Imaging-Guided Diagnosis and Precision Assessment in Spine and Joint Disorders

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

Deadline for manuscript submissions: 30 September 2026 | Viewed by 2818

Special Issue Editors


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Guest Editor
Unit of Analgesia and Percutaneous Surgery, Fondazione Istituto G. Giglio, Cefalù, Italy
Interests: interventional pain medicine; musculoskeletal and spine diagnostics; imaging-guided procedures; regenerative medicine; AI-supported clinical decision making; outcome prediction
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Guest Editor
The Spine and Nerve Centers of the Virginias, Charleston, WV, USA
Interests: neuromodulation; spine interventions; outcomes research; imaging-guided pain therapies

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Guest Editor
1. Department of Anesthesiology, New York University Langone Medical Center, New York, NY, USA
2. Department of Anesthesiology, The Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
Interests: interventional pain management; spine diagnostics; image-guided procedures; clinical outcomes

Special Issue Information

Dear Colleagues,

Chronic spine and joint disorders represent a major source of disability worldwide, yet diagnostic uncertainty and patient heterogeneity continue to limit the effectiveness and predictability of therapeutic interventions. Advances in imaging technologies and analytical methods are creating new opportunities to move from descriptive assessment toward precision-oriented diagnostics in pain and musculoskeletal medicine.

This Special Issue focuses on the advanced and clinically pragmatic use of ultrasound, fluoroscopy, MRI, CT, and hybrid imaging techniques to improve diagnostic accuracy, patient phenotyping, and outcome prediction in spine and joint disorders. Particular emphasis will be placed on imaging strategies that directly inform clinical decision making, including patient selection for interventional, neuromodulatory, and regenerative therapies.

We welcome original research, systematic and narrative reviews, and translational studies addressing multimodal imaging pathways, imaging-derived biomarkers, radiomics, artificial intelligence applications, and outcome-oriented diagnostic frameworks. Contributions highlighting real-world implementation, reproducibility, and clinical impact are especially encouraged.

By integrating imaging science with pain medicine and data-driven approaches, this Special Issue aims to provide a practical and forward-looking overview of how advanced imaging can enhance personalized care and improve outcomes in patients with spine and joint disorders.

Dr. Giuliano Lo Bianco
Dr. Timothy Deer
Dr. Kenneth B. Chapman
Guest Editors

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Keywords

  • imaging-guided diagnostics
  • precision pain medicine
  • chronic pain
  • spine and joint disorders
  • artificial intelligence in imaging
  • radiomics and imaging biomarkers
  • neuromodulation and image-guided interventions

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Published Papers (1 paper)

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10 pages, 5981 KB  
Case Report
Ultrasound-Guided Hydrodissection for Carpal Tunnel Syndrome with Bifid Median Nerve and Persistent Median Artery: An Imaging-Based Case Report with Alpha-2 Macroglobulin
by Jeimylo C. de Castro, Daniel Wang, Jeffrey Strakowski and Yonghyun Yoon
Diagnostics 2026, 16(9), 1362; https://doi.org/10.3390/diagnostics16091362 - 30 Apr 2026
Viewed by 253
Abstract
Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity and results from compression of the median nerve within the fibro-osseous carpal tunnel. Anatomical variants such as a bifid median nerve (BMN) and a persistent median artery (PMA) [...] Read more.
Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity and results from compression of the median nerve within the fibro-osseous carpal tunnel. Anatomical variants such as a bifid median nerve (BMN) and a persistent median artery (PMA) may increase tunnel occupancy and complicate both diagnosis and treatment. High-resolution musculoskeletal ultrasound enables detailed evaluation of these anatomical variations and facilitates image-guided interventions. Ultrasound-guided hydrodissection has emerged as a minimally invasive technique capable of mechanically releasing perineural adhesions and restoring nerve mobility. Alpha-2 macroglobulin (A2M), an autologous plasma protease inhibitor with anti-inflammatory and cytokine-binding properties, has recently been explored as a biologic adjunct in musculoskeletal conditions. Case Presentation: We report the case of a 60-year-old right-handed woman who presented with a one-year history of numbness, paresthesia, and pain within the median nerve distribution of her dominant hand. Ultrasound examination demonstrated a bifid median nerve accompanied by a persistent median artery and perineural edema within the proximal carpal tunnel. The patient underwent three weekly sessions of ultrasound-guided hydrodissection using autologous A2M prepared through the APEX filtration system. The patient reported progressive clinical improvement following treatment. Grip strength increased from 12 kg at baseline to 22 kg at week twelve. Follow-up ultrasound performed ten months after treatment showed restoration of median nerve fascicular architecture and normalization of nerve morphology, findings consistent with interval structural improvement. Discussion: This case highlights the role of ultrasound in the integrated evaluation and management of CTS with anatomical variants, including diagnosis, procedural guidance, and longitudinal assessment. Conclusions: Ultrasound-guided hydrodissection with A2M may represent a feasible minimally invasive approach in selected patients; however, further prospective studies are required to determine its safety and therapeutic efficacy. Full article
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