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Diagnostics
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Advances in Ultrasound Imaging for Musculoskeletal Diseases
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Advances in Ultrasound Imaging for 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: 30 August 2024 | Viewed by 6498

Special Issue Editor

Dr. Felice Galluccio

E-Mail Website
Guest Editor
1. Morphological Madrid Research Center (MoMaRC), Ultradissection Spain Echo Training School, 28029 Madrid, Spain
2. Fisiotech Lab Studio, Rheumatology and Pain Management, Florence, Italy
3. Center for Regional Anesthesia and Pain Medicine (CRAPM), Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
Interests: assessment; rehabilitation; treatment; pain medicine; pain management; osteoporosis; clinical trials; tissue engineering; ultrasonography; biomarkers

Special Issue Information

Dear Colleagues, 

The advances in ultrasound technology have revolutionized the diagnosis and guided intervention of musculoskeletal diseases. The benefits of employing ultrasound to investigate musculoskeletal pain include free radiation, real-time imaging, non-invasive evaluation of vascularity and the opportunity to conduct dynamic studies. Advanced ultrasound modalities/modes such as dynamic sonography, sonoelastography and superb microvascular imaging enable rheumatologists to carry out precise evaluations of disease progression and early recognition of hidden pathologies. More importantly, interventions can also be introduced through ultrasound guidance, improving the rate of treatment success. Several studies have pointed out that ultrasound guidance leads to more efficacious management of musculoskeletal pain than landmark guidance. Because pain significantly interferes with quality of life and has been regarded as the fifth vital sign in recent years, the role of ultrasound in the precision medicine of pain management has been recognized by more and more rheumatologists. Therefore, this Special Issue aims to collect systematic reviews, basic research and clinical studies that employ ultrasound to explore the cause and mechanism of musculoskeletal pain and to guide interventions. 

The following is a list of topics to be covered: 

  1. dynamic ultrasound for musculoskeletal disorders; 
  2. sonoelastography for myotendinous problems; 
  3. superb microvascular imaging for inflammatory disease; 
  4. ultrasound-guided interventions and diagnosis of musculoskeletal and neuromuscular pain; 
  5. application of artificial intelligence in musculoskeletal ultrasound.

Dr. Felice Galluccio
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

  • sonography
  • arthritis
  • tendon
  • rheumatology
  • pain
  • sonoelastography

Published Papers (5 papers)

