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Best Practice & Research. Clinical... Apr 2013Over the last decade, increasing numbers of rheumatologists have incorporated musculoskeletal ultrasound (MSUS) as a valuable diagnostic tool into their clinical... (Review)
Review
Over the last decade, increasing numbers of rheumatologists have incorporated musculoskeletal ultrasound (MSUS) as a valuable diagnostic tool into their clinical practice. Some countries have established training programmes for MSUS. The European League Against Rheumatism has developed education guidelines for the content and conductance of MSUS courses and it would be useful to standardise rheumatology MSUS training worldwide. A thorough knowledge of anatomy, US physics and technology, US scanning methods, US pattern of normal and pathological musculoskeletal tissues, definitions for US pathology, artefacts and pitfalls in both greyscale and Doppler modalities is necessary to perform efficient MSUS. MSUS training includes attending theoretical-practical and online courses, as well as studying textbooks and using digital video discs (DVDs). Having access to US equipment and performing supervised normal and pathological MSUS examinations for a training period are mandatory for consolidating MSUS learning. A proposal to accredit and certificate competence in MSUS is now being discussed.
Topics: Clinical Competence; Humans; Musculoskeletal Diseases; Musculoskeletal System; Rheumatic Diseases; Rheumatology; Ultrasonography
PubMed: 23731935
DOI: 10.1016/j.berh.2013.02.004 -
Jornal de Pediatria 2022To evaluate idiopathic musculoskeletal pain, musculoskeletal pain syndromes, and use of electronic devices in adolescents with asthma and healthy controls.
OBJECTIVE
To evaluate idiopathic musculoskeletal pain, musculoskeletal pain syndromes, and use of electronic devices in adolescents with asthma and healthy controls.
METHODS
Cross-sectional study was conducted on 150 asthmatic adolescents and 300 controls. Adolescents completed a self-administered questionnaire regarding painful symptoms, use of electronic devices, and physical activity. Seven musculoskeletal pain syndromes were evaluated, and Asthma Control Test (ACT) was assessed.
RESULTS
Musculoskeletal pain (42% vs. 61%, p = 0.0002) and musculoskeletal pain syndromes (2.7% vs. 15.7%, p = 0.0006) were significantly lower in asthmatic adolescents than in controls. The frequency of pain in the hands and wrists was reduced in asthmatic than in controls (12.6% vs. 31.1%, p = 0.004), in addition to cell phone use (80% vs. 93%, p < 0.0001), simultaneous use of at least two electronic media (47% vs. 91%, p < 0.0001), myofascial syndrome (0% vs. 7.1%, p = 0.043), and tendinitis (0% vs. 9.2%, p = 0.008). Logistic regression analysis, including asthma with musculoskeletal pain as the dependent variable, and female sex, ACT > 20, simultaneous use of at least two electronic devices, cell phone use, and weekends and weekdays of cell phone use, as independent variables, showed that female sex (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.929-6.316; p = 0.0009) and ACT ≥ 20 (OR, 0.194; 95% CI, 0.039-0.967; p = 0.045) were associated with asthma and musculoskeletal pain (Nagelkerke R = 0.206).
CONCLUSIONS
Musculoskeletal pain and musculoskeletal pain syndromes were lower in adolescents with asthma. Female sex was associated with musculoskeletal pain in asthmatic, whereas patients with asthma symptoms and well-controlled disease reported a lower prevalence of musculoskeletal pain.
Topics: Adolescent; Asthma; Cross-Sectional Studies; Electronics; Female; Humans; Musculoskeletal Pain; Rheumatic Diseases; Syndrome
PubMed: 34246587
DOI: 10.1016/j.jped.2021.06.002 -
Current Osteoporosis Reports Dec 2014In the musculoskeletal system, muscle, tendon, and bone tissues develop in a spatially and temporally coordinated manner, and integrate into a cohesive functional unit... (Review)
Review
In the musculoskeletal system, muscle, tendon, and bone tissues develop in a spatially and temporally coordinated manner, and integrate into a cohesive functional unit by forming specific connections unique to each region of the musculoskeletal system. The mechanisms of these patterning and integration events are an area of great interest in musculoskeletal biology. Hox genes are a family of important developmental regulators and play critical roles in skeletal patterning throughout the axial and appendicular skeleton. Unexpectedly, Hox genes are not expressed in the differentiated cartilage or other skeletal cells, but rather are highly expressed in the tightly associated stromal connective tissues as well as regionally expressed in tendons and muscle connective tissue. Recent work has revealed a previously unappreciated role for Hox in patterning all the musculoskeletal tissues of the limb. These observations suggest that integration of the musculoskeletal system is regulated, at least in part, by Hox function in the stromal connective tissue. This review will outline our current understanding of Hox function in patterning and integrating the musculoskeletal tissues.
