Ultrasound-guided perineural hydrodissection (HD) is a novel technique that has been found to be effective in providing mechanical release of perineural adhesions and decompression of the nerve, reducing inflammation and edema and restoring its physiological function. It has a significant impact on chronic neuropathic pain (20 ± 4 weeks with VAS < 5 or VAS diminished by 2 points after the procedure). Carpal tunnel syndrome (CTS) is a common entrapment mononeuropathy, and its distribution is typically innervated by the median nerve. Patients with mild or moderate CTS may benefit from nonsurgical treatments or conservative therapies. This review was conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement guidelines. Four investigators assessed each title, abstract, and full-text article for eligibility, with disagreements being resolved by consensus with two experienced investigators. The qualitative assessment of the studies was carried out using the modified Oxford quality scoring system, also known as the modified Jadad score. Furthermore, risk of possible biases was assessed using the Cochrane collaboration tool. The results of this review suggest that US-guided HD is an innovative, effective, well-tolerated, and safe technique (11 out of 923 patients had collateral or side effects after the procedure). However, further studies comparing all drugs and with a larger sample population are required to determine the most effective substance.

The knee is an essential part of our body, and identifying its injuries is crucial since it can significantly affect quality of life. To date, the preferred way of evaluating knee injuries is through magnetic resonance imaging (MRI), which is an effective imaging technique that accurately identifies injuries. The issue with this method is that the high amount of detail that comes with MRIs is challenging to interpret and time consuming for radiologists to analyze. The issue becomes even more concerning when radiologists are required to analyze a significant number of MRIs in a short period. For this purpose, automated tools may become helpful to radiologists assisting them in the evaluation of these images. Machine learning methods, in being able to extract meaningful information from data, such as images or any other type of data, are promising for modeling the complex patterns of knee MRI and relating it to its interpretation. In this study, using a real-life imaging protocol, a machine-learning model based on convolutional neural networks used for detecting medial meniscus tears, bone marrow edema, and general abnormalities on knee MRI exams is presented. Furthermore, the model’s effectiveness in terms of accuracy, sensitivity, and specificity is evaluated. Based on this evaluation protocol, the explored models reach a maximum accuracy of 83.7%, a maximum sensitivity of 82.2%, and a maximum specificity of 87.99% for meniscus tears. For bone marrow edema, a maximum accuracy of 81.3%, a maximum sensitivity of 93.3%, and a maximum specificity of 78.6% is reached. Finally, for general abnormalities, the explored models reach 83.7%, 90.0% and 84.2% of maximum accuracy, sensitivity and specificity, respectively.

Parkinson’s disease is the second most common neurodegenerative disease worldwide, characterized by bradykinesia, rigidity, tremor, and postural instability. These symptoms often lead to significant postural deformities and an increased risk of falls, severely impacting the quality of life. Conventional rehabilitation methods have shown benefits, but recent advancements suggest that virtual reality (VR) could offer a promising alternative. This scoping review aims to analyze the current literature to evaluate the effectiveness of VR in the postural rehabilitation of patients with PD. A scientific literature search was performed using the following databases: PubMed, PEDro, Cochrane, and Google Scholar, focusing on randomized controlled trials (RCTs) published in English. Our selection criteria included studies that compared VR-based rehabilitation to traditional methods regarding posture-related outcomes. We identified and analyzed nine RCTs that met our inclusion criteria. The results consistently demonstrated that VR-based rehabilitation leads to greater improvements in balance and gait compared to conventional therapy. Key findings include significant enhancements in balance confidence and postural control and a reduction in fall rates. The superior efficacy of VR-based rehabilitation can be attributed to its engaging and immersive nature, which enhances patient motivation and adherence to therapy. VR allows for precise, repeatable training scenarios tailored to individual patient needs, providing a safe environment to practice and improve motor skills. In conclusion, VR-based rehabilitation represents an innovative approach with substantial potential to improve the quality of life for PD patients. However, limitations such as small sample sizes and short intervention durations in existing studies highlight the need for larger multicenter trials with longer follow-up periods to confirm these findings.

