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Diagnostics
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Musculoskeletal Imaging 2025, 2nd Edition
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Musculoskeletal Imaging 2025, 2nd Edition

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

Deadline for manuscript submissions: closed (30 November 2025) | Viewed by 8734

Editor

Dr. Parham Pezeshk

E-Mail Website
Guest Editor
Division of Musculoskeletal Radiology, Department of Radiology, UT Southwestern Medical Center, Dallas, TX 75390, USA
Interests: imaging of arthritis; spondyloarthritis; bone and soft tissue tumors; neurography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The development of new and improved imaging technologies has revolutionized our ability to diagnose pathologies more accurately and at an earlier stage, enabling clinicians to provide better care for their patients. In the past decade, musculoskeletal imaging has particularly benefited from advancements in more sophisticated imaging tools and scanners, which have allowed radiologists to narrow their differential diagnoses and play a crucial role in patient management.

Exciting ongoing research on incorporating artificial intelligence into diagnostic imaging presents a promising future for improving patient care. In this Special Issue, we are pleased to present perspectives on selected topics in musculoskeletal imaging.

Dr. Parham Pezeshk
Guest Editor

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

  • imaging
  • radiology
  • diagnostic
  • musculoskeletal
  • artificial intelligence

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Related Special Issue

Published Papers (5 papers)

