study
by Jun-Jie Yang, Chao Ju, Long-Tao Yang, Ye-Xin Li, Mao-Sheng Wang, Jun-Jiao Hu and Jun Liu
Diagnostics 2026, 16(8), 1121; https://doi.org/10.3390/diagnostics16081121 - 8 Apr 2026
Viewed by 829
Abstract
Background/Objectives: Objective, non-invasive biomarkers are needed to track anterior cruciate ligament (ACL) graft maturation and support individualized return-to-sport decisions. This study evaluated a single-session multiparametric quantitative MRI (qMRI) protocol for longitudinal assessment of ACL graft microstructural evolution and its association with patient-reported outcomes. [...] Read more.
Background/Objectives: Objective, non-invasive biomarkers are needed to track anterior cruciate ligament (ACL) graft maturation and support individualized return-to-sport decisions. This study evaluated a single-session multiparametric quantitative MRI (qMRI) protocol for longitudinal assessment of ACL graft microstructural evolution and its association with patient-reported outcomes. Methods: Twenty-eight patients undergoing primary ACL reconstruction with hamstring autografts underwent multiparametric qMRI (T1, T2*, R2*, and PD mapping) at 1, 3, 6, and 12 months. The contralateral native ACL served as a within-subject control. IKDC, Lysholm, and VAS scores were recorded at each visit. Linear mixed-effects models were used to test longitudinal changes. Correlations of baseline-normalized changes between adjacent visits were used to evaluate imaging–clinical associations. Results: All qMRI parameters changed significantly over time (all p < 0.001). At 1 month, T1, PD, and T2* were lower and R2* higher than the contralateral native ACL (all p < 0.001). Thereafter, T1, PD, and T2* increased and R2* decreased, with most metrics approaching contralateral values by 3–6 months (all p < 0.05), and changes entered a plateau after 6 months (all p > 0.05). IKDC, Lysholm, and VAS improved over time (all p < 0.001), mainly before 6 months. Greater early T2* increases and R2* decreases (1–3 months) were associated with less pain relief and smaller Lysholm improvement (p < 0.05); no significant associations were observed from 6–12 months. Conclusions: Single-session multiparametric qMRI sensitively captures ACL graft maturation and highlights 3–6 months as a critical remodeling window, providing objective biomarkers to complement clinical assessment for individualized rehabilitation monitoring and return-to-sport timing. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to Musculoskeletal Disorders: From Imaging to Management)
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8 pages, 1023 KB  
Case Report
Sonographic Diagnosis of Flexor Tendon Incarceration by a Malunited Fracture Fragment: A Case Report
by Yuan-Chen Chang, Yu-Te Lin and Yu-Hsuan Cheng
Diagnostics 2026, 16(9), 1260; https://doi.org/10.3390/diagnostics16091260 - 23 Apr 2026
Viewed by 522
Abstract
Background and Clinical Significance: Post-traumatic finger stiffness is frequently attributed to soft tissue adhesions; however, mechanical obstruction from occult osseous structures remains a rare but critical differential diagnosis in adults. Case Presentation: This report describes a 56-year-old female presenting with severe, [...] Read more.
Background and Clinical Significance: Post-traumatic finger stiffness is frequently attributed to soft tissue adhesions; however, mechanical obstruction from occult osseous structures remains a rare but critical differential diagnosis in adults. Case Presentation: This report describes a 56-year-old female presenting with severe, refractory stiffness of the little finger eight months after a proximal phalanx fracture. Despite extensive conservative therapy, active and passive flexion at the proximal and distal interphalangeal joints remained locked in extension. While conventional radiographs demonstrated bony union, musculoskeletal ultrasonography (MSUS) revealed an occult protruding malunited fragment incarcerating the flexor tendons. Dynamic MSUS provided real-time evidence of mechanical impingement by demonstrating proximal muscle contraction without distal tendon excursion. Intraoperatively, initial soft tissue tenolysis failed to restore motion; further exploration guided by MSUS evidence successfully identified a sharp bone spike. Subsequent ostectomy resulted in immediate restoration of functional range of motion. This case underscores the limitations of static imaging in evaluating the dynamic gliding mechanism and highlights the valuable role of MSUS in identifying mechanical functional obstructions. Conclusions: Early sonographic evaluation should be considered for refractory post-traumatic stiffness to prevent prolonged, ineffective conservative care and to guide definitive surgical management. Full article
(This article belongs to the Special Issue Interdisciplinary Approaches to Musculoskeletal Disorders: From Imaging to Management)
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