Advance in the Diagnostics and Management of Musculoskeletal Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 38723

Special Issue Editors

Orthopaedics and Traumatology Unit, “Maggiore della carità” Hospital, Department of Health Sciences, University of Piemonte Orientale (UPO), Via Solaroli 17, 28100 Novara, Italy
Interests: orthopaedics and traumatology; musculoskeletal system; hand surgery; foot surgery
Special Issues, Collections and Topics in MDPI journals
Department of Biology, University of Pisa, Pisa, Italy
Interests: neuromuscular diseases; metabolism; neuroinflammation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pathologies of the musculoskeletal system can and must be addressed by many professionals such as orthopedists, traumatologists, physiatrists, physiotherapists, rheumatologists, geriatricians, radiologists, biologists, biotechnologists, bioengineers and other doctors, health professionals, and basic scientists. Their interaction in a multi- and transdisciplinary approach is very important.

The aims of this Special Issue are: (1) to summarize through literature reviews, possibly systematic or meta-analyses, the state of the art of the most interesting and current problems of the musculoskeletal system; (2) offer the most current and innovative research through original articles.

Both basic science and clinical papers are welcome as long as they concern diagnostics of the musculoskeletal system even with therapeutic aspects.

Prof. Dr. Massimiliano Leigheb
Prof. Dr. Alessandro de Sire
Prof. Dr. Elisabetta Ferraro
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. 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

  • Musculoskeletal system
  • Joint
  • Orthopedics
  • Traumatology
  • Rehabilitation
  • Radiology
  • Fracture
  • Muscle
  • Connective tissues
  • Regenerative medicine
  • Tissue engineering

Published Papers (16 papers)

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Editorial

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5 pages, 220 KiB  
Editorial
Advance in the Diagnostics and Management of Musculoskeletal Diseases
by Alessandro de Sire, Elisabetta Ferraro and Massimiliano Leigheb
Diagnostics 2022, 12(7), 1588; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12071588 - 29 Jun 2022
Cited by 4 | Viewed by 1086
Abstract
Musculoskeletal disorders are a broad spectrum of diseases, affecting muscles, bones, ligaments, and tendons worldwide [...] Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)

Research

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14 pages, 2082 KiB  
Article
Impact of Diffuse Idiopathic Skeletal Hyperostosis on Clinico-Radiological Profiles and Prognosis for Thoracic Ossification of Ligamentum Flavum-Myelopathy: A Propensity-Matched Monocentric Analysis
by Baoliang Zhang, Guanghui Chen, Xi Chen, Zhongqiang Chen and Chuiguo Sun
Diagnostics 2022, 12(7), 1652; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12071652 - 07 Jul 2022
Cited by 2 | Viewed by 1381
Abstract
Background: Diffuse idiopathic skeletal hyperostosis (DISH) has been evaluated as a potential risk factor of poor surgical outcomes for lumbar spinal stenosis, whereas the influence of DISH on neuroimaging characteristics and postoperative prognosis of patients with thoracic myelopathy has not been established. Therefore, [...] Read more.