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Research

13 pages, 2608 KiB  
Article
Comparison between Ultrasound-Guided and Palpatory Localization of the Dorsal Joint Space of the Shoulder Joint
by Stephan Stein, Andreas Weimer, Svenja Berthold, Johannes Matthias Weimer, Arnold J. Suda, Christopher Tuffs, Gerhard Schmidmaier and Christian T. Schamberger
Diagnostics 2024, 14(6), 650; https://doi.org/10.3390/diagnostics14060650 - 20 Mar 2024
Viewed by 496
Abstract
Aim of the study: Arthroscopy ranks among the frequently performed interventions in orthopedics. The aim of this study was to compare the palpation technique with the ultrasound technique for locating the dorsal glenohumeral joint space (JS) in shoulder joint punctures. Material and Methods: [...] Read more.
Aim of the study: Arthroscopy ranks among the frequently performed interventions in orthopedics. The aim of this study was to compare the palpation technique with the ultrasound technique for locating the dorsal glenohumeral joint space (JS) in shoulder joint punctures. Material and Methods: Participants inexperienced in ultrasound examinations were included. Palpatory and ultrasound finding of the joint space by the participants was performed according to current recommendations and was initially demonstrated by an instructional video. The ideal point (IP) was marked under ultrasound visualization by an experienced ultrasound examinator and shoulder–elbow surgeon. Furthermore, a corridor for a safe puncture was defined. The palpatorily determined point (pdP) was marked by the participants and evaluated by means of a coordinate system. The evaluation of the sonographically determined point (sdP) was performed similarly to that of the palpatory procedure. Results: Fifty-four participants were included in the study, and the mean length of work experience was 6.3 years. On average, participants had performed 16.5 punctures of the shoulder joint and 6.8 arthroscopies of the shoulder joint. The mean experience in performing sonographic examinations of the shoulder was 27.6 examinations. A total of 100 shoulder joints were examined (54 left, 46 right shoulders). The mean deviation from the ideal point (IP) for the palpatory approach was 17.1 mm with a maximum deviation of 59.5 mm; for the sonographic technique, the mean deviation was 10.3 mm (max. 30.2 mm). Overall, 22% of pdPs were within the defined corridor, while 42% of sdPs were within the target corridor. The average difference between palpatory and sonographic approaches was 9.0 mm in favor of the sonographic technique (max. 46.5 mm). A significantly greater deviation (p < 0.001) from the IP was observed with the palpatory approach than with the sonographic approach. Conclusion: Based on the results, the authors recommend ultrasound imaging of the shoulder joint as well as ultrasound-assisted punctures, especially for inexperienced users. Furthermore, training in ultrasound-assisted interventions should be implemented in future training curricula. Full article
(This article belongs to the Special Issue Advances in Ultrasound Imaging for Musculoskeletal Diseases)
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12 pages, 2130 KiB  
Article
The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle
by Christian T. Schamberger, Tobias Grossner, Christian Fischer, Sebastian Findeisen, Thomas Ferbert, Arnold J. Suda, Gerhard Schmidmaier and Stephan Stein
Diagnostics 2024, 14(5), 486; https://doi.org/10.3390/diagnostics14050486 - 23 Feb 2024
Viewed by 522
Abstract
Background: An increased or decreased critical shoulder angle (CSA) is a known risk factor for osteoarthritis, lesions, and re-ruptures in the rotator cuff. A CSA greater than 35° correlates with degenerative rotator cuff tears, while a CSA of less than 30° correlates with [...] Read more.
Background: An increased or decreased critical shoulder angle (CSA) is a known risk factor for osteoarthritis, lesions, and re-ruptures in the rotator cuff. A CSA greater than 35° correlates with degenerative rotator cuff tears, while a CSA of less than 30° correlates with osteoarthritis in the glenohumeral joint. The diagnostic gold standard for its determination is X-ray or MRI. Objectives: The primary objective of this research was to assess the viability of utilizing sonography imaging as a diagnostic tool to determine the modified critical shoulder angle (mCSA). This study aimed to investigate the feasibility and effectiveness of sonographic techniques in accurately diagnosing CSA compared to MRI. Study Design and Methods: A cohort study was carried out (level of evidence 3). The CSA (MRI) and the mCSA (ultrasound) were assessed retrospectively by two independent board-certified investigators in 109 patients with shoulder pain by MRI and musculoskeletal sonography. The CSA in the MRI dataset was determined using routine protocols and then compared to the values assessed using the modified sonography-assisted method (mCSA). Both results were analyzed with linear regression to determine a possible correlation. All investigations were performed by a DEGUM (German Society for Medical Ultrasound)-certified specialist in musculoskeletal sonography. Results: A total of 112 patients were included in this study, namely 40 female patients and 72 male patients with a mean age of 54.7 years at the time of the investigation. The mean CSA in MRI was 31.5° ± 3.899, and the mCSA in sonography was 30.1° ± 4.753. The inter- and intraobserver reliability for the CSA was factual with values of 0.993 and 0.967. The inter- and intraobserver reliability for mCSA was factual as well, with values of 0.989 and 0.948. The ANOVA analysis did not reveal a significant difference between the CSA and the mCSA values, and linear regression determined the R2 value to be 0.358 with p < 0.05. Conclusions: Diagnosing the mCSA using sonography is a safe and valid method. No statistically significant differences between the results in MRI and sonography could be seen. Although this is a retrospective, single-center study including only Caucasian mid-Europeans, and with the known limitations of ultrasound imaging, it nevertheless shows that sonography can be used as a simple, cheap, and fast technique to assess a modified CSA, which shows very good correlation with the standard CSA without losing the diagnostic quality. Full article
(This article belongs to the Special Issue Advances in Ultrasound Imaging for Musculoskeletal Diseases)
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10 pages, 1134 KiB  
Article
Association of Chondrolabral Lesions with Ultrasound-Guided Detection of Pathological Head–Neck Contour
by Christian T. Schamberger, Christopher Tuffs, Arnold J. Suda, Tobias Grossner, Gerhard Schmidmaier and Stephan Stein
Diagnostics 2023, 13(21), 3334; https://doi.org/10.3390/diagnostics13213334 - 29 Oct 2023
Viewed by 822
Abstract
Objective: This study aimed to investigate whether the asphericity of the neck–head junction of the femur confirmed via ultrasound is associated with further pathology due to femoro-acetabular impingement (FAI). Methodology: After a clinical examination with positive FAI tests, an ultrasound examination of the [...] Read more.