Topics: Animals; Cell Differentiation; Cell Proliferation; Extremities; Genes, Homeobox; Humans; Models, Animal; Musculoskeletal Development
PubMed: 25266923
DOI: 10.1007/s11914-014-0241-0 -
Cureus Jul 2022Background Musculoskeletal conditions often affect patients' mobility and ability to participate in health behaviors such as exercise, potentially affecting their...
Background Musculoskeletal conditions often affect patients' mobility and ability to participate in health behaviors such as exercise, potentially affecting their systemic health. The purpose of this research is to determine how frequently cardiac-related comorbidities present in a veteran population with musculoskeletal service-connected disability and how this affects musculoskeletal health care utilization. Methodology A retrospective cohort of Iraq and Afghanistan Veterans who received a Veterans Affairs (VA) disability determination for service-connected musculoskeletal disability were categorized according to the diagnosis of cardiac comorbidity including diabetes mellitus, hyperlipidemia, hypertension, and obesity, and atherosclerosis disease documented by ICD-9 codes in the VA administrative data. Among veterans with musculoskeletal service-connected disability, logistic regression was modeled to determine if musculoskeletal clinic utilization was associated with also having a cardiac comorbid condition. Results Veterans with musculoskeletal disability had a comorbid cardiac disorder 43% of the time. Post-traumatic arthritis was the only musculoskeletal condition positively associated with comorbid cardiac conditions. Veterans with comorbid cardiac diagnoses had 26-37% higher odds of receiving care by physical and occupational therapy, physical medicine, and orthopaedic surgery clinics compared to veterans without comorbid cardiac disease. Conclusions Veterans in this cohort with musculoskeletal service-connected disability, plus cardiac conditions had greater clinic use for musculoskeletal and rehabilitation services compared to those without cardiac conditions. These results have implications for the rehabilitation and other health service needs of a new generation of veterans.
PubMed: 36017301
DOI: 10.7759/cureus.27139 -
Sports Health Sep 2016Musculoskeletal ultrasound (US) research is expanding due to increased clinical utility of sonography. (Review)
Review
CONTEXT
Musculoskeletal ultrasound (US) research is expanding due to increased clinical utility of sonography.
STUDY DESIGN
Clinical review.
LEVEL OF EVIDENCE
Level 4.
RESULTS
Ultrasound is widely applied in musculoskeletal imaging and sports medicine. The real-time capabilities and favorable cost profile of US make it ideal for use in diagnosis of musculoskeletal conditions. The enthusiasm for the use of US in musculoskeletal imaging has led to an increase in US research to broaden its applications.
CONCLUSION
Several recent advances have been made in conventional and novel US imaging techniques, quantitative US imaging, and US-guided interventions.
STRENGTH OF RECOMMENDATIONS TAXONOMY SORT
C.
Topics: Humans; Joint Diseases; Muscular Diseases; Musculoskeletal Diseases; Musculoskeletal System; Peripheral Nervous System Diseases; Tendinopathy; Ultrasonography
PubMed: 27528698
DOI: 10.1177/1941738116664326 -
Frontiers in Pharmacology 2023Musculoskeletal health is paramount in an ageing population susceptible to conditions such as osteoporosis, arthritis and fractures. Age-related changes in bone, muscle,... (Review)
Review
Musculoskeletal health is paramount in an ageing population susceptible to conditions such as osteoporosis, arthritis and fractures. Age-related changes in bone, muscle, and joint function result in declining musculoskeletal health, reduced mobility, increased risk of falls, and persistent discomfort. Preserving musculoskeletal wellbeing is essential for maintaining independence and enhancing the overall quality of life for the elderly. The global burden of musculoskeletal disorders is significant, impacting 1.71 billion individuals worldwide, with age-related muscle atrophy being a well-established phenomenon. Tocotrienols, a unique type of vitamin E found in various sources, demonstrate exceptional antioxidant capabilities compared to tocopherols. This characteristic positions them as promising candidates for addressing musculoskeletal challenges, particularly in mitigating inflammation and oxidative stress underlying musculoskeletal disorders. This review paper comprehensively examines existing research into the preventive and therapeutic potential of tocotrienols in addressing age-related musculoskeletal issues. It sheds light on the promising role of tocotrienols in enhancing musculoskeletal health and overall wellbeing, emphasizing their significance within the broader context of age-related health concerns.