Background: Diffuse idiopathic skeletal hyperostosis (DISH) has been evaluated as a potential risk factor of poor surgical outcomes for lumbar spinal stenosis, whereas the influence of DISH on neuroimaging characteristics and postoperative prognosis of patients with thoracic myelopathy has not been established. Therefore, this study aimed to shed light on this issue. Methods: A monocentric study enrolled 167 eligible patients with thoracic ossification of ligamentum flavum (TOLF), who were followed up for at least 2 years. Clinico-radiological parameters and surgical outcomes were compared between the DISH+ and DISH− groups before and after propensity matching. Subgroup analysis was conducted to compare the functional outcomes between mild DISH (M-DISH) and moderately severe DISH (MS-DISH) groups. Results: Fifty-eight patients were diagnosed as DISH, and its prevalence was 34.7%. Patients with DISH presented with older age, more males, taller stature, heavier weight, more commonly diffuse-type TOLF (p < 0.05). The DISH group showed significantly worse recovery rate (RR) at the final follow-up before and after propensity matching (p < 0.01), and slightly lower preoperative VAS, higher postoperative VAS and lower VAS reduction, despite not reaching the significant differences. Subgroup analysis demonstrated that the M-DISH group was associated with the lower mJOA score (p = 0.01) and RR at the final follow-up (p = 0.001), and tended to present higher preoperative VAS than the MS-DISH group. Conclusions: DISH has a significant predisposition to the elderly males with diffuse-type TOLF. Although the presence of M-DISH might bring about a suboptimal surgical outcome, both DISH and non-DISH patients experienced good neurological function improvements and pain relief through thoracic posterior decompression. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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11 pages, 1642 KiB  
Article
Feasibility of 18F-Fluorocholine PET for Evaluating Skeletal Muscle Atrophy in a Starved Rat Model
by Sun Mi Park, Jisu Kim, Suji Baek, Joo-Yeong Jeon, Sang Ju Lee, Seo Young Kang, Min Young Yoo, Hai-Jeon Yoon, Seung Hae Kwon, Kiwon Lim, Seung Jun Oh, Bom Sahn Kim, Kang Pa Lee and Byung Seok Moon
Diagnostics 2022, 12(5), 1274; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12051274 - 20 May 2022
Cited by 3 | Viewed by 1601
Abstract
Imaging techniques for diagnosing muscle atrophy and sarcopenia remain insufficient, although various advanced diagnostic methods have been established. We explored the feasibility of 18F-fluorocholine (18F-FCH) positron emission tomography/computed tomography (PET/CT) for evaluating skeletal muscle atrophy, as an imaging technique that [...] Read more.
Imaging techniques for diagnosing muscle atrophy and sarcopenia remain insufficient, although various advanced diagnostic methods have been established. We explored the feasibility of 18F-fluorocholine (18F-FCH) positron emission tomography/computed tomography (PET/CT) for evaluating skeletal muscle atrophy, as an imaging technique that tracks choline level changes in muscles. Cell uptake in L6 cells by 18F-FCH was performed in a complete medium containing serum (untreated group, UN) and a serum-free medium (starved group, ST). Small-animal-dedicated PET/CT imaging with 18F-FCH was examined in in-vivo models with rats that were starved for 2 days to cause muscle atrophy. After the hind limbs were dissected, starvation-induced in-vivo models were anatomically confirmed by reverse-transcription polymerase chain reaction to evaluate the expression levels of the atrophy markers muscle RING-finger protein-1 (MuRF-1) and atrogin-1. 18F-FCH uptake was lower in the starvation-induced cells than in the untreated group, and in-vivo PET uptake also revealed a similar tendency (the average standardized uptake value (SUVmean) = 0.26 ± 0.06 versus 0.37 ± 0.07, respectively). Furthermore, the expression levels of MuRF-1 and atrogin-1 mRNA were significantly increased in the starvation-induced muscle atrophy of rats compared to the untreated group. 18F-FCH PET/CT may be a promising tool for diagnosing skeletal muscle atrophy. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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19 pages, 23282 KiB  
Article
A User-Friendly Approach for Routine Histopathological and Morphometric Analysis of Skeletal Muscle Using CellProfiler Software
by Valerio Laghi, Valentina Ricci, Francesca De Santa and Alessio Torcinaro
Diagnostics 2022, 12(3), 561; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12030561 - 22 Feb 2022
Cited by 8 | Viewed by 3100
Abstract
Adult skeletal muscle is capable of active and efficient differentiation in the event of injury in both physiological and pathological conditions, such as in Duchenne muscular dystrophy (DMD). DMD is characterized by different features, such as continuous cycles of degeneration/regeneration, fiber heterogeneity, chronic [...] Read more.