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Research

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18 pages, 6729 KB  
Article
Dynamic Ultrasound of the Infrapatellar Fat Pad for Detecting Anterior Cruciate Ligament Deficiency: A Biomechanical Cadaveric Proof-of-Concept Study
by Yoshiyuki Tokuda, Tsuneo Nakamura, Yoshitake Shiraishi, Kiyomi Hori, Hiroaki Okuda and Noriyuki Ozaki
Diagnostics 2026, 16(7), 1097; https://doi.org/10.3390/diagnostics16071097 - 5 Apr 2026
Viewed by 1097
Abstract
Background/Objectives: Diagnosing anterior cruciate ligament (ACL) insufficiency, particularly partial tears, remains challenging with standard static imaging. This study introduces a novel conceptual approach: assessing the dynamic kinematics of the infrapatellar fat pad (IPFP) as an indirect marker of ACL deficiency. Methods: [...] Read more.
Background/Objectives: Diagnosing anterior cruciate ligament (ACL) insufficiency, particularly partial tears, remains challenging with standard static imaging. This study introduces a novel conceptual approach: assessing the dynamic kinematics of the infrapatellar fat pad (IPFP) as an indirect marker of ACL deficiency. Methods: In this biomechanical proof-of-concept study, dynamic ultrasound tracked IPFP kinematics in eight cadaveric knees evaluated in intact (Control), Sham, and Torn ACL states during passive flexion. The primary endpoints were (i) the absolute anteroposterior position at 90° (y2 − y1) and (ii) the posterior displacement during the 60–90° flexion arc (ΔY 60–90°). Results: ACL deficiency significantly altered deep-flexion IPFP kinematics. For ΔY 60–90°, the Torn ACL group demonstrated a substantial loss of posterior excursion compared to the Control group (Mean ± SD: −0.25 ± 1.03 vs. 2.88 ± 1.29 mm; Welch’s p < 0.001; Hedges’ g = 2.54, 95% CI: 1.18 to 3.89) and the Sham group (3.46 ± 1.63 mm; p < 0.001; g = −2.57, 95% CI: −3.90 to −1.25). Consequently, for y2 − y1 at 90°, the Torn ACL group remained abnormally anterior versus Control (p = 0.003; g = −1.97) and Sham (p < 0.001; g = −1.82). Conclusions: ACL deficiency induces a distinct reduction in posterior IPFP displacement. While these massive effect sizes establish a strong biomechanical rationale, this study serves as a foundational proof-of-concept. Large-scale in vivo clinical trials are strictly required to validate its diagnostic utility before clinical implementation. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging 2025, 2nd Edition)
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18 pages, 1575 KB  
Article
Association Between Calcaneal Inclination Angle and Spinal and Lower Limb Alignment: A Retrospective Radiographic Analysis
by Yunhee Han, Seojae Jeon, Hyeonjun Woo, Wonbae Ha, Tae-Yong Park, Jin-Hyun Lee and Junghan Lee
Diagnostics 2026, 16(6), 921; https://doi.org/10.3390/diagnostics16060921 - 19 Mar 2026
Viewed by 969
Abstract
Background/Objectives: This study aimed to clinically investigate how variations in foot morphology influence spinal and lower limb alignment, based on the concept of an ascending kinetic chain. Methods: We analyzed the medical records of 100 patients who met the inclusion criteria. The X-ray [...] Read more.
Background/Objectives: This study aimed to clinically investigate how variations in foot morphology influence spinal and lower limb alignment, based on the concept of an ascending kinetic chain. Methods: We analyzed the medical records of 100 patients who met the inclusion criteria. The X-ray image data used in the analysis included weight-bearing lateral views of both feet, whole-spine anteroposterior (AP) and lateral views, and full-length standing AP scanograms of the lower legs. In the obtained X-ray images, Calcaneal Inclination Angle (CIA), Tibiotalar Tilt Angle (TTA), Tibiotalar Angle (TA), Quadriceps Angle (Q-angle), Pelvic Incidence (PI), Pelvic Tilt (PT), Sacral Slope (SS), and L1–S1 Lordosis (LL) were measured. Participants were categorized into subgroups based on their CIA values: Pes Planus, Normal, and Pes Cavus. These subgroups were analyzed by foot orientation (right and left) using one-way analysis of variance (ANOVA) and Pearson correlation coefficient analysis. Results: The one-way ANOVA identified significant differences in mean right foot PT values among subgroups. Correlation analysis shows moderate associations between foot CIA and Q-angle of the knee, as well as pelvic parameters including PI, PT, SS, and LL. Conclusions: Analysis of the correlation between foot parameters and body alignment, in the context of diagnostic and evaluative aspects of Chuna manual medicine (CMM), revealed moderate correlations among the foot, ankle, knee, pelvis, and lumbosacral regions. These findings suggest that foot morphology may play a clinically relevant role in posture-related disorders and could contribute to preventive and corrective strategies for musculoskeletal alignment. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging 2025, 2nd Edition)
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11 pages, 2708 KB  
Article
Serum Interleukin-17 and Its Association with Inflammation and Bone Remodeling in Rheumatoid Arthritis and Hand Osteoarthritis: Insights from Musculoskeletal Ultrasound
by Amany M. Ebaid, Essam Atwa, Mohamed A. Mortada, Hibah Abdulrahim Bahri, Noura Almadani and Noha M. Hammad
Diagnostics 2025, 15(11), 1335; https://doi.org/10.3390/diagnostics15111335 - 26 May 2025
Cited by 4 | Viewed by 1694
Abstract
Objectives: The objective of this study was to evaluate the relationship between interleukin-17 (IL-17) serum levels, musculoskeletal ultrasound (MSUS) observations, and clinical disease activity in patients with rheumatoid arthritis (RA) and hand osteoarthritis (OA). Methods: This case–control study involved 120 participants, [...] Read more.
Objectives: The objective of this study was to evaluate the relationship between interleukin-17 (IL-17) serum levels, musculoskeletal ultrasound (MSUS) observations, and clinical disease activity in patients with rheumatoid arthritis (RA) and hand osteoarthritis (OA). Methods: This case–control study involved 120 participants, with 40 individuals assigned to each of the three groups: RA, OA, and control. IL-17 serum levels were quantified in all participants. MSUS of the hand joints was performed on all RA and OA patients. Disease activity in patients with RA was assessed using the Clinical Disease Activity Score (CDAS). Both RA and OA patients completed a Visual Analog Scale (VAS) to evaluate pain intensity. Functional status was evaluated using the Health Assessment Questionnaire (HAQ) for RA patients, while the Australian/Canadian (AUSCAN) Osteoarthritis Hand Index was utilized for OA patients. Results: Serum levels of IL-17 were significantly higher in both the RA and OA groups compared to the control group. Among RA patients, a positive correlation was identified between the CDAS and the VAS for pain. In OA patients, a significant correlation was observed between VAS scores and serum IL-17 levels. Additionally, serum IL-17 levels were associated with the presence of synovitis in both RA and OA groups; however, no significant association was found between IL-17 levels and bony changes such as erosions or osteophytes. In terms of functional evaluation, serum IL-17 levels correlated with HAQ in the RA group, but not with AUSCAN in the OA group. Conclusions: Elevated IL-17 serum levels are linked to inflammatory changes identified by MSUS but not to bony changes. These findings suggest that the rise in IL-17 levels in both OA and RA is primarily driven by underlying inflammatory processes, positioning IL-17 as a potential therapeutic target for both conditions. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging 2025, 2nd Edition)
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Review

