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Life
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Musculoskeletal Medicine in Rheumatic Diseases
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Musculoskeletal Medicine in Rheumatic Diseases

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (28 November 2025) | Viewed by 17041

Special Issue Editors

Prof. Dr. Florentin Ananu Vreju

E-Mail Website
Guest Editor
Department of Rheumatology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
Interests: spondyloarthritis; crystal arthropathies; rheumatoid arthritis; sport related musculoskeletal involvement
Special Issues, Collections and Topics in MDPI journals
Dr. Emilio Filippucci

E-Mail Website
Guest Editor
Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Jesi, Italy
Interests: ultrasound in rheumatic and musculo-skeletal diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Rheumatic diseases, including rheumatoid arthritis, axial and peripheral spondylarthritis, as well as crystal-related arthritis, are systemic inflammatory conditions that primarily affect the musculoskeletal system. These diseases cause chronic, often irreversible damage, leading to significant functional deficits and a reduced quality of life.

Recent advances in diagnostics, including early identification of immunological changes and modern imaging methods, such as musculoskeletal ultrasonography or magnetic resonance imaging, have revolutionized the management of these conditions. Over the past five decades, treatment goals have shifted from symptom relief to achieving and maintaining remission, stopping radiographic progression, and striving for drug-free remission.

New therapeutic agents, such as targeted synthetic disease-modifying antirheumatic drugs (tDMARDs) and biologics, are crucial in this evolution. Early diagnosis and identifying "hard-to-treat" cases, allowing for tailored treatment strategies, are essential for optimal outcomes.

This Special Issue provides comprehensive insights into the latest research, diagnostics, and therapies in musculoskeletal medicine for rheumatic diseases, serving as an essential resource for practitioners and researchers in the field.

Prof. Dr. Florentin Ananu Vreju
Prof. Dr. Emilio Filippucci
Guest Editors

Manuscript Submission Information

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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. Life is an international peer-reviewed open access monthly 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

  • rheumatic disease
  • rheumatoid arthritis
  • spondylarthritis
  • microcrystal arthritis
  • musculoskeletal ultrasonography
  • biologic treatment
  • disease-modifying antirheumatic drugs
  • imagining techniques

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Published Papers (5 papers)

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11 pages, 460 KB  
Article
Distinct Characteristics of Patients with Gout and an Underweight or Normal Body Mass Index: A Single-Center Retrospective Cross-Sectional Study
by Sung Soo Ahn, Jiyoung Agatha Kim, Soorack Ryu, Yagop Shin, Sung Hoon Choi, Ka Young Choi and Kunhyung Bae
Life 2025, 15(12), 1876; https://doi.org/10.3390/life15121876 - 8 Dec 2025
Viewed by 1093
Abstract
Gout is an inflammatory arthritis triggered by monosodium urate crystal deposition, especially in obese patients. However, distinctions between the characteristics of obese and non-obese patients with gout remain unclear. We aimed to investigate the clinical differences by body mass index (BMI) with gout. [...] Read more.
Gout is an inflammatory arthritis triggered by monosodium urate crystal deposition, especially in obese patients. However, distinctions between the characteristics of obese and non-obese patients with gout remain unclear. We aimed to investigate the clinical differences by body mass index (BMI) with gout. We conducted a single-center retrospective cross-sectional study of 269 patients with gout from March 2020 to May 2024. Patients were classified into two groups: underweight/normal BMI and overweight/obesity. Baseline demographics, laboratory data, and clinical outcomes were compared between these groups. Stepwise logistic regression analysis was performed to identify predictors of underweight/normal BMI in gout patients. The underweight/normal BMI group included 35 patients (13.0%), characterized by older age, a higher proportion of females, and a lower prevalence of hypertension and alcohol consumption. This group also demonstrated lower uric acid, lipid profile, and alanine aminotransferase (ALT) levels but had a higher erythrocyte sedimentation rate. Logistic regression analysis identified female sex (odds ratio [OR] 3.831, 95% confidence interval [CI] 1.254–11.705, p = 0.018), presence of hypertension (OR 0.367, 95% CI 0.166–0.809, p = 0.013), total cholesterol (OR 0.990, 95% CI 0.982–0.999, p = 0.031), and ALT (OR 0.967, 95% CI 0.941–0.995, p = 0.019) as significant predictors of underweight/normal BMI gout. Understanding these characteristics may improve the identification of underweight/normal BMI subgroups, leading to improved approaches for gout management. Full article
(This article belongs to the Special Issue Musculoskeletal Medicine in Rheumatic Diseases)
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14 pages, 1015 KB  
Article
Exercise Intervention in Women with Fibromyalgia and Its Influence on Pain, Psychological Variables, and Disability: An Observational Study
by María Elena González-Álvarez, Víctor Riquelme-Aguado, Giacomo Rossettini, Josué Fernández-Carnero and Jorge Hugo Villafañe
Life 2025, 15(1), 40; https://doi.org/10.3390/life15010040 - 31 Dec 2024
Cited by 10 | Viewed by 5094
Abstract
(1) Background: Fibromyalgia syndrome (FM) is a specific condition within the spectrum of musculoskeletal pain disorders, with an estimated global prevalence of 2%. Physical exercise has shown promise in modulating pain and improving physical function without the drawbacks of pharmacotherapy. This study aims [...] Read more.
(1) Background: Fibromyalgia syndrome (FM) is a specific condition within the spectrum of musculoskeletal pain disorders, with an estimated global prevalence of 2%. Physical exercise has shown promise in modulating pain and improving physical function without the drawbacks of pharmacotherapy. This study aims to examine the effects of a 6-week telerehabilitation combined exercise program—including mobility, strength, and high-intensity exercises—on pain, psychological variables, and disability in women with fibromyalgia. (2) Methods: In this observational study involving 53 FM patients, the outcomes measured were the pressure pain threshold (PPT), the conditioned pain modulation (CPM) paradigm, levels of pain on the measurement day and the average of the last week (using NRS) the impact of the fibromyalgia (using Fibromyalgia Impact Questionnaire (FIQ), and anxiety (using the Spanish version of the State–Trait Anxiety Inventory—STAI). (3) Results: Statistically significant changes were observed in the intervention group in PPT, CPM, NRS, and FIQ. (4) Conclusions: A six-week telerehabilitation therapeutic exercise intervention consisting of two scheduled exercise sessions per week lasting approximately 45 min each is associated with reduced pain levels, enhanced pain inhibitory pathways, and a decreased impact of fibromyalgia compared to patients who do not adopt a more active lifestyle. Full article
(This article belongs to the Special Issue Musculoskeletal Medicine in Rheumatic Diseases)
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9 pages, 1274 KB  
Article
Clinical Efficacy and Safety of Ultrasound-Guided Injection with Low-Molecular-Weight Peptides from Hydrolyzed Collagen in Patients with Partial Supraspinatus Tendon Tears: A Pilot Study
by Luca Latini, Francesco Porta, Vincenzo Maccarrone, Davide Zompa, Edoardo Cipolletta, Riccardo Mashadi Mirza, Emilio Filippucci and Florentin Ananu Vreju
Life 2024, 14(11), 1351; https://doi.org/10.3390/life14111351 - 22 Oct 2024
Cited by 5 | Viewed by 5253
Abstract
Background: This study evaluates the clinical efficacy and safety of two ultrasound (US)-guided injections of a 5 mg/1 mL low-molecular-weight peptide (LWP) solution derived from hydrolyzed bovine collagen in patients with supraspinatus partial tendon tears. Methods: A total of 21 patients with symptomatic [...] Read more.
Background: This study evaluates the clinical efficacy and safety of two ultrasound (US)-guided injections of a 5 mg/1 mL low-molecular-weight peptide (LWP) solution derived from hydrolyzed bovine collagen in patients with supraspinatus partial tendon tears. Methods: A total of 21 patients with symptomatic partial tears of the supraspinatus tendon, detected by US, were consecutively enrolled and received one injection at a baseline visit (T0) and one after two weeks (T1). The primary outcome measure was the visual analogue scale (VAS) for pain. Secondary outcomes were the shoulder pain and disability index (SPADI) total score and the safety of LWP injections. Patients were examined at baseline (T0), at a week 2 follow-up visit (T1), and at a week 12 follow-up visit (T2). Results: A statistically significant improvement was found for both VAS pain and SPADI total scores, between T0 and T2 visits. US-guided injections were well tolerated and, apart from one patient with a progression of a tendon tear, no adverse events were recorded. Conclusions: Intratendinous tear US-guided injection therapy with an LWP solution was found to be safe and effective in improving both pain and shoulder function at a 12-week follow-up visit. The present pilot study should be considered the first step justifying a larger confirmatory investigation. Full article
(This article belongs to the Special Issue Musculoskeletal Medicine in Rheumatic Diseases)
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9 pages, 3729 KB  
Article
Comparison of Radiation Doses for Different Techniques in Fluoroscopy-Guided Lumbar Facet Medial Branch Blocks: A Retrospective Cohort Study
by Mesut Bakır, Şebnem Rumeli, Mehmet Ertargın, Nurettin Teker, Mustafa Azizoğlu and Gülçin Gazioğlu Türkyılmaz
Life 2024, 14(9), 1179; https://doi.org/10.3390/life14091179 - 19 Sep 2024
Cited by 1 | Viewed by 3607
Abstract
Chronic lumbar facet pain is commonly treated with fluoroscopy-guided facet medial branch blocks (FMBBs). However, the associated radiation exposure of both patients and clinicians is a growing concern. This study aimed to compare radiation doses and fluoroscopy times between two techniques, i.e., oblique [...] Read more.
Chronic lumbar facet pain is commonly treated with fluoroscopy-guided facet medial branch blocks (FMBBs). However, the associated radiation exposure of both patients and clinicians is a growing concern. This study aimed to compare radiation doses and fluoroscopy times between two techniques, i.e., oblique and posterior–anterior (PA) fluoroscopic approaches, while also examining the impact of physician experience on these metrics. A retrospective analysis was conducted on 180 patients treated at Mersin University Hospital Pain Clinic between January and July 2024. Patients were divided into two groups: 90 received the oblique technique (Group O) and 90 received the AP technique (Group A). Radiation dose and fluoroscopy time data were collected for each patient. The AP technique was associated with significantly lower radiation doses (mean 66 mGy) and shorter fluoroscopy times (mean 28 s) compared to the oblique technique (mean radiation dose of 109 mGy and fluoroscopy time of 46 s) (p < 0.001). Physician experience also influenced these outcomes, with more experienced physicians consistently using less radiation. The AP technique should be considered for FMBBs, as it reduces radiation exposure while maintaining procedural efficiency, highlighting the importance of experience in optimizing outcomes. Full article
(This article belongs to the Special Issue Musculoskeletal Medicine in Rheumatic Diseases)
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14 pages, 545 KB  
Systematic Review
Efficacy and Safety of Biologic and Targeted Synthetic DMARDs in Young-Onset Rheumatoid Arthritis: A Systematic Review
by Mara Russu, Vladia Lăpuște, Diana Elena Cosău, Alexandra Lori Donica, Alexandra-Diana Diaconu, Georgiana Strugariu, Cristina Pomîrleanu and Codrina Ancuța
Life 2026, 16(2), 225; https://doi.org/10.3390/life16020225 - 29 Jan 2026
Viewed by 1010
Abstract
Background: Young-onset rheumatoid arthritis (YORA), defined by disease onset between 16–40 years, raises distinct clinical challenges related to long-term disease burden, fertility, and prolonged exposure to immunomodulatory therapy. Despite its relevance, evidence regarding treatment outcomes in this population remains limited and heterogeneous, [...] Read more.
Background: Young-onset rheumatoid arthritis (YORA), defined by disease onset between 16–40 years, raises distinct clinical challenges related to long-term disease burden, fertility, and prolonged exposure to immunomodulatory therapy. Despite its relevance, evidence regarding treatment outcomes in this population remains limited and heterogeneous, largely due to inconsistent definitions of YORA across studies. Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines to synthesize contemporary evidence on the efficacy and safety of biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in younger rheumatoid arthritis populations. A structured search of PubMed and Embase was performed to identify studies published between 2020 and 2025 that evaluated advanced therapies in patients with young-onset rheumatoid arthritis or in rheumatoid arthritis cohorts reporting age-stratified outcomes for younger adults. Results: From the screened literature, 16 studies met the predefined inclusion criteria, including 6 studies explicitly defining YORA based on age at disease onset and 10 studies reporting outcomes in younger adult subgroups (<40–45 years). Across studies, younger patients demonstrated higher remission rates, greater reductions in disease activity, and superior treatment persistence compared with older-onset rheumatoid arthritis cohorts. Tumor necrosis factor inhibitors, interleukin-6 receptor antagonists, and Janus kinase inhibitors showed consistent clinical efficacy. Structural outcomes, reported in a limited number of studies, suggested low rates of radiographic progression in younger patients. Safety profiles were generally favorable, with infections and laboratory abnormalities representing the most reported adverse events and no age-specific safety signals being identified. Conclusions: Biologic and targeted therapies provide substantial clinical benefit in YORA and younger adult RA populations, with outcomes being generally superior to those observed in older-onset RA. However, heterogeneity in YORA definitions and limited long-term data highlight the need for prospective, age-at-onset-defined studies and extended pharmacovigilance to better inform lifelong treatment strategies. Full article
(This article belongs to the Special Issue Musculoskeletal Medicine in Rheumatic Diseases)
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