Adult skeletal muscle is capable of active and efficient differentiation in the event of injury in both physiological and pathological conditions, such as in Duchenne muscular dystrophy (DMD). DMD is characterized by different features, such as continuous cycles of degeneration/regeneration, fiber heterogeneity, chronic inflammation and fibrosis. A well-defined and standardized approach for histological and morphometric analysis of muscle samples is necessary in order to measure and quantify specific regenerative parameters in myopathies. Indeed, non-automatic methods are time-consuming and prone to error. Here, we describe a simple automatized computational approach to quantify muscle parameters with specific pipelines to be run by CellProfiler software in an open-source and well-defined fashion. Our pipelines consist of running image-processing modules in CellProfiler with the aim of quantifying different histopathological muscle hallmarks in mdx mice compared to their wild-type littermates. Specifically, we quantified the minimum Feret diameter, centrally nucleated fibers and the number of macrophages, starting from multiple images. Finally, for extracellular matrix quantification, we used Sirius red staining. Collectively, we developed reliable and easy-to-use pipelines that automatically measure parameters of muscle histology, useful for research in myobiology. These findings should simplify and shorten the time needed for the quantification of muscle histological properties, avoiding challenging manual procedures. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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12 pages, 1847 KiB  
Article
Interrater and Intrarater Reliability of the EasyForce Dynamometer for Assessment of Maximal Shoulder, Knee and Hip Strength
by Nebojša Trajković, Žiga Kozinc, Darjan Smajla and Nejc Šarabon
Diagnostics 2022, 12(2), 442; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12020442 - 09 Feb 2022
Cited by 4 | Viewed by 2247
Abstract
This study aimed to determine the interrater and intrarater reliability of EasyForce dynamometer for assessing shoulder, knee, and hip muscle strength in healthy young adults. Shoulder, knee, and hip maximal isometric strength were measured using the EasyForce in healthy adults (11 women and [...] Read more.
This study aimed to determine the interrater and intrarater reliability of EasyForce dynamometer for assessing shoulder, knee, and hip muscle strength in healthy young adults. Shoulder, knee, and hip maximal isometric strength were measured using the EasyForce in healthy adults (11 women and 12 men). Three repetitions of shoulder internal rotation, abduction, knee flexion, extension, and hip abduction and adduction were performed. The tests were performed by three raters on the same day. The results showed good to high inter- and intrarater reliability (intraclass correlation coefficient range: 0.63–0.91). Moreover, the absolute reliability of the EasyForce was slightly higher than acceptable for all tests (CV > 10%) except for hip abduction on the right leg (CV = 7.2%). The EasyForce dynamometer can be considered a reliable tool for assessing shoulder internal rotation and abduction, knee extension and flexion, as well as hip abduction and adduction strength. The EasyForce dynamometer showed no differences between the raters’ measurements, which could be of great importance for professionals who want to perform the tests regardless of their strength on the values. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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10 pages, 1017 KiB  
Article
Sarcopenia Diagnosis: Reliability of the Ultrasound Assessment of the Tibialis Anterior Muscle as an Alternative Evaluation Tool
by Massimiliano Leigheb, Alessandro de Sire, Matteo Colangelo, Domenico Zagaria, Federico Alberto Grassi, Ottavio Rena, Patrizio Conte, Pierluigi Neri, Alessandro Carriero, Gian Mauro Sacchetti, Fabio Penna, Giuseppina Caretti and Elisabetta Ferraro
Diagnostics 2021, 11(11), 2158; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112158 - 21 Nov 2021
Cited by 22 | Viewed by 2738
Abstract
Sarcopenia is a skeletal muscle disorder characterized by reduced muscle mass, strength, and performance. Muscle ultrasound can be helpful in assessing muscle mass, quality, and architecture, and thus possibly useful for diagnosing or screening sarcopenia. The objective of this study was to evaluate [...] Read more.
