Neurofibromatosis type 1 (NF1) or von Recklinghausen disease is one of the most common autosomal dominant genetic diseases. It is characterized by ‘café‑au‑lait’ spots and multiple tumors starting from the central and peripheric nervous system. The diagnosis is determined on two out of seven criteria: i) A total of 6 or more light brown spots larger than 5 mm in diameter (pre‑puberty) or 15 mm in diameter (post‑puberty); ii) a total of 2 or more neurofibromas or one plexiform neurofibroma; iii) axillary or inguinal freckling; iv) optic glioma; v) a total of 2 or more Lisch nodules; vi) bone abnormalities: tibia pseudarthrosis or dysplasia of the sphenoid wing; and vii) a relative of first degree having an NF1 diagnosis. A total of ~50% of patients have significant musculoskeletal manifestation, with scoliosis and congenital pseudarthrosis of tibia most common. Management of the orthopaedic manifestations of NF1 is often difficult. Due to NF1 influencing multiple organ systems, patients are likely to benefit most from a multidisciplinary treatment strategy.

Psoriatic arthritis is a significant medical condition with a high prevalence, a wide variety of non-specific symptoms, and a high degree of overlap with other spondylarthritis disorders, particularly ankylosing spondylitis. Hence, knowledge of the magnetic resonance imaging (MRI) manifestations and a multidisciplinary strategy are required for the better management of these patients. We searched publications from the last 10 years and focused on the most relevant ones which discussed the classification criteria, the MRI characteristics of axial psoriatic arthritis, the importance of MRI for follow up, and the reliability of skin and synovial biopsy. Axial spondylarthritis can be diagnosed and followed up on using the well-established MRI technique and, additionally, a biopsy. The analysis and concordance between them can provide new directions for future studies.

Background: Multiple sclerosis (MS) is a neurodegenerative and chronic inflammatory disease, often associated with psychiatric comorbidities, particularly depression and anxiety, which play a major role in disability, cognitive dysfunction, and quality of life. Growing evidence suggests that affective symptoms in MS are not only related to psychosocial burden but also to structural and functional abnormalities in the brain that can be identified using magnetic resonance imaging (MRI). Methods: A systematic database search was performed to identify studies for a structured narrative review. Original articles that examined MRI correlates of depression and anxiety in adult MS patients were included. Structural MRI, diffusion imaging, and functional MRI studies evaluating lesion distribution, cortical and subcortical atrophy, white matter microstructure, and network connectivity were analyzed alongside psychometric instruments used to assess affective symptoms. Results: Depression in MS was consistently associated with fronto-limbic and subcortical abnormalities including cortical thinning, hippocampal and thalamic atrophy, white matter disconnection and altered connectivity within the default mode, salience and executive control networks. Diffusion MRI studies have shown microstructural damage in associative white matter tracts, and functional MRI studies have supported a model of network-level dysfunction. In contrast, anxiety had less robust and reproducible associations with conventional MRI findings, indicating a more complex interaction between inflammatory, neurobiological and psychosocial mechanisms. Conclusions: Multimodal MRI approaches may increase our knowledge of the neurobiological substrates of depression and anxiety in MS and may contribute to more personalized diagnostic and therapeutic strategies.

Background: Due to the aging process and the associated psychiatric pathology, the decrease in visual acuity, anemia, muscle atrophy and the decrease in bone resistance, the most common mechanism of hip fracture production is represented by falling from the same level. Early diagnosis and treatment of psychiatric diseases can reduce the occurrence of hip fractures through proper care of patients in different centers under the strict supervision of qualified personnel. Objectives: Assessment of pain, measurement of locomotion capacity after surgery, quality of life and life expectancy in patients with dementia and hip fractures surgically or functionally treated. Evaluation of the patient's well-being and prognosis after specific types of osteosynthesis and hip arthroplasty. Results: During one year, 520 patients with hip fractures presented themselves at the EU, of which 66 presented both pathologies. The mortality rate seemed to be lower in patients that underwent surgery, compared to those who chose functional treatment. However, treatment decisions require a multidisciplinary team and individualized recommendations for each patient, due to high surgical risk in the elderly.