PubMed: 38146461
DOI: 10.3389/fphar.2023.1290721 -
Journal of Magnetic Resonance Imaging :... Jul 2018New integrated PET-MRI systems potentially provide a complete imaging modality for diagnosis and evaluation of musculoskeletal disease. MRI is able to provide excellent... (Review)
Review
UNLABELLED
New integrated PET-MRI systems potentially provide a complete imaging modality for diagnosis and evaluation of musculoskeletal disease. MRI is able to provide excellent high-resolution morphologic information with multiple contrast mechanisms that has made it the imaging modality of choice in evaluation of many musculoskeletal disorders. PET offers incomparable abilities to provide quantitative information about molecular and physiologic changes that often precede structural and biochemical changes. In combination, hybrid PET-MRI can enhance imaging of musculoskeletal disorders through early detection of disease as well as improved diagnostic sensitivity and specificity. The purpose of this article is to review emerging applications of PET-MRI in musculoskeletal disease. Both clinical applications of malignant musculoskeletal disease as well as new opportunities to incorporate the molecular capabilities of nuclear imaging into studies of nononcologic musculoskeletal disease are discussed. Lastly, we discuss some of the technical considerations and challenges of PET-MRI as they specifically relate to musculoskeletal disease.
LEVEL OF EVIDENCE
5 TECHNICAL EFFICACY: Stage 3 J. Magn. Reson. Imaging 2018;48:27-47.
Topics: Adult; Arthritis, Rheumatoid; Bone Diseases; Bone and Bones; Humans; Magnetic Resonance Imaging; Metals; Multimodal Imaging; Multiple Myeloma; Muscle, Skeletal; Musculoskeletal Diseases; Neoplasm Metastasis; Osteoarthritis; Pain; Positron-Emission Tomography; Prognosis
PubMed: 29969193
DOI: 10.1002/jmri.26183 -
Acta Biomaterialia Jul 2019Musculoskeletal disorders are a significant burden on the global economy and public health. Advanced drug delivery plays a key role in the musculoskeletal field and... (Review)
Review
Musculoskeletal disorders are a significant burden on the global economy and public health. Advanced drug delivery plays a key role in the musculoskeletal field and holds the promise of enhancing the repair of degenerated and injured musculoskeletal tissues. Ideally, drug delivery should have the ability to directly deliver therapeutic agents to the diseased/injured sites with a desirable drug level over a period of time. Here, we present a mini-review of the current state-of-the-art research associated with local drug delivery and its use for the treatment of musculoskeletal disorders. First, an overview of drug delivery strategies, with a focus on issues related to musculoskeletal pathology, potential therapeutic strategies, conventional and non-conventional drugs, and various delivery systems, is introduced. Then, we highlight recent advances in the emerging fields of musculoskeletal local drug delivery, involving therapeutic drugs (e.g., genes, small molecule therapeutics, and stem cells), novel delivery vehicles (e.g., 3D printing and tissue engineering techniques), and innovative delivery approaches (e.g., multi-drug delivery and smart stimuli-responsive delivery). The review concludes with future perspectives and associated challenges for developing local drug delivery for musculoskeletal applications. STATEMENT OF SIGNIFICANCE: Three important aspects are highlighted in this manuscript: 1) The advanced musculoskeletal drug delivery is introduced from the aspects ranging from musculoskeletal disorders, potential therapeutic solutions, and various drug delivery systems. 2) The recent advances in the emerging fields of musculoskeletal local drug delivery, involving therapeutic drugs (e.g., genes, small molecule therapeutics, and stem cells), novel delivery vehicles (e.g., 3D printing and tissue engineering technique), and innovative delivery approaches (e.g., multi-drug delivery and smart stimuli-responsive delivery), are highlighted. 3) The challenges and perspectives of future research directions in the development of musculoskeletal local drug delivery are presented.