Sarcopenia is a skeletal muscle disorder characterized by reduced muscle mass, strength, and performance. Muscle ultrasound can be helpful in assessing muscle mass, quality, and architecture, and thus possibly useful for diagnosing or screening sarcopenia. The objective of this study was to evaluate the reliability of ultrasound assessment of tibialis anterior muscle in sarcopenia diagnosis. We included subjects undergoing total or partial hip replacement, comparing measures with a healthy control group. We measured the following parameters: tibialis anterior muscle thickness, echogenicity, architecture, stiffness, skeletal muscle index (SMI), hand grip strength, and sarcopenia related quality of life evaluated through the SarQoL questionnaire. We included 33 participants with a mean age of 54.97 ± 23.91 years. In the study group we found reduced tibialis anterior muscle thickness compared to the healthy control group (19.49 ± 4.92 vs. 28.94 ± 3.63 mm, p < 0.05) with significant correlation with SarQoL values (r = 0.80, p < 0.05), dynamometer hand strength (r = 0.72, p < 0.05) and SMI (r = 0.76, p < 0.05). Moreover, we found reduced stiffness (32.21 ± 12.31 vs. 27.07 ± 8.04 Kpa, p < 0.05). AUC measures of ROC curves were 0.89 predicting reduced muscle strength, and 0.97 predicting reduced SMI for tibialis anterior muscle thickness, while they were 0.73 and 0.85, respectively, for muscle stiffness. Our findings showed that ultrasound assessment of tibialis anterior muscle might be considered a reliable measurement tool to evaluate sarcopenia. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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11 pages, 3102 KiB  
Article
Developing a Technique for the Imaging-Based Measurement of ACL Elongation: A Proof of Principle
by Robert Csapo, Dieter Heinrich, Andrew D. Vigotsky, Christian Marx, Shantanu Sinha and Christian Fink
Diagnostics 2021, 11(11), 2126; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112126 - 16 Nov 2021
Cited by 2 | Viewed by 1902
Abstract
Towards the goal of obtaining non-invasive biomarkers reflecting the anterior cruciate ligament’s (ACL) loading capacity, this project aimed to develop a magnetic resonance imaging (MRI)-based method facilitating the measurement of ACL elongations during the execution of knee stress tests. An MRI-compatible, computer-controlled, and [...] Read more.
Towards the goal of obtaining non-invasive biomarkers reflecting the anterior cruciate ligament’s (ACL) loading capacity, this project aimed to develop a magnetic resonance imaging (MRI)-based method facilitating the measurement of ACL elongations during the execution of knee stress tests. An MRI-compatible, computer-controlled, and pneumatically driven knee loading device was designed to perform Lachman-like tests and induce ACL strain. A human cadaveric leg was used for test purposes. During the execution of the stress tests, a triggered real-time cine MRI sequence with a temporal resolution of 10 Hz was acquired in a parasagittal plane to capture the resultant ACL elongations. To test the accuracy of these measurements, the results were compared to in situ data of ACL elongation that were acquired by measuring the length changes of a surgical wire directly sutured to the ACL’s anteromedial bundle. The MRI-based ACL elongations ranged between 0.7 and 1.7 mm and agreed very well with in situ data (root mean square errors, RMSEs ≤ 0.25 mm), although peak elongation rates were underestimated by the MRI (RMSEs 0.19–0.36 mm/s). The high accuracy of elongation measurements underlines the potential of the technique to yield an imaging-based biomarker of the ACL’s loading capacity. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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13 pages, 803 KiB  
Article
Obesity and Bone Loss at Menopause: The Role of Sclerostin
by Paolo Marzullo, Chiara Mele, Stefania Mai, Antonio Nardone, Massimo Scacchi and Gianluca Aimaretti
Diagnostics 2021, 11(10), 1914; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101914 - 16 Oct 2021
Cited by 5 | Viewed by 1976
Abstract
Background. Peripheral fat tissue is known to positively influence bone health. However, evidence exists that the risk of non-vertebral fractures can be increased in postmenopausal women with obesity as compared to healthy controls. The role of sclerostin, the SOST gene protein product, [...] Read more.