Background: The rehabilitative treatment of muscle injuries is mostly conservative, but it does not always follow precise protocols. Appropriate physiotherapy, exercises, and training are essential components of the rehabilitation and reconditioning of injured muscles. The purpose of this review is to assess the good rehabilitative practices in the treatment of patients affected by muscle injuries. Methods: We performed research on Medline and Cochrane Database. Guidelines focusing on the rehabilitative treatment of muscle injuries were evaluated for inclusion. Statements about non-rehabilitative treatments were also reported only for the guidelines that mainly focused on rehabilitative treatments. Results: Eight guidelines meeting the inclusion criteria were included in the review. Results were framed into a narrative overview. Two of them mainly focused on hamstring rehabilitation, the others focused on several muscular districts. Conclusions: Conservative treatment of muscle injuries is currently the gold standard, with good results in terms of both rehabilitation times and post-injury sports performance. However, there is not a complete agreement on the type of exercises and the timing of rehabilitation when these should be performed. More research is needed to draw conclusions about the use of physical therapy instruments and other rehabilitation approaches and techniques.

Background/Objectives: Cervical facet joint syndrome (CFJS) is a frequent cause of neck pain and motor disability. Among the available therapies for CFJS, ultrasound (US)-guided injections are becoming more and more widespread, but the evidence about their accuracy and effectiveness is still debated in the scientific literature. The aim of this systematic review is to assess efficacy, accuracy and feasibility of US-guided cervical facet injections for the related chronic neck pain treatment. Methods: This review was conducted following the preferred reporting items for systematic reviews and meta-analysis 2020 (PRISMA) statement guidelines. The scientific articles were identified through the PubMed, Google Scholar and Cochrane Library databases. Qualitative assessment of the selected studies was carried out using the modified Oxford quality scoring system. Nine studies with a total of 958 patients were included in this review. The risk of bias was assessed using the Cochrane Collaboration tool. The protocol was registered at PROSPERO 2024 (n°CRD42024512214). Results: The results of this review suggest that the US-guided cervical facet injection for CFJS treatment is an effective technique in terms of accuracy (using the lateral technique it ranges from 92% to 98%), and efficiency (it grants pain relief with a decrease in the procedure time and fewer needle passes in comparison with the X-ray-guided technique, which also involves radiation exposure). Conclusions: US-guided injections are a safe and effective method to treat this musculoskeletal disease, granting a high functional recovery and long-lasting pain relief, net of the used drugs. However, these procedures are strictly operator-dependent and require important training to acquire good expertise.

Background/Objectives: Tendinopathies represent a prevalent musculoskeletal condition characterized by load-dependent pain, stiffness, weakness, and impaired functionality. Current treatment includes therapeutic exercise, physical modalities and injective therapy. Hyaluronic acid (HA) is a fundamental component of the extracellular matrix and plays a crucial role in tissue hydration, elasticity, and lubrication. This study aims to evaluate the effectiveness of ultrasound-guided injections of HA in improving pain symptoms and functionality in patients with supraspinatus tendinopathy. Methods: Patients with a confirmed diagnosis of supraspinatus tendinopathy, verified through ultrasound imaging, were included in the study. Patients underwent 3 ultrasound guidance injections (1/week) of Sodium Hyaluronate (Hyalotend, 20 mg/2 mL). Patients were evaluated at the baseline, 1 month (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after the first injection through the VAS, the QuickDASH and the SF-12. Results: Twenty-four patients were enrolled. As regards the VAS there was a statistically significant reduction (p < 0.01) of averages of values over time. The scores collected through the QuickDASH questionnaire have a statistically significant variation over time (p < 0.001). The values collected through the SF-12 Mental Component Summary (MCS) questionnaire show a highly statistically significant variation over time (p < 0.005). The values collected through the SF-12 Physical Component Summary (PCS) questionnaire show a statistically highly significant change over time (p < 0.001). Conclusions: Our results suggest that HA (Hyalotend) injections could represent a viable therapeutic option for patients with supraspinatus tendinopathy in the short, medium, and long term. Further studies with larger patient samples and a control group are needed to better investigate the effects and the modalities of administration of HA in tendinopathies.