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Musculoskeletal Imaging and Intervention
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Musculoskeletal Imaging and Intervention

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nuclear Medicine & Radiology".

Deadline for manuscript submissions: 25 August 2025 | Viewed by 7383

Special Issue Editors

Dr. Miguel Malo-Urriés

E-Mail Website
Guest Editor
Health Sciences Faculty, Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
Interests: ultrasound; invasive physiotherapy; neuromodulation; percutaneous electrolysis; dry needling; minimally invasive surgical procedures
Dr. Jacobo Rodríguez-Sanz

E-Mail Website
Guest Editor
Department of Medicine, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
Interests: ultrasound; invasive physiotherapy;neuromodulation; percutaneous electrolysis; dry needling; anatomy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to explore the latest advances in interventional and imaging techniques within the realm of health sciences, reflecting the current state of research and addressing the main challenges in this field. The main objectives include presenting innovative methodologies, evaluating the efficacy of new technologies, and encouraging interdisciplinary collaboration. This Special Issue will cover a wide range of topics, such as new imaging modalities, minimally invasive surgical procedures, invasive physiotherapy, and the integration of artificial intelligence into diagnostic and therapeutic processes. By presenting a comprehensive overview of the latest advances, this Special Issue aims to highlight both the potential and limitations of these techniques. Key issues to be addressed include improving accuracy, ameliorating patient outcomes, and reducing procedural risks. The scope of this Special Issue encompasses studies ranging from basic research to clinical applications, with an emphasis on translational aspects that bridge the gap between laboratory findings and real-world practice. Through this mobilization of knowledge, this Special Issue aims to inspire future research and innovation, ultimately contributing to the advancement of medical and physiotherapeutic practices.

Dr. Miguel Malo-Urriés
Dr. Jacobo Rodríguez-Sanz
Guest Editors

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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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • ultrasound
  • invasive physiotherapy
  • minimally invasive surgical procedures
  • magnetic resonance
  • image analysis

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Published Papers (4 papers)

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Research

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14 pages, 4600 KiB  
Article
Testing the Safety of Piriformis Dry Needling Interventions: An Observational Study Evaluating the Predictive Value of Anthropometric and Demographic Factors
by Juan Antonio Valera-Calero, Umut Varol, Gustavo Plaza-Manzano, César Fernández-de-las-Peñas, Pedro Belón-Pérez, Mónica López-Redondo and Marcos José Navarro-Santana
J. Clin. Med. 2024, 13(22), 6674; https://doi.org/10.3390/jcm13226674 - 7 Nov 2024
Viewed by 2079
Abstract
Objectives: The dry needling of the piriformis muscle (especially in the medial region) is a challenging procedure since there is a high risk of accidentally puncturing the sciatic nerve. This study aimed to explain the variance of the deep limit of the [...] Read more.
Objectives: The dry needling of the piriformis muscle (especially in the medial region) is a challenging procedure since there is a high risk of accidentally puncturing the sciatic nerve. This study aimed to explain the variance of the deep limit of the piriformis based on anthropometric and demographic predictors potentially associated with it by exploring if clinicians can select the optimal needle length needed accurately to avoid accidental punctures of the sciatic nerve during palpation-guided dry needling interventions. Methods: An observational study was conducted that included fifty-six patients with piriformis muscle syndrome. We recorded the skin-to-sciatic nerve distance at the location with greatest risk of accidental sciatic puncture (assessed with ultrasound imaging) and demographic (e.g., age, gender, height, weight and body mass index—BMI) and anthropometric (hip circumference) variables. Results: Thirty-four males (n = 34) and twenty-two females (n = 22) were analyzed. Although men presented a significantly greater hip circumference than women (p = 0.007), no skin-to-sciatic nerve distance differences were observed (p > 0.05). Correlation analyses revealed that the sciatic nerve’s depth is associated with weight, BMI and hip perimeter (all, p < 0.01) but not with age or height (p > 0.05). Due to shared variance and multicollinearity, the hip circumference was the only predictor included in the regression model, explaining 37.9% of the piriformis muscle’s deeper fascia depth variance (R2 Adjusted = 0.379). Conclusions: Although the use of landmarks and measuring the hip perimeter may result in greater dry needling accuracy and a lower risk of adverse events derived from accidental sciatic nerve puncture, ultrasound guidance is encouraged as is the safest method for avoiding serious adverse events. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging and Intervention)
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10 pages, 3121 KiB  
Article
New Ultrasound-Guided Approach to Access to the Posterolateral Part of Intervertebral Lumbar Discs: A Cadaveric Study
by Jacobo Rodríguez-Sanz, Sergio Borrella-Andrés, Carlos López-de-Celis, Isabel Albarova-Corral, Albert Pérez-Bellmunt, Elena Bueno-Gracia and Miguel Malo-Urriés
J. Clin. Med. 2024, 13(15), 4411; https://doi.org/10.3390/jcm13154411 - 28 Jul 2024
Viewed by 2426
Abstract
Background: Approximately 40% of chronic low back pain patients have a discogenic origin. In relation to intervertebral disc injuries, most of them are in the posterior and lateral zone of the disc, involving the anterior lumbar roots and the spinal cord. Objective: [...] Read more.
Background: Approximately 40% of chronic low back pain patients have a discogenic origin. In relation to intervertebral disc injuries, most of them are in the posterior and lateral zone of the disc, involving the anterior lumbar roots and the spinal cord. Objective: The objective was to analyze and describe the accuracy and safety of a new ultrasound-guided approach to target the posterolateral part of the intervertebral lumbar discs in cadaveric specimens. Methods: A cross-anatomical study on sixty cadaver intervertebral lumbar discs was performed. A needle was introduced in the posterolateral part of the discs using ultrasound guidance. A transducer was placed in the anterior abdomen to visualize the discs in cross-section as well. A dissection of the specimen was performed to visualize the final position of the needle tip and its distance from the main lumbar structures. The angulation, length, and distance of the needle from the vertebral spine, the relevant ultrasound anatomical references, and the accuracy of the procedure were evaluated. Results: The needle tip reached the posterolateral part of the discs in 93.3% of the attempts. The mean length of the needle inserted was 79 ± 15 mm, the angulation 129 ± 20.2°, the distance from the spinous process was 77 ± 19 mm, and the distance of the needle to the nerve roots was 2.0 ± 1.2 mm. No statistically significant differences between genders were found. Conclusions: An ultrasound-guided technique can be an accurate and safe technique to perform invasive procedures on the posterolateral part of the intervertebral lumbar discs. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging and Intervention)
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Other