Background. Peripheral fat tissue is known to positively influence bone health. However, evidence exists that the risk of non-vertebral fractures can be increased in postmenopausal women with obesity as compared to healthy controls. The role of sclerostin, the SOST gene protein product, and body composition in this condition is unknown. Methods. We studied 28 severely obese premenopausal (age, 44.7 ± 3.9 years; BMI, 46.0 ± 4.2 kg/m2) and 28 BMI-matched post-menopausal women (age, 55.5 ± 3.8 years; BMI, 46.1 ± 4.8 kg/m2) thorough analysis of bone density (BMD) and body composition by dual X-ray absorptiometry (DXA), bone turnover markers, sclerostin serum concentration, glucose metabolism, and a panel of hormones relating to bone health. Results. Postmenopausal women harbored increased levels of the bone turnover markers CTX and NTX, while sclerostin levels were non-significantly higher as compared to premenopausal women. There were no differences in somatotroph, thyroid and adrenal hormone across menopause. Values of lumbar spine BMD were comparable between groups. By contrast, menopause was associated with lower BMD values at the hip (p < 0.001), femoral neck (p < 0.0001), and total skeleton (p < 0.005). In multivariate regression analysis, sclerostin was the strongest predictor of lumbar spine BMD (p < 0.01), while menopausal status significantly predicted BMD at total hip (p < 0.01), femoral neck (p < 0.001) and total body (p < 0.05). Finally, lean body mass emerged as the strongest predictor of total body BMD (p < 0.01). Conclusions. Our findings suggest a protective effect of obesity on lumbar spine and total body BMD at menopause possibly through mechanisms relating to lean body mass. Given the mild difference in sclerostin levels between pre- and postmenopausal women, its potential actions in obesity require further investigation. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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11 pages, 1025 KiB  
Article
Fat-Bone Relationship in Chronic Kidney Disease—Mineral Bone Disorders: Adiponectin Is Associated with Skeletal Events among Hemodialysis Patients
by Po-Cheng Chen, Shu-Wei Chang, Chih-Yu Hsieh, Jian-Chiun Liou, Jia-Feng Chang and Ting-Ming Wang
Diagnostics 2021, 11(7), 1254; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11071254 - 13 Jul 2021
Cited by 2 | Viewed by 1493
Abstract
Background: The risk of skeletal events is rising in parallel with the burden of chronic kidney disease and mineral bone disorder (CKD-MBD), whilst the role of the fat-bone axis in CKD-MBD remains elusive. Adiponectin derived from adipocytes has emerged as a valid biomarker [...] Read more.
Background: The risk of skeletal events is rising in parallel with the burden of chronic kidney disease and mineral bone disorder (CKD-MBD), whilst the role of the fat-bone axis in CKD-MBD remains elusive. Adiponectin derived from adipocytes has emerged as a valid biomarker of low bone mineral density and increased marrow adiposity. We aimed to explore the association between adiponectin and bone fracture (BF) risks in patients with maintenance hemodialysis (MHD). Methods: Serum concentrations of adiponectin and bio-clinical data were determined at study entry. The Cox proportional hazard regression analyses were used to assess unadjusted and adjusted hazard ratios (aHRs) of adiponectin and various clinical predictors for BF risks. The predictive accuracy of adiponectin for BF events was evaluated by receiver operating characteristic (ROC) curve analysis. Results: Age and serum concentrations of adiponectin, phosphate, and intact parathyroid hormone were significantly associated with higher risks of BF. With respect to the risk of BF events, the cumulative event-free survival curves differed significantly between the high and low concentration groups of adiponectin (p = 0.02). In multivariable analysis, higher adiponectin levels were associated with an incremental risk of BF (adjusted hazard ratios (aHRs): 1.08 (95% confidence interval (CI): 1.01–1.15, p < 0.05). The ROC analysis of adiponectin cutoff point concentration (18.15 ug/mL) for prediction of BF showed 0.66 (95% CI = 0.49 to 0.84). Conclusion: Adiponectin was associated with an incremental risk of BF that could serve as a potential predictor of BF in MHD patients. In the high-risk population with hyperphosphatemia, an elevated adiponectin level could alert clinicians to the urgent need to correct mineral dysregulation and undertake further bone survey. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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10 pages, 1062 KiB  
Article
Electromyographic Assessment of Anterior Cruciate Ligament Injury Risk in Male Tennis Players: Which Role for Visual Input? A Proof-of-Concept Study
by Alessandro de Sire, Nicola Marotta, Andrea Demeco, Lucrezia Moggio, Pasquale Paola, Marcello Marotta, Teresa Iona, Marco Invernizzi, Massimiliano Leigheb and Antonio Ammendolia
Diagnostics 2021, 11(6), 997; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11060997 - 30 May 2021
Cited by 29 | Viewed by 3597
Abstract
Anterior cruciate ligament (ACL) injury incidence is often underestimated in tennis players, who are considered as subjects conventionally less prone to knee injuries. However, evaluation of the preactivation of knee stabilizer muscles by surface electromyography (sEMG) showed to be a predictive value in [...] Read more.