Topics: Drug Delivery Systems; Humans; Musculoskeletal Diseases; Printing, Three-Dimensional; Stem Cell Transplantation; Tissue Engineering
PubMed: 30685475
DOI: 10.1016/j.actbio.2019.01.043 -
Bioengineering (Basel, Switzerland) Apr 2023The extracellular microenvironment regulates many of the mechanical and biochemical cues that direct musculoskeletal development and are involved in musculoskeletal... (Review)
Review
The extracellular microenvironment regulates many of the mechanical and biochemical cues that direct musculoskeletal development and are involved in musculoskeletal disease. The extracellular matrix (ECM) is a main component of this microenvironment. Tissue engineered approaches towards regenerating muscle, cartilage, tendon, and bone target the ECM because it supplies critical signals for regenerating musculoskeletal tissues. Engineered ECM-material scaffolds that mimic key mechanical and biochemical components of the ECM are of particular interest in musculoskeletal tissue engineering. Such materials are biocompatible, can be fabricated to have desirable mechanical and biochemical properties, and can be further chemically or genetically modified to support cell differentiation or halt degenerative disease progression. In this review, we survey how engineered approaches using natural and ECM-derived materials and scaffold systems can harness the unique characteristics of the ECM to support musculoskeletal tissue regeneration, with a focus on skeletal muscle, cartilage, tendon, and bone. We summarize the strengths of current approaches and look towards a future of materials and culture systems with engineered and highly tailored cell-ECM-material interactions to drive musculoskeletal tissue restoration. The works highlighted in this review strongly support the continued exploration of ECM and other engineered materials as tools to control cell fate and make large-scale musculoskeletal regeneration a reality.
PubMed: 37106640
DOI: 10.3390/bioengineering10040453 -
BMJ Open Apr 2022This study aimed to investigate whether a musculoskeletal health climate, expressing the shared perceptions among workers concerning musculoskeletal health, is...
OBJECTIVES
This study aimed to investigate whether a musculoskeletal health climate, expressing the shared perceptions among workers concerning musculoskeletal health, is associated with number of musculoskeletal pain sites and sickness absence.
DESIGN
Cross-sectional study.
SETTING
Six slaughterhouses from 2 companies in Denmark and 6 home-nursing units and 12 nursing homes from 1 municipality in Jutland, Denmark.
PARTICIPANTS
A total of 1092 slaughter house workers and 410 care workers completed an online questionnaire from February to October 2019.
OUTCOME MEASURES
The exposure variable was musculoskeletal health climate assessed by two domains; (1) perceived management priority of musculoskeletal health measured by a modified subscale from the Nordic Safety Climate Questionnaire and (2) work group pain acceptance which was a modified version of the activity engagement subscale of the chronic pain acceptance scale. Outcomes variables were number of musculoskeletal pain sites (0-6) and days with sickness absence.
RESULTS
The associations between the two subscales, number of musculoskeletal pain sites and sickness absence were calculated using mixed linear and generalised estimating equation regression models. Higher perceived management priority scores were associated with a lower number of musculoskeletal pain sites across both job groups: β=-.57 (95% CI -0.91 to -0.23) and sickness absence (>5 days) due to musculoskeletal pain prevalence ratio (PR) 0.79 (95% CI 0.57 to 1.08). In contrast higher work group pain acceptance scores were associated with higher number of musculoskeletal pain sites: β=0.38 (0.11 to 0.66), whereas associations with sickness absences seemed to be modified by job groups; PR 1.59 care workers and PR 0.86 slaughterhouse workers.
CONCLUSION
The observed relationship between musculoskeletal health climate, musculoskeletal pain sites and sickness absence indicate that cultural factors should receive increased attention in work place preventive interventions.
Topics: Cross-Sectional Studies; Humans; Musculoskeletal Diseases; Musculoskeletal Pain; Occupational Diseases; Sick Leave; Workplace
PubMed: 35414557
DOI: 10.1136/bmjopen-2021-056485