Musculoskeletal Diseases Commons^™

Personalized Treatment Of Chronic Tendinopathy Using Ultrasound And Neuroimmune Markers: A Narrative Review, Rohan Phadke, Samer Salman, Kirtan Patel, Jad Wardeh, Akhil Marupudi, Rahul Kumar, Arbaz A. Momin, Alireza Tavakkoli

Department of Neurosurgery Faculty Papers

Introduction: : Chronic tendinopathy affects approximately 30% of musculoskeletal consultations, yet treatment outcomes remain inconsistent despite numerous available interventions. This variability stems from the absence of validated frameworks to match individual patients to optimal treatments based on underlying pathophysiology. To synthesize current evidence on ultrasound imaging biomarkers, neuroimmune mechanisms, and interventional therapies in chronic tendinopathy, and propose a clinically applicable framework integrating ultrasound phenotyping with neuroimmune assessment to guide personalized treatment selection. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science through December 2025. Studies examining ultrasound/elastography imaging, neuroimmune mechanisms, or treatment interventions in chronic …

A “Found-Down” Non-Traumatic Compartment Syndrome Of Upper Extremity Requiring Amputation, Nicholas Ray, Aileen Ebadat

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Musculoskeletal Infection Reporting And Data System (Mski-Rads): Reviewed And Explained, Angela He, Flavio Duarte Silva, Mina Guirguis, Erin F. Alaia, William B Morrison, Avneesh Chhabra

Department of Radiology Faculty Papers

A standardized guideline and scoring system are recommended for the imaging evaluation of musculoskeletal infections on MR imaging. The Musculoskeletal Infection Reporting and Data System (MSKI-RADS) is a recently developed and validated classification system using MR imaging that can be used to classify the severity and extent of musculoskeletal infections, improve radiology-pathology concordance, and outline the corresponding management recommendations. This review article explains MSKI-RADS and discusses the different elements of this system in detail with a review of pertinent literature so that the readers can apply it in their practices. The work outlines the technical considerations for optimal MR imaging …

Reliability Of Existing Measures And Classification Systems For Trochlear Dysplasia, Sean R. Waldron, Nihar S. Shah, Matthew W. Veerkamp, Brendan A. Williams, John A. Schlechter, Lauren H. Redler, Matthew D. Ellington, Shital N. Parikh

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Patellofemoral instability (PFI) is common in adolescent patients and can lead to a reduction in quality of life and function, as well as long-term arthritis. Treatment of PFI involves assessing and, at times, surgically correcting underlying anatomic abnormalities. Trochlear dysplasia is the most common anatomic risk factor present in PFI.

PURPOSE: To determine the interrater reliability of existing measures and classification systems for the assessment of trochlear dysplasia.

STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3.

METHODS: As part of the PRISM (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) patellar instability Research Interest Group (RIG) project, a …

Utility Of Pocus In Expediting Time To Diagnosis In Two Separate Presentations Of Fournier's Gangrene, Arjavon Talebzadeh, Charles Budzyn, Taryn Hoffman, Mark Attlesey

South Atlantic Division GME Research Days 2026

No abstract provided.

The Role Of Full Femur Imaging For Early Detection Of Incomplete Atypical Femur Fractures, Ashley B. Humrickhouse, Donald Eagerton, Anne G. La Rochelle

South Atlantic Division GME Research Days 2026

No abstract provided.

Ulcer Osteoma: The Role Of Mri In Differentiating Reactive Proliferative Periostitis From Osteomyelitis, Reza Ayoubi, Mathew Dixon

South Atlantic Division GME Research Days 2026

No abstract provided.

Clinical Outcomes Of Biodegradable Temporizing Matrix In Complex Lower Extremity Wound From Necrotizing Fasciitis, Christian B. Allen, Andres Toledo, Ryan Dennett, Brogan Hill, John Harker, Richard Crank

West Florida Division GME Research Day 2026

No abstract provided.