Anterior cruciate ligament (ACL) injury incidence is often underestimated in tennis players, who are considered as subjects conventionally less prone to knee injuries. However, evaluation of the preactivation of knee stabilizer muscles by surface electromyography (sEMG) showed to be a predictive value in the assessment of the risk of ACL injury. Therefore, this proof-of-concept study aimed at evaluating the role of visual input on the thigh muscle preactivation through sEMG to reduce ACL injury risk in tennis players. We recruited male, adult, semiprofessional tennis players from July to August 2020. They were asked to drop with the dominant lower limb from a step, to evaluate—based on dynamic valgus stress—the preactivation time of the rectus femoris (RF), vastus medialis, biceps femoris, and medial hamstrings (MH), through sEMG. To highlight the influence of visual inputs, the athletes performed the test blindfolded and not blindfolded on both clay and grass surfaces. We included 20 semiprofessional male players, with a mean age 20.3 ± 4.8 years; results showed significant early muscle activation when the subject lacked visual input, but also when faced with a less-safe surface such as clay over grass. Considering the posteromedial–anterolateral relationship (MH/RF ratio), tennis players showed a significant higher MH/RF ratio if blindfolded (22.0 vs. 17.0% not blindfolded; p < 0.01) and percentage of falling on clay (17.0% vs. 14.0% in grass; p < 0.01). This proof-of-principle study suggests that in case of absence of visual input or falling on a surface considered unsafe (clay), neuro-activation would tend to protect the anterior stress of the knee. Thus, the sEMG might play a crucial role in planning adequate athletic preparation for semiprofessional male athletes in terms of reduction of ACL injury risk. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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Review

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11 pages, 912 KiB  
Review
Balance Remains Impaired after Hip Arthroplasty: A Systematic Review and Best Evidence Synthesis
by Giorgio Di Laura Frattura, Vittorio Bordoni, Pietro Feltri, Augusto Fusco, Christian Candrian and Giuseppe Filardo
Diagnostics 2022, 12(3), 684; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12030684 - 11 Mar 2022
Cited by 8 | Viewed by 2052
Abstract
Background: Hip arthroplasty (HA) is the most common intervention for joint replacement, but there is no consensus in the literature on the real influence of this procedure on balance, or on what factors in the pre-operative, surgical, and post-operative stages may affect it. [...] Read more.
Background: Hip arthroplasty (HA) is the most common intervention for joint replacement, but there is no consensus in the literature on the real influence of this procedure on balance, or on what factors in the pre-operative, surgical, and post-operative stages may affect it. Purpose: To synthesize the evidence on how Hip Arthroplasty (HA) affects balance, identifying pre-operative, surgical, and postoperative risk factors that may impair balance in HA patients, with the aim to improve patients’ management strategies. Methods: A literature search was performed on PubMed, PeDRO, and Cochrane Collaboration on 25 May 2021. Inclusion criteria: clinical report of any level of evidence; written in English; with no time limitation; about balance changes in hip osteoarthritis (OA) patients undergoing HA and related factors. Results: 27 papers (391 patients) were included. Overall, the evidence suggested that balance is impaired immediately after surgery and, 4–12 months after surgery, it becomes better than preoperatively, although without reaching the level of healthy subjects. A strong level of evidence was found for hip resurfacing resulting in better balance restoration than total HA (THA), and for strength and ROM exercises after surgery positively influencing balance. Conclusion: Both the surgical technique and the post-operative protocols are key factors influencing balance; thus, they should be carefully evaluated when managing hip OA in patients undergoing HA. Moreover, balance at 4–12 months after surgery is better than preoperatively, although without reaching the level of the healthy population. Attention should be paid in the early post-operative phase, when balance may be impaired in patients undergoing HA. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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22 pages, 975 KiB  
Review
Gait Alterations in Adults after Ankle Fracture: A Systematic Review
by Marta Mirando, Corrado Conti, Federica Zeni, Fabio Pedicini, Antonio Nardone and Chiara Pavese
Diagnostics 2022, 12(1), 199; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12010199 - 14 Jan 2022
Cited by 7 | Viewed by 3475
Abstract
(1) Background: Ankle fracture results in pain, swelling, stiffness and strength reduction, leading to an altered biomechanical behavior of the joint during the gait cycle. Nevertheless, a common pattern of kinematic alterations has still not been defined. To this end, we analyzed the [...] Read more.
