TL;DR
Advances in quantitative MRI and AI may improve diagnostic accuracy, workflow efficiency, and individualized patient management, although further prospective multicentre studies are needed before routine clinical implementation.
Advances in quantitative MRI and AI may improve diagnostic accuracy, workflow efficiency, and individualized patient management, although further prospective multicentre studies are needed before routine clinical implementation.
MRI provides a detailed evaluation of knee injuries, aiding diagnosis and management, and MRI detection of associated abnormalities helps guide treatment and improve patient outcomes.
Spine degeneration is one of the most common causes of musculoskeletal pain, disability, and decreased quality of life globally. The combination of spine degeneration, osteoporosis, and functional impairment creates diagnostic difficulties that require special attention to be paid to the development of appropriate assessment methods. The present study is devoted to the review of the existing scientific research on the use of quantitative bone imaging and functional physiotherapy tests to diagnose and manage spine degenerative disorders. To this end, peer-reviewed publications and clinical cases were analyzed in order to identify the developments in imaging techniques, bone quality evaluation, functional tests in physiotherapy, and diagnostics. The conclusions show that quantitative imaging modalities, including DEXA, QCT, MRI, and advanced imaging biomarkers, give useful insights into vertebral integrity, bone quality, and structural degeneration. On the other hand, physiotherapy assessments of posture, mobility, muscular strength, balance, gait, pain, and disability supplement imaging findings through evaluation of the clinical impact of structural alterations. Integration of structural and functional assessments increases the diagnostic accuracy, allows for risk stratification, and facilitates the development of a personalized rehabilitation plan. Moreover, modern technologies such as AI, radiomics, wearables, and tele-rehabilitation systems bring new perspectives to precision spine care. Thus, combining quantitative bone imaging and physiotherapy functional assessment can be considered a basis for improvement of early diagnosis, rehabilitation, and treatment of spine degeneration disorders.
Occult osteochondral lesions represent an important challenge in sports medicine because they may remain undetected during initial assessment despite persistent pain, swelling, mechanical symptoms, and functional limitation. This study analyzed the role of diagnostic imaging, clinical and structural evolution, and return-to-sport criteria in athletes with osteochondral injuries, with particular emphasis on the knee and ankle. An integrative descriptive and analytical review was conducted using the Scientific Method, incorporating evidence related to magnetic resonance imaging, computed tomography, CT arthrography, conservative management, surgical treatment, rehabilitation, and athletic recovery. The findings demonstrated that conventional radiography has limited sensitivity for early osteochondral abnormalities, whereas magnetic resonance imaging provides superior visualization of cartilage integrity, bone marrow edema, subchondral changes, and lesion stability. Computed tomography and CT arthrography offer complementary value for defining osseous architecture and selected cartilage-surface abnormalities. Clinical improvement and radiological recovery were not consistently parallel, indicating that symptomatic improvement does not necessarily imply complete structural restoration. Surgical procedures such as bone marrow stimulation, fixation, osteochondral transplantation, and cartilage restoration showed favorable clinical and return-to-sport outcomes in appropriately selected patients, although return to the pre-injury level was consistently lower than return to sport at any level. The reviewed literature also revealed substantial heterogeneity in rehabilitation protocols and a predominant reliance on time-based criteria for sports clearance. Overall, the evidence supports an individualized and multidimensional return-to-sport approach integrating symptoms, range of motion, muscle strength, neuromuscular control, tolerance to loading, sport-specific performance, psychological readiness, and imaging follow-up when clinically indicated. Early diagnosis and criterion-based rehabilitation may contribute to safer athletic reintegration and improved long-term preservation of joint function.
Despite ongoing challenges related to standardization, acquisition time, multicenter reproducibility, and clinical implementation, quantitative MRI is expected to become an integral component of routine musculoskeletal and neuroimaging practice.
PURPOSE Bone stress injuries of the upper limb are less common than those of the lower limb, but they can cause substantial diagnostic delay in athletes because symptoms are often subtle and non-specific. This narrative review summarizes clinically relevant mechanisms, risk factors, diagnostic challenges, anatomical patterns, management strategies, and return-to-sport considerations. METHODS This narrative review was developed from a targeted, non-systematic review of the current literature and clinical experience, with emphasis on sports that expose the shoulder, arm, forearm, wrist, and hand to repetitive loading. Particular attention was given to imaging features, regional presentations, and practical decision-making in athletic populations. RESULTS Upper-limb bone stress injuries occur when repetitive loading exceeds the capacity for skeletal adaptation, progressing from marrow oedema and periosteal reaction to cortical disruption if loading continues. Plain radiographs may be normal early, whereas magnetic resonance imaging is most useful for detecting early stress reactions. Injuries may affect the scapula, clavicle, humerus, ulna, radius, carpal bones, metacarpals, and phalanges. Management usually involves load modification, immobilization when appropriate, structured rehabilitation, and correction of biomechanical or training-related contributors. Surgery is reserved for selected displaced, non-union, or functionally limiting injuries. CONCLUSION Recognition of upper-limb bone stress injuries requires a high index of suspicion. Individualized, multidisciplinary care is essential to prevent progression, guide safe return to sport, and reduce recurrence.