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14 pages, 1010 KiB  
Systematic Review
Redefining Knee Arthroplasty: Does Robotic Assistance Improve Outcomes Beyond Alignment? An Evidence-Based Umbrella Review
by Fernando García-Sanz, María Dolores Sosa-Reina, Gonzalo Jaén-Crespo, Ángel González-de-la-Flor, Jorge Hugo Villafañe and Carlos Romero-Morales
J. Clin. Med. 2025, 14(8), 2588; https://doi.org/10.3390/jcm14082588 - 9 Apr 2025
Viewed by 524
Abstract
Background: Robotic-assisted total knee arthroplasty (rTKA) has been introduced to improve surgical precision and alignment in knee replacement procedures. However, its impact on clinical outcomes, pain relief, and cost-effectiveness remains debated. This umbrella review synthesizes evidence from systematic reviews and meta-analyses comparing [...] Read more.
Background: Robotic-assisted total knee arthroplasty (rTKA) has been introduced to improve surgical precision and alignment in knee replacement procedures. However, its impact on clinical outcomes, pain relief, and cost-effectiveness remains debated. This umbrella review synthesizes evidence from systematic reviews and meta-analyses comparing rTKA to conventional TKA. Methods: An umbrella review was conducted in PubMed, Scopus, Web of Science, Embase, and the Cochrane Database of Systematic Reviews. Systematic reviews and meta-analyses comparing rTKA with conventional TKA were included. Methodological quality was assessed using AMSTAR 2 and ROBIS tools. Primary outcomes included hospital stay, radiographic alignment, postoperative pain, functional outcomes, and patient satisfaction. Results: Ten systematic reviews were included. rTKA demonstrated superior alignment accuracy and a reduction in alignment outliers. Some studies reported shorter hospital stays and lower early postoperative pain scores for rTKA. However, these benefits did not consistently translate into improved long-term functional outcomes, patient satisfaction, or reduced revision rates. Cost-effectiveness analyses indicated that rTKA remains an expensive option, with benefits largely dependent on surgical volume and healthcare system resources. Conclusions: While rTKA improves surgical precision and may offer short-term advantages, its long-term superiority over conventional TKA remains unproven. Higher costs and longer operative times limit its widespread adoption. Further high-quality, long-term studies are needed to determine its clinical and economic value. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging and Intervention)
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14 pages, 1703 KiB  
Systematic Review
To Operate or Not? Evaluating the Best Approach for First-Time Patellar Dislocations: A Review
by Roberto Tedeschi, Daniela Platano, Federica Giorgi and Danilo Donati
J. Clin. Med. 2024, 13(18), 5434; https://doi.org/10.3390/jcm13185434 - 13 Sep 2024
Cited by 2 | Viewed by 1861
Abstract
Background: The optimal management of first-time patellar dislocations remains a subject of debate. While surgical intervention is often recommended to reduce the risk of redislocation, the benefits over conservative treatment regarding knee function and complication rates are not clearly established. This systematic review [...] Read more.
Background: The optimal management of first-time patellar dislocations remains a subject of debate. While surgical intervention is often recommended to reduce the risk of redislocation, the benefits over conservative treatment regarding knee function and complication rates are not clearly established. This systematic review aims to compare the effectiveness of surgical versus conservative treatment in preventing redislocation and improving knee function, while also considering complication rates. Methods: A comprehensive search of databases, including PubMed, Scopus, and Web of Science, was conducted up to July 2024. Seven randomized controlled trials involving 411 participants were included. The primary outcome was the redislocation rate, with secondary outcomes including knee function, complication rates, and the need for re-interventions. The quality of the studies was assessed using the PEDro scale. Results: Surgical treatment generally resulted in lower redislocation rates compared to conservative management. However, the improvement in knee function was inconsistent, with some studies showing no significant differences or even favoring conservative treatment. Surgical intervention was associated with a higher risk of complications and re-interventions, particularly in older studies with less advanced techniques. Conclusions: Surgical intervention appears effective in reducing redislocation rates but comes with a risk of complications. Conservative treatment remains a viable option, particularly for patients with lower activity levels or higher surgical risks. The decision between surgical and conservative management should be individualized, taking into account patient-specific factors and potential risks. Further high-quality research is needed to provide more definitive guidance. Full article
(This article belongs to the Special Issue Musculoskeletal Imaging and Intervention)
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