(1) Background: Ankle fracture results in pain, swelling, stiffness and strength reduction, leading to an altered biomechanical behavior of the joint during the gait cycle. Nevertheless, a common pattern of kinematic alterations has still not been defined. To this end, we analyzed the literature on instrumental gait assessment after ankle fracture, and its correlation with evaluator-based and patient-reported outcome measures. (2) Methods: We conducted a systematic search, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, of articles published from January 2000 to June 2021 in PubMed, Embase and PEDro on instrumental gait assessment after ankle fracture. (3) Results: Several changes in gait occur after ankle fracture, including a reduction in step length, swing time, single support time, stride length, cadence, speed and an earlier foot-off time in the affected side. Additionally, trunk movement symmetry (especially vertical) is significantly reduced after ankle fracture. The instrumental assessments correlate with different clinical outcome measures. (4) Conclusions: Instrumental gait assessment can provide an objective characterization of the gait alterations after ankle fracture. Such assessment is important not only in clinical practice to assess patients’ performance but also in clinical research as a reference point to evaluate existing or new rehabilitative interventions. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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Other

10 pages, 605 KiB  
Systematic Review
Cervical Spine Manipulations: Role of Diagnostic Procedures, Effectiveness, and Safety from a Rehabilitation and Forensic Medicine Perspective: A Systematic Review
by Andrea Bernetti, Raffaele La Russa, Alessandro de Sire, Francesco Agostini, Stefania De Simone, Giacomo Farì, Giorgia Viola Lacasella, Gabriele Santilli, Stefania De Trane, Michele Karaboue, Pierangela Ruiu, Massimiliano Mangone, Massimiliano Leigheb, Valter Santilli and Pietro Fiore
Diagnostics 2022, 12(5), 1056; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12051056 - 23 Apr 2022
Cited by 17 | Viewed by 2120
Abstract
Background: Cervical spine manipulations (CSM) have been performed for centuries and are a widely practiced intervention to manage cervical spine musculoskeletal disorders. We aimed to perform an overview of the literature concerning the effects and the adverse events of CSM in the Physical [...] Read more.
Background: Cervical spine manipulations (CSM) have been performed for centuries and are a widely practiced intervention to manage cervical spine musculoskeletal disorders. We aimed to perform an overview of the literature concerning the effects and the adverse events of CSM in the Physical and Rehabilitation Medicine (PRM) field with a forensic medicine perspective. Methods: A search in the scientific literature (PubMed, Google Scholar, PEDro and Cochrane) was carried out from inception until October 2020. Results: Fourteen articles were included in this narrative summary. The possible development of side effects requires a careful mandatory balance of benefits and risks even when there is an indication for this approach. Moreover, a qualified professional is essential to perform CSM–a non-invasive therapeutic procedure that can be potentially harmful. Conclusions: In conclusion, it is essential to perform the diagnosis, to treat, and to manage complications within the PRM field, both for the reduction of malpractice claims and, most importantly, for the safety of the patient. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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20 pages, 3745 KiB  
Case Report
Hajdu-Cheney Syndrome: Report of a Case in Spain
by Jonathan Cortés-Martín, Juan Carlos Sánchez-García, Beatriz Piqueras-Sola, Raquel Rodríguez-Blanque, María Isabel Tovar-Gálvez and Lourdes Díaz-Rodríguez
Diagnostics 2022, 12(3), 566; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12030566 - 23 Feb 2022
Cited by 4 | Viewed by 2702
Abstract
This paper describes the case of a 54-year-old woman diagnosed with Hajdu–Cheney syndrome, who presents with characteristic craniofacial dysmorphia, short stature, premature loss of teeth, developmental skeletal disorders, fibrocystic mastopathy, bilateral hearing loss and an intermittent mild neutropenia. The patient received treatment with [...] Read more.