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15 pages, 4064 KB  
Review
Clock-Face Sonography of the Glenoid Labrum: A Pictorial Technical Protocol for Patients Ineligible for MRI/MR Arthrography
by Tomasz Poboży, Wojciech Konarski, Kacper Janowski, Klaudia Michalak, Kamil Poboży, Julia Domańska-Poboża and Maciej Kielar
Diagnostics 2025, 15(23), 3031; https://doi.org/10.3390/diagnostics15233031 - 28 Nov 2025
Viewed by 1279
Abstract
This work presents a standardized 360-degree, clock-face ultrasonographic protocol for comprehensive static and dynamic assessment of the glenoid labrum. The protocol translates the arthroscopic clock-face orientation into ultrasound scanning windows, providing reproducible steps for each labral quadrant (12 to 12 o’clock) including patient [...] Read more.
This work presents a standardized 360-degree, clock-face ultrasonographic protocol for comprehensive static and dynamic assessment of the glenoid labrum. The protocol translates the arthroscopic clock-face orientation into ultrasound scanning windows, providing reproducible steps for each labral quadrant (12 to 12 o’clock) including patient positioning, transducer orientation, and dynamic maneuvers. By leveraging linear transducers with trapezoidal imaging and an optional convex transducer to bypass acoustic shadowing from the acromion and coracoid, all labral segments can be consistently visualized, while dynamic testing reveals subtle clefts, irregular margins, and medial displacement patterns. Clinically, this approach is particularly valuable for patients who cannot undergo MRI or MR arthrography (e.g., due to metallic implants, contrast allergy, claustrophobia or renal dysfunction) and in settings where MR/MRA is unavailable or impractical (sports medicine, urgent care, postoperative follow-up). The pictorial atlas and step-by-step checklists aim to support adoption in routine practice and to facilitate communication with surgeons through shared clock-face terminology. This protocol is not intended to replace MR arthrography for surgical planning; rather, when MRI/MRA cannot be performed or access is limited, it provides actionable, dynamic information that complements clinical decision-making. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging 2025, 2nd Edition)
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Other

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12 pages, 3573 KB  
Case Report
The Impact of Persevering Home Full-Body In-Bed Gym Exercise on Body Muscles in Aging: A Case Report by Quantitative Radio-Densitometric Study Using 3D and 2D Color CT
by Riccardo Forni, Paolo Gargiulo, Gabriele Boretti, Marco Quadrelli, Tommaso Baccaglini, Aldo Morra, Barbara Ravara, Sandra Zampieri, Amber Pond, Ugo Carraro, Maria Chiara Maccarone and Stefano Masiero
Diagnostics 2024, 14(24), 2808; https://doi.org/10.3390/diagnostics14242808 - 13 Dec 2024
Cited by 3 | Viewed by 1982
Abstract
Background and Clinical Significance: Sarcopenia, characterized by muscle loss and fat infiltration, poses a significant health burden for aging populations. Quantitative Color 2D and 3D radiodensitometry provides a powerful tool to monitor muscle quality and quantity through CT imaging. This study assessed the [...] Read more.
Background and Clinical Significance: Sarcopenia, characterized by muscle loss and fat infiltration, poses a significant health burden for aging populations. Quantitative Color 2D and 3D radiodensitometry provides a powerful tool to monitor muscle quality and quantity through CT imaging. This study assessed the impact of a ten-year-long home-bed gym exercise intervention on muscle quality in an elderly subject using CT-derived radiodensitometric analysis. The study involved two comparative analyses: Study A, which compared knee-to-ankle CT scans of the subject between 2013 and 2023; and Study B, which compared the subject’s 2023 thigh CT scan with a cohort of 2500 elderly Icelandic individuals from the AGES-Reykjavik study. Case Presentation: A 70-year-old male began a home-based Full-Body In-Bed Gym exercise program in 2013. Quantitative muscle volume and radiodensity measurements were performed using CT at baseline and after ten years. Results: Study A shows significant improvements in muscle volume observed in the knee-to-ankle region, while a slower decline in radiodensity was noted, indicating substantial preservation of muscle quality despite the expected decay of ten-year aging. For instance, muscle volume increased by 15% in the left Soleus muscle and by 6% in the right Soleus muscle, while the average radiodensity decreased by 12–17 HU. The subject’s thigh muscle quality at 80-years-old is above the AGES-Reykjavik’s cohort average, with reduced fat infiltration. Conclusions: Long-term home Full-Body In-Bed Gym, a low-impact exercise, can mitigate aging sarcopenia, as evidenced by improved tissue radiodensity and muscle mass substantial preservation. This suggests potential applications in personalized healthcare strategies to enhance muscle preservation among aging populations. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging 2025, 2nd Edition)
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