Biomechanical Effects Of Exercise-Based Interventions In Chronic Nonspecific Low Back Pain: A Systematic Review And Meta-Analysis, Lara De Vecchi Machado

Theses and Dissertations--Kinesiology and Health Promotion

Chronic nonspecific low back pain (CNLBP) is the leading cause of years lived with disability worldwide and represents a complex, multifactorial, and heterogeneous condition. It is characterized by substantial interindividual variability in muscle activation patterns, lumbo-pelvic coordination, and movement strategies. Although exercise is widely recommended as a first-line intervention and its clinical benefits are well established, the biomechanical mechanisms underlying functional improvement remain fragmented in the literature and are rarely synthesized quantitatively.

This dissertation conducted a systematic review with meta-analysis to investigate the biomechanical effects of exercise-based interventions in individuals with CNLBP. A total of 39 studies were included and …

Magnesium-Based Metal Matrix Nanocomposite Implants And Nanobubble-Based Delivery Systems: Integrated Strategies For Bone Loss Treatment With Cytocompatibility Evaluation, Lucas José Martinho Bizuti

Honors Undergraduate Theses

This thesis intends to investigate the development of different multimodal therapeutic strategies for combating bone loss. Most specifically, this paper will emphasize the utilization of Magnesium-Based Metal Matrix Nanocomposite Implants (MMNC) and Nanobubble-Based Delivery Systems as options for future treatment focus. The effects of biodegradable magnesium implants were evaluated for cytotoxicity and cytocompatibility via Hematoxylin and Eosin, and Masson’s Trichrome staining, as well as radiological images. The Nanobubble-Based Delivery System is being developed and optimized as a delivery system to target osteoclast activity. This paper focused on optimizing experimental parameters, which include Rotational speeds for nanobubble stimulation under microgravity conditions …

P-15 Peptide Enhanced Bone Graft Improves Time To Fusion In Transforaminal Lumbar Interbody Fusion: A Randomized, Controlled, Investigational Device Exemption Study, James S. Harrop, Michael P. Steinmetz, John E. O'Toole, Christopher D Chaput, Rick C. Sasso, K. Brandon Strenge, Greg Maislin, Jeffrey P. Mullin, Thomas B. Freeman, Anthony Guanciale, Howard Lantner, Michael E. Janssen, David G. Schwartz, John M. Small, Wellington K. Hsu, Paul M. Arnold

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Prospective, multicenter, single-blind, randomized, and controlled pivotal study.

OBJECTIVE: Compare time-to-fusion in patients treated with P-15L (PearlMatrix TM P-15 peptide enhanced bone graft) versus local autograft over 24 months and evaluate changes in pain and quality of life at 24 months relative to baseline.

SUMMARY OF BACKGROUND DATA: P-15L, an FDA-designated breakthrough device, is a composite bone graft with P-15, a 15-amino acid polypeptide that promotes cellular adhesion, proliferation, and differentiation to support bone formation.

METHODS: Patients (22-80 y) with degenerative disc disease were randomized to the investigational (P-15L) or control (local autograft) group during single-level transforaminal lumbar …

Conservative Vs Invasive Interventions For Temporomandibular Disorders–An Executive Summary Of The Clinical Practice Guideline, Gary D. Klasser, Charles S. Greene

School of Dentistry Faculty Publications

This guideline is based on the International Association for Dental, Oral, and Craniofacial Research (IADR) list of keypoints for the diagnosis and management of TMDs. Clinical Question: Are conservative reversible therapies more effective for TMDs as compared to invasive and irreversible interventions?

Neutrophil Lymphocyte Ratio As A Marker Of Skin Disease Activity In Older Children With Juvenile Dermatomyositis, Shreya Swaminathan, Nidhi Naik, Susan Shenoi, Sarah Vandenbergen, Jessica L. Turnier, Zilan Zheng, Jessica Neely, James S. Andrews, Christian Lood

Student Papers, Posters & Projects

BACKGROUND: Neutrophils contribute to the pathogenesis of many autoimmune diseases. While the neutrophil to lymphocyte ratio (NLR) is associated with disease activity in adult dermatomyositis, its clinical utility in juvenile dermatomyositis (JDM) is unknown.

METHODS: Demographic, medication use, autoantibody profile, disease activity markers, and laboratory data from 97 JDM patients was collected using retrospective chart review. Patients were age-stratified (0–9 vs. 9–21 years of age), as white blood cell count stabilizes at 9 years. The relationships between NLR with JDM disease activity measures were analyzed using spearman’s correlation.

RESULTS: Patients were primarily white (56.7%) and female (71.1%). Older children had …

The Associations Between Meniscus Tear Location And The Prevalence And Severity Of Cartilage Wear In Different Knee Compartments Using An Arthroscopic Grading System, Tara Korbal, Claudia Leonardi, Amy Bronstone, Vinod Dasa

School of Medicine Faculty Publications

Introduction: Meniscus tears are associated with progressive cartilage degeneration and worsening osteoarthritis. Although several previous studies have explored the relationship between meniscus tears and cartilage damage, few have examined the relationship between tear location and cartilage wear in all knee compartments using an arthroscopic grading system. Objectives: Evaluate the association between meniscus tear location and the prevalence and severity of high-grade cartilage wear in knee compartments. Methods: A total of 210 patients were categorized into groups based on meniscus tear location: medial meniscus tear (MMT, n = 106), lateral meniscus tear (LMT, n = 41), and medial-lateral meniscus tear (MLMT, …

Cmc Arthroplasty For Treatment Of The Painful And Arthritic Thumb: A Review Of Surgical Treatment Options With Preferred Technique, Jon E. Hammarstedt, Yehuda A. Masturov, Sebastian D. Arango, Jacob Zeitlin, Samuel H. Payne, Mark S. Rekant

Department of Medicine Faculty Papers

Arthritis of the first carpometacarpal joint is a prevalent and often disabling condition for many older adults. The diagnosis is typically established through a comprehensive patient history, physical examination, and confirmatory radiographs. Nonsurgical management with splinting and anti-inflammatory medication has demonstrated effectiveness. Several surgical options have proven effectiveness for those who fail nonsurgical management. Surgical options include silicone implantation, resection arthroplasty, tendon interposition, ligament reconstruction, denervation, and joint implant arthroplasty. In the following review, we will elaborate upon the array of therapeutic approaches, culminating in the delineation of our preferred method.

Septic Arthritis And Abscess Of The Temporomandibular Joint, Frank Rizzuto, Abdul Khan, Jagan D. Gupta, Neel D. Gupta, Triet M. Do, Enrique Palacios

School of Medicine Faculty Publications

No abstract provided.

Comparison Of Anterior And Posterior Surgical Approaches For Cervical Ossification Of The Posterior Longitudinal Ligament Stratified By Spinal Levels: A Systematic Review And Meta-Analysis, Seyed Danial Alizadeh, Sepehr Khosravi, Farzin Farahbakhsh, Vali Baigi, Moein Khormali, Mohsen Hajiqasemi, Zahra Eskandari, Mahgol Sadat Hassan Zadeh Tabatabaei, Amirmahdi Khayyamfar, Mohammad-Rasoul Jalalifar, Sepehr Armaghan, Masoud Pourghahramani Koltapeh, Zahra Ghodsi, Michael G. Fehlings, Alex R. Vaccaro, Vafa Rahimi-Movaghar

Rothman Institute Papers

OBJECTIVE: To compare the outcomes of anterior and posterior surgical approaches for treating cervical ossification of the posterior longitudinal ligament across multiple spinal levels, including 1-2 spinal levels, ≥ 3 levels, or studies that operated on both spinal levels, called mixed spinal levels.

METHODS: A search strategy using pertinent keywords was employed in the MEDLINE, Embase, Scopus, and Web of Science databases. Data on Modified Japanese Orthopaedic Association (mJOA) scores, radiographic outcomes, and complications were extracted. A random-effects meta-analysis, subgroup meta-analysis, and sensitivity analysis were performed.

RESULTS: Among 13 included