Deep Gluteal Syndrome (DGS) has traditionally been defined as a clinical entity caused by sciatic nerve (SN) entrapment. However, recent anatomical and imaging studies suggest that muscle- and tendon-origin pathologies—including enthesopathy—may also serve as primary pain generators. This narrative review aims to broaden the current understanding of DGS by integrating muscle and tendon pathologies into its diagnostic and therapeutic framework. The literature was selectively reviewed from PubMed, Cochrane Library, Google Scholar, PEDro, and Web of Science to identify clinically relevant studies illustrating evolving concepts in DGS pathophysiology, diagnosis, and management. We review clinical features and diagnostic tools including physical examination, MRI, and dynamic ultrasonography, with special attention to deep external rotator enthesopathy. Treatment strategies are summarized, including conservative therapy, ultrasound-guided injections, hydrodissection, and prolotherapy. This narrative synthesis underscores the importance of recognizing muscle-origin enthesopathy and soft-tissue pathologies as significant contributors to DGS. A pathophysiology-based, multimodal approach is essential for accurate diagnosis and effective treatment.

The currently available drugs to treat neuropathic pain do not provide adequate pain management. As such, other treatments including stem cells, platelet-rich plasma and plasma-derived molecules su... Plain language summary The currently available drugs to treat neuropathic pain do not provide adequate pain control. As such, other various regenerative treatments modalities are being explored bec...

Background/Objectives: Intramedullary (IM) nailing for hip fractures can cause iatrogenic abductor muscle injury, leading to pain and functional impairment. This study evaluated whether early extracorporeal shockwave therapy (ESWT) safely accelerates recovery. Methods: In this open-label randomized controlled trial, 51 patients (≥50 years; intention-to-treat: ESWT n = 26; control n = 25) received either standard postoperative care (control) or standard care plus three ESWT sessions. The primary outcome was pain (Visual Analog Scale, VAS); the secondary outcome was hip function (modified Harris Hip Score, mHHS), assessed at 3, 6, and 12 months. Results: Linear mixed-effects modeling showed significantly faster pain reduction in the ESWT group (group × time β = 0.086 points/month; p = 0.027), corresponding to an additional 1.0-point VAS reduction over 12 months. Functional improvement (mHHS) did not reach statistical significance (group × time β = 0.485; p = 0.462). No ESWT-related adverse events were observed. Conclusions: Early postoperative ESWT is a safe adjunctive therapy that accelerates pain relief after IM nailing for hip fractures. Although functional improvements were not statistically significant, pain reduction may facilitate early mobilization and rehabilitation.

Aim: To describe the successful treatment of bone marrow edema in the setting of hip osteoarthritis using ultrasound-guided injection of photoactivated leukocyte-rich platelet-rich plasma (LR-PRP).... Plain language summary Aim: To describe the successful treatment of bone marrow swelling in the setting of hip osteoarthritis using ultrasound-guided injection of enhanced platelet-rich plasma (PRP...

Background and Clinical Significance: Wartenberg’s syndrome (cheiralgia paresthetica) is classically described as a pure sensory neuropathy of the superficial branch of the radial nerve (SBRN). However, in rare circumstances, dynamic mechanical irritation around the radial styloid may produce an atypical clinical phenotype with concurrent motor impairment, broadening the clinical significance of recognizing motion-related compression mechanisms. Case Presentation: A 35-year-old woman presented with persistent dorsoradial wrist pain and numbness, accompanied by progressive weakness of thumb extension, five years after a conservatively treated nondisplaced scaphoid fracture. Neurological examination demonstrated sensory loss in the SBRN distribution and Medical Research Council (MRC) grade 3/5 strength of the extensor pollicis longus (EPL). Nerve conduction studies revealed a markedly prolonged EPL motor latency (4.5 ms; normal ≤ 2.5 ms) with preserved sensory conduction. High-resolution ultrasound showed focal enlargement of the SBRN (cross-sectional area 0.13 cm²) and, critically, dynamic snapping of the nerve over the radial styloid that reproduced the patient’s symptoms. The patient underwent ten weekly sessions of ultrasound-guided hydrodissection with 5% dextrose. After treatment, the pain Visual Analog Scale improved from 8/10 to 0/10 and EPL strength recovered to MRC 5/5. Follow-up nerve conduction studies demonstrated normalization of EPL motor latency (2.1 ms), and repeat ultrasound confirmed resolution of SBRN enlargement and snapping. Conclusions: This case expands the phenotype of Wartenberg’s syndrome to include mixed sensory–motor involvement associated with dynamic SBRN snapping at the radial styloid. Dynamic ultrasound was pivotal for identifying the motion-dependent mechanism, and ultrasound-guided 5% dextrose hydrodissection achieved complete sensory and motor recovery as a minimally invasive and effective treatment option.

The anterior labral–ligamentous complex (ALLC), formed by the integration of the anterior inferior glenohumeral ligament and anterior glenoid labrum, plays a critical role in shoulder stability and represents a potential target for regenerative injection therapy. However, precise ultrasound-guided targeting of this capsular–labral interface has not been anatomically validated. This feasibility cadaveric study evaluated the accuracy of ultrasound-guided in-plane injection directed at the ALLC at its glenoid attachment. A fresh-frozen human cadaver specimen was examined in the supine position with the shoulder in external rotation. Stepwise lateral-to-medial and cranial-to-caudal ultrasound scanning was performed to localize the ALLC. A 23-gauge needle was advanced in a cranial-to-caudal in-plane trajectory, and 1–2 mL of red filler was injected into the capsular–labral interface. Subsequent layer-by-layer dissection was conducted to assess injectate localization. In both shoulders (2/2), red filler was confined within the ALLC without extra-capsular leakage, diffuse intra-articular pooling, or neurovascular staining. These findings demonstrate the anatomical feasibility of ultrasound-guided targeted delivery to the anterior capsular–labral complex. This proof-of-concept study provides foundational anatomical validation for the development of regenerative injection protocols directed at the shoulder capsular–labral enthesis.