Objective: This study aimed to investigate whether the asphericity of the neck–head junction of the femur confirmed via ultrasound is associated with further pathology due to femoro-acetabular impingement (FAI). Methodology: After a clinical examination with positive FAI tests, an ultrasound examination of the hip was performed. In the case of asphericity, a quantitative ultrasound-assisted assessment of the hip was performed, followed by contrast-enhanced arthro-MRI with the question of cartilage or labral damage. Results and Conclusions: We included 51 patients with a mean age of 35.25. According to the examination algorithm, asphericity was present in all patients via ultrasonography. The average anterior alpha angle (AAA) determined in ultrasonography was 43.49°. The average AAA on the arthro-MRI was 44.19°. The mean anterior head neck offset (AHNO) in ultrasound was 5.27 mm, and in arthro-MRI, it was 5.36 mm. Arthro-MRI confirmed a bump in 47 patients and a talization disorder in 4 patients. In 49 patients, a labral lesion was found, with one being a re-rupture. Furthermore, in one patient, labral degeneration was identified. Cartilage damage to the hip joint was found in 25 patients. Two patients had neither labral nor cartilage damage in the arthro-MRI. In our study, sonographically confirmed asphericity of the head–neck junction was found in 49 cases, which was associated with further pathology and, according to the current doctrine, was attributable to the FAI and required surgical intervention. This study shows that the detection of a pathologic head and neck contour via ultrasound in combination with positive clinical signs, as present in FAI, is associated with chondrolabral lesions detected via arthro-MRI in 96.1% of cases. Full article
(This article belongs to the Special Issue Advances in Ultrasound Imaging for Musculoskeletal Diseases)
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11 pages, 1288 KiB  
Article
The Correlation between Transperineal Shear-Wave Elastography and Transabdominal Ultrasound When Assessing Pelvic Floor Function in Nulliparous Women
by Yerim Do, Youngeun Lim, Soohyun Lee and Haneul Lee
Diagnostics 2023, 13(18), 3002; https://doi.org/10.3390/diagnostics13183002 - 20 Sep 2023
Viewed by 833
Abstract
Pelvic floor muscles (PFMs) play a crucial role in maintaining pelvic organ support and continence. However, pelvic floor dysfunction (PFD), often resulting from insufficient PFM control, poses a substantial global health challenge for women. This study aims to explore the relationship between levator [...] Read more.
Pelvic floor muscles (PFMs) play a crucial role in maintaining pelvic organ support and continence. However, pelvic floor dysfunction (PFD), often resulting from insufficient PFM control, poses a substantial global health challenge for women. This study aims to explore the relationship between levator ani muscle elasticity when assessed through transperineal shear-wave elastography (SWE) and bladder base displacement, quantified using transabdominal ultrasonography (TAUS), as a means to comprehensively evaluate PFM function. A total of 42 nulliparous women participated in this study. Participants received instructions on proper PFM contractions using Kegel exercises. Levator ani muscle elasticity was assessed both at rest and during contractions using transperineal SWE, while bladder base displacement was simultaneously measured through TAUS. Repeated measures demonstrated strong intraclass correlation coefficients of 0.906 at rest and 0.687 during contractions for levator ani muscle elasticity. The mean elasticity values were 24.7 ± 4.5 kPa at rest and 62.1 ± 10.4 kPa during contractions. Additionally, the mean bladder base displacement was 7.2 ± 2.5 mm, and the normalized bladder base displacement via body mass index was 0.3 ± 0.1 mm. Significantly, a moderate correlation was identified between the PFM function, represented by the difference in levator ani elasticity during contractions and resting, and bladder base displacement (r = 0.486, p = 0.001). These findings underscore the potential utility of transperineal SWE as a reliable and noninvasive method to assess levator ani muscle elasticity and, consequently, PFM function. In conclusion, this study sheds light on the interplay between PFM elasticity and bladder base displacement, offering insights into PFM function assessments. The observed correlation suggests the clinical relevance of SWE in providing valuable information for treatment planning in PFD. These findings contribute to a deeper understanding of PFM dynamics, ultimately aiding in the effective management of PFD among women. Full article
(This article belongs to the Special Issue Advances in Ultrasound Imaging for Musculoskeletal Diseases)
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11 pages, 3830 KiB  
Article
Ultrasound Imaging of Thoracolumbar Fascia Thickness: Chronic Non-Specific Lower Back Pain versus Healthy Subjects; A Sign of a “Frozen Back”?
by Carmelo Pirri, Nina Pirri, Diego Guidolin, Veronica Macchi, Andrea Porzionato, Raffaele De Caro and Carla Stecco
Diagnostics 2023, 13(8), 1436; https://doi.org/10.3390/diagnostics13081436 - 16 Apr 2023
Cited by 2 | Viewed by 3222
Abstract
The thoracolumbar fascia (TLF) plays an important role in lower back pain (LBP). Recent studies have revealed an association between increases in TLF thickness and reduced TLF gliding in patients with LBP. The purpose of this study was to measure and compare by [...] Read more.
The thoracolumbar fascia (TLF) plays an important role in lower back pain (LBP). Recent studies have revealed an association between increases in TLF thickness and reduced TLF gliding in patients with LBP. The purpose of this study was to measure and compare by ultrasound (US) imaging the thickness of the TLF at the bilateral L3 level of the lumbar spine in the longitudinal and transverse axes in chronic non-specific LBP and in healthy subjects. A cross-sectional study was performed using US imaging to measure the longitudinal and transverse axes with a new protocol in a sample of 92 subjects: 46 chronic non-specific LBP patients and 46 healthy participants. The findings for TLF thickness revealed statistically significant differences (p < 0.05) in the longitudinal and transverse axes between the two groups. Moreover, in the healthy group, a statistically significant difference was found between the longitudinal and transverse axes (p = 0.001 for left and p = 0.02 for right), which was not evident in the LBP patients. These findings suggest that the LBP patients lost anisotropy of the TLF, with it becoming homogeneously thicker and losing adaptability in the transversal direction. The US imaging evaluation suggests that TLF thickness behavior points out altered fascial remodelling compared to healthy subjects, a sort of “frozen back”. Full article
(This article belongs to the Special Issue Advances in Ultrasound Imaging for Musculoskeletal Diseases)
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