This paper describes the case of a 54-year-old woman diagnosed with Hajdu–Cheney syndrome, who presents with characteristic craniofacial dysmorphia, short stature, premature loss of teeth, developmental skeletal disorders, fibrocystic mastopathy, bilateral hearing loss and an intermittent mild neutropenia. The patient received treatment with bisphosphonates and was awaiting evaluation for surgical arthroplasty of both hips when she suffered a motor vehicle accident, which led to a rapid progression in her disease by increasing her degree of dependence for most activities of daily living. The clinical presentation and radiologic findings seen in this case confirm the three main features of the syndrome: phenotypic variability, an age-dependent progression and the presence of generalized osteoporosis and acroosteolysis of distal phalanges. The main objective of the manuscript is to describe a new case of a patient diagnosed with Hajdu–Cheney syndrome. Due to the low prevalence of the syndrome and the small number of cases reported in the scientific literature, obtaining a complete description and a global perspective of the disease is complex. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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14 pages, 1964 KiB  
Systematic Review
Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis
by Michela Barini, Domenico Zagaria, Davide Licandro, Sergio Pansini, Chiara Airoldi, Massimiliano Leigheb and Alessandro Carriero
Diagnostics 2021, 11(10), 1782; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101782 - 28 Sep 2021
Cited by 10 | Viewed by 2453
Abstract
Background: The studies about injury to the anterior talo-fibular ligament (ATFL) are focused mainly on chronic symptoms and chronic instability, and the literature about the accuracy of magnetic resonance imaging (MRI) in acute injuries is quite lacking. Methods: This systematic review with meta-analysis [...] Read more.
Background: The studies about injury to the anterior talo-fibular ligament (ATFL) are focused mainly on chronic symptoms and chronic instability, and the literature about the accuracy of magnetic resonance imaging (MRI) in acute injuries is quite lacking. Methods: This systematic review with meta-analysis analyzes the diagnostic accuracy of MRI on acute ATFL injury. Relative studies were retrieved after searching three databases (MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trails). Eligible studies were summarized. The quality of the included articles was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data were extracted to calculate pooled sensitivity and specificity of MRI. Results: Seven studies met our inclusion and exclusion criteria. For MRI, the pooled sensitivities and specificity in diagnosing acute ATFL injury were respectively 1.0 (95% CI: 0.58–1) and 0.9 (95% CI: 0.79–0.96). Pooled LR+ and LR− were respectively 10.4 (95% CI: 4.6–23) and 0 (95% CI: 0–0.82). Conclusion: This systematic review with meta-analysis investigated the accuracy of imaging for the diagnosis of acute ATFL injury. Our results demonstrated that MRI shows high diagnostic accuracy in the diagnosis of acute ATFL lesions. These results suggest that routine MRI in the case of suspected ATFL acute injury may be clinically useful, although this is not done in clinical practice due probably to high cost. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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11 pages, 17041 KiB  
Case Report
Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review
by Antimo Moretti, Francesca Gimigliano, Marco Paoletta, Matteo Bertone, Sara Liguori, Giuseppe Toro and Giovanni Iolascon
Diagnostics 2021, 11(9), 1596; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11091596 - 01 Sep 2021
Cited by 5 | Viewed by 2620
Abstract
Complex regional pain syndrome type I (CRPS I)—or algodystrophy—is a rare disease that usually occurs after a traumatic event. It is characterized by typical clinical findings such as severe and disabling pain disproportionate to the injury, functional limitations, as well as sensory and [...] Read more.
Complex regional pain syndrome type I (CRPS I)—or algodystrophy—is a rare disease that usually occurs after a traumatic event. It is characterized by typical clinical findings such as severe and disabling pain disproportionate to the injury, functional limitations, as well as sensory and vasomotor alterations. However, some people do not report any injury associated with algodystrophy onset in personal history. We describe the management of an unusual case of CRPS I which occurred during the long-term follow-up of percutaneous transluminal coronary angioplasty (PTCA) and performed a narrative review of algodystrophy in non-orthopedic surgery. A clinical case of a 44-year-old man with a spontaneous onset of CRPS I of the right ankle is presented. He did not refer to history of any memorable significant trigger event. Approximately 5 months before the onset of clinical manifestations, he received a PTCA via the right femoral approach. We suppose an association between CRPS and this procedure and propose a possible pathophysiologic mechanism. The patient was treated with intramuscular neridronate, which resulted in significant pain relief and improved his quality of life. A comprehensive clinical and instrumental evaluation in patients with CRPS is challenging but mandatory for a correct diagnosis. An extensive analysis of patient history is important for identifying any potential trigger event, including non-orthopedic procedures. Bone scan could have a pivotal role for improving diagnostic sensitivity and specificity in CRPS I. Neridronate was a safe and effective therapeutic approach for this patient, confirming the results of the high-quality evidence available. Full article
(This article belongs to the Special Issue Advance in the Diagnostics and Management of Musculoskeletal Diseases)
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