Background: Extracorporeal shockwave therapy (ESWT) has been widely used for various musculoskeletal disorders, including knee osteoarthritis (OA), and has been shown in several studies to be a safe treatment. Although some studies have confirmed the pain-relieving effect of ESWT for knee OA, research on objectivity for structural changes in knee OA is lacking. The aim of this study was to evaluate the ESWT treatment mechanisms in patients with knee OA by means of clinical symptoms and ultrasound techniques as objective measures. Methods: Eighteen patients with mild knee OA were enrolled and randomized to 1 of 2 treatment groups: active or sham. Patients in the experimental group received 0.05 mJ/mm² total energy with 1000 pulses weekly for 3 weeks. We then assessed them before, immediately after, and 1-month after the last treatment using the following measurements: pain on a visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne index, knee joint range of motion, and ultrasonographic features (articular cartilage thickness, Doppler activity, and joint effusion height). Results: All 18 patients completed the 3 treatment sessions without any complication. Both the experimental and control groups improved in terms of OA symptoms, as measured by the visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index score, and Lequesne index (P < .05). The height of the suprapatellar effusion decreased with time course in the experimental group (P < .05) and showed significant differences with control group at 1-month follow-up (P < .05). The experimental group showed an increase in knee flexion range of motion and Doppler activity immediately following the last treatment session (P < .05), but the effect was not sustained at the 1-month follow-up. Conclusions: Although the therapeutic activity itself could improve OA symptoms, objective improvements were only observed after ESWT. Suprapatellar effusion height was reduced after ESWT and the effect was maintained after 1-month. Our results suggest that ESWT may be effective in reducing suprapatellar effusion and improving symptoms in mild knee OA. However, studies with a larger sample size are required.

Background/Objectives: This study aimed to evaluate bone mineral density (BMD) discordance and its implications in veterans with unilateral lower-limb amputation, emphasizing the need for comprehensive hip assessments. Methods: Data were collected from 84 male veterans, and BMD was measured using dual-energy X-ray absorptiometry (DXA) at the lumbar spine, intact hip, and amputated hip. Results: The T-scores for the lumbar spine, intact hip, and amputated hip were −0.27 ± 1.69, −0.25 ± 1.20, and −1.07 ± 1.33, respectively. Osteoporosis and osteopenia were present in 19% and 34.6% of patients, respectively. Osteopenia and osteoporosis were most prevalent in the hips on the amputated side (32.1% and 13.1%, respectively), followed by the lumbar spines (22.6% and 8.3%) and the hips on the intact side (17.9% and 2.4%). BMD discordance between the lumbar spine and hip was found in 47.6% of participants, while discordance between both hips was observed in 39.3%. Transfemoral amputees had significantly lower BMD at the amputated hip compared to transtibial amputees (−2.38 ± 1.72 vs. −0.87 ± 1.16, p < 0.001). Conclusions: Veterans with unilateral lower-limb amputation exhibit a high prevalence of osteoporosis and significant BMD discordance, particularly between both hips. These findings underscore the necessity for bilateral hip assessments to ensure the accurate diagnosis and effective management of osteoporosis in this population.

Background/Objectives: Ultrasound-guided flexor pollicis longus (FPL) injection is limited by the muscle’s deep location and its proximity to the cephalic vein (CV) and superficial branch of the radial nerve (SBRN). We aimed to identify the wrist and forearm posture producing the largest measured corridor width and target exposure. Methods: This prospective single-center study evaluated 51 forearms from 27 healthy adult volunteers with full range of motion, using transverse ultrasound of the distal volar forearm in six standardized positions. Two corridors were measured: CV-to-SBRN (L₁, Approach A) and CV-to-radial-cortex apex (L₂, Approach B), with FPL exposure height (F). Results: L₂ was present in all limbs and was wider with forearm supination than in neutral (supination [SUP], +2.36 mm; flexion plus supination [F+SUP], +2.05 mm; extension plus supination [E+SUP], +2.66 mm; each p < 0.001), an ~40% increase; the three supination postures did not differ. F increased across the same postures and was greatest in E+SUP (+2.32 mm), which did not differ from SUP. L₁ was absent in 12–28% of limbs and, where present, was narrower with supination (both p < 0.001). Conclusions: In healthy adults, forearm supination widened the safety corridor and increased target exposure. Applicability to spasticity requires confirmation.