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Diagnostics
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Diagnostic Imaging in Musculoskeletal Diseases
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Diagnostic Imaging in Musculoskeletal Diseases

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

Deadline for manuscript submissions: 31 May 2025 | Viewed by 3509

Special Issue Editor

Dr. Markus Schwarz

E-Mail Website
Guest Editor
Department of Trauma Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Interests: MRI; CT; ultrasound; muscle bone

Special Issue Information

Dear Colleagues,

The field of musculoskeletal imaging is rapidly evolving, driven by advancements in technology and an ever-deepening understanding of musculoskeletal disorders. Recent developments in imaging modalities, including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound, have significantly enhanced the ability to diagnose, monitor, and treat a wide array of musculoskeletal conditions. Innovations such as high-resolution imaging, functional imaging techniques, and artificial intelligence (AI)-assisted diagnostics are revolutionizing the landscape of musculoskeletal healthcare. These technologies offer more precise, accurate, and earlier detection of pathologies, leading to improved patient outcomes and more personalized treatment plans. For instance, the integration of AI in musculoskeletal imaging not only aids in the rapid and accurate interpretation of complex imaging data but also assists in identifying subtle abnormalities that might be missed by the human eye. Additionally, the advent of advanced MRI techniques, such as diffusion tensor imaging (DTI) and dynamic contrast-enhanced MRI (DCE-MRI), provides deeper insights into tissue characterization and the biomechanical properties of musculoskeletal structures. As the population ages and the prevalence of musculoskeletal disorders increases, these cutting-edge developments are poised to play a crucial role in enhancing the quality of care and advancing the field of musculoskeletal medicine.

Dr. Markus Schwarz
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 100 words) can be sent to the Editorial Office for announcement on this website.

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. 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

  • MRI
  • CT
  • ultrasound
  • muscle
  • bone
  • research

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Published Papers (4 papers)

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Research

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16 pages, 5107 KiB  
Article
Quantitative MRI Assessment of Supraspinatus Tendon Remodeling Following a Single Platelet-Rich Plasma Injection Using T2 Mapping and Relaxation Time Profiling
by Karlo Pintarić, Andrej Vovk, Vladka Salapura, Žiga Snoj and Jernej Vidmar
Diagnostics 2025, 15(8), 1049; https://doi.org/10.3390/diagnostics15081049 - 21 Apr 2025
Abstract
Background: Quantitative magnetic resonance imaging (MRI) techniques such as T2 mapping may detect early tendon changes following biologic therapies. This study aimed to assess the structural remodeling of the supraspinatus tendon using mean T2 values and T2 distribution profiles after [...] Read more.
Background: Quantitative magnetic resonance imaging (MRI) techniques such as T2 mapping may detect early tendon changes following biologic therapies. This study aimed to assess the structural remodeling of the supraspinatus tendon using mean T2 values and T2 distribution profiles after an ultrasound (US)-guided single platelet-rich plasma (PRP) injection. Methods: Twenty-six patients with symptomatic supraspinatus tendinopathy were divided into tendinosis (n = 9) and partial tear (n = 13) groups. T2 mapping and clinical evaluations (shoulder pain and disability index questionnaire (SPADI), Constant-Murley score) were conducted at baseline and 6 months post-PRP. Mean T2 values were measured in three tendon segments (lateral, middle, and medial), and T2 profiles were compared to asymptomatic controls. Results: Clinical outcomes showed significant improvement in both the tendinosis and partial tear groups at the 6-month follow-up. Although no significant changes were observed in the mean T2 relaxation times across tendon segments following PRP treatment, T2 distribution profiling revealed statistically significant alterations in both groups. In the tendinosis group, post-treatment T2 profiles approached those of the asymptomatic controls, suggesting structural remodeling consistent with tendon healing. Conclusions: T2 mapping is an effective tool for detecting tendon remodeling following PRP therapy. Structural improvements indicative of tissue healing were observed in cases of tendinosis, but not in partial tendon tears. These findings support the use of T2 mapping—particularly the T2 distribution profiling—as a quantitative biomarker for assessing treatment response to PRP. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Musculoskeletal Diseases)
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12 pages, 1578 KiB  
Article
Opportunistic Screening for Osteoporosis by CT as Compared with DXA
by Molaya Chaisen, Chanika Sritara, Niyata Chitrapazt, Chaiyawat Suppasilp, Wichana Chamroonrat, Sasivimol Promma, Arpakorn Kositwattanarerk, Chaninart Sakulpisuti and Kanungnij Thamnirat
Diagnostics 2024, 14(24), 2846; https://doi.org/10.3390/diagnostics14242846 - 18 Dec 2024
Cited by 1 | Viewed by 809
Abstract
Background: Osteoporosis is commonly evaluated using dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD). Non-contrast computed tomography (CT) scans provide an alternative for opportunistic osteoporosis assessment. This study aimed to evaluate screening thresholds for osteoporosis based on CT attenuation values in Hounsfield [...] Read more.
Background: Osteoporosis is commonly evaluated using dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD). Non-contrast computed tomography (CT) scans provide an alternative for opportunistic osteoporosis assessment. This study aimed to evaluate screening thresholds for osteoporosis based on CT attenuation values in Hounsfield units (HU) of L1–L4 vertebrae from CT scans of the abdominal region, compared to DXA assessments of the lumbar spine and hips. Methods: Conducted retrospectively over approximately two years, the analysis included 109 patients who had both CT and DXA scans within 12 months, excluding those with metal artifacts affecting the vertebrae. CT attenuation values in the trabecular region of the vertebrae were measured and compared among three groups based on the lowest T-score from DXA. Results: In a predominantly female cohort (mean age 66.3 years), the lowest CT attenuation values for L1–L4 vertebrae showed a moderate correlation with the lowest T-score, with a Pearson correlation coefficient of 0.542 (95% CI: 0.388, 0.667). A HU threshold of ≤142 at the L1 vertebra showed 91.9% sensitivity and 48.4% specificity, while a threshold of ≤160 HU showed 97.3% sensitivity and 31.3% specificity for screening osteoporosis. Conclusions: This study supports the use of non-contrast CT with these HU thresholds as an opportunistic tool for osteoporosis assessment. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Musculoskeletal Diseases)
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23 pages, 5798 KiB  
Article
Ultrasound Examination of Skin, Fasciae and Subcutaneous Tissue: Optimizing Rehabilitation for Secondary Upper Limb Lymphedema
by Carmelo Pirri, Chiara Ferraretto, Nina Pirri, Lara Bonaldo, Raffaele De Caro, Stefano Masiero and Carla Stecco
Diagnostics 2024, 14(24), 2824; https://doi.org/10.3390/diagnostics14242824 - 15 Dec 2024
Viewed by 959
Abstract
Background: Lymphedema represents a frequent cause of disability for patients undergoing oncological treatments and, being a chronic, non-reversible pathology, requires targeted and continuous rehabilitation treatments. To date, the studies available on the use of ultrasound in patients with lymphedema mainly report descriptive data; [...] Read more.
Background: Lymphedema represents a frequent cause of disability for patients undergoing oncological treatments and, being a chronic, non-reversible pathology, requires targeted and continuous rehabilitation treatments. To date, the studies available on the use of ultrasound in patients with lymphedema mainly report descriptive data; therefore, with this study, we wanted to describe in a more objective way the typical ultrasound alterations found in these patients, measuring the thickness of the different superficial structures, and defining subcutis echogenicity. Methods: 14 patients affected by secondary lymphedema of the upper limbs were enrolled in this cross-sectional observational study (12 had breast cancer and 2 with melanoma as their primary diagnosis). All patients were classified as stage II according to the ISL classification. Patients were examined between March and July 2023 with a clinical and an ultrasound evaluation. Ultrasound evaluation was performed following a protocol and took into consideration thickness of the cutis, subcutis, superficial and deep fascia, and subcutis echogenicity. Results: The cutis of the affected limbs was thicker in the distal anterior region of the arm and throughout the anterior region of the forearm. The subcutaneous tissue was thicker in the posterior region of the distal arm and throughout the forearm, including the dorsum of the hand and excluding only the proximal posterior region of the forearm. Fascial structures did not demonstrate statistically significant differences in thickness between pathological and healthy limbs, despite undergoing significant changes from a qualitative point of view (loss of the trilaminar skin appearance and the development of anechoic areas due to fluid accumulation around the hyperechoic adipose lobule). A statistically significant difference in the echogenicity of subcutaneous tissue was found at the distal anterior region of the arm and at the entire anterior forearm. Conclusions: High-resolution ultrasound has been confirmed to be a tool capable of supporting the diagnosis of lymphedema and identifying the most compromised regions of the limb. A tailored rehabilitation plan can be developed based on the non-uniform alterations in subcutaneous tissue, where some areas are affected earlier than others. This compartmentalization should be considered in lymphedema staging and management. Ultrasound may provide early detection of these changes, guiding a more precise therapeutic approach. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Musculoskeletal Diseases)
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Review

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16 pages, 655 KiB  
Review
Role of Ultrasound in Evaluating Ligament Injuries Around the Ankle: A Narrative Review
by Soichi Hattori, Rachit Saggar, Joseph Mullen, Abdulganeey Olawin, Eva Heidinger, Warren Austin, Akeem Williams, Glenn Reeves and MaCalus Vinson Hogan
Diagnostics 2025, 15(3), 392; https://doi.org/10.3390/diagnostics15030392 - 6 Feb 2025
Cited by 1 | Viewed by 1272
Abstract
Ultrasound has emerged as a valuable imaging modality for evaluating ligamentous injuries around the ankle joint, offering several advantages over traditional imaging techniques. It is more cost-effective and widely available than MRI, and it avoids the ionizing radiation exposure associated with X-rays, making [...] Read more.
Ultrasound has emerged as a valuable imaging modality for evaluating ligamentous injuries around the ankle joint, offering several advantages over traditional imaging techniques. It is more cost-effective and widely available than MRI, and it avoids the ionizing radiation exposure associated with X-rays, making it a safer option, particularly for pediatric and adolescent populations. In cases of inversion ankle sprains, ultrasound allows for more accurate assessment of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) compared to X-rays and manual examination and yields diagnostic results comparable to MRI. For high ankle sprains involving syndesmosis injuries, ultrasound—especially stress ultrasound—has shown high diagnostic accuracy. Additionally, ultrasound evaluation of the deltoid ligament (DL) in cases of ankle fractures can aid surgeons in determining the need for ligament repair in conjunction with fracture management. This review explores recent developments in ultrasound imaging of the lateral, medial, and syndesmotic ligaments of the ankle joint and discusses its potential applications for evaluating the spring and posterior ligaments. The review provides a comprehensive overview of the ever-expanding role of ultrasound in the management of ankle ligamentous injuries. Full article
(This article belongs to the Special Issue Diagnostic Imaging in Musculoskeletal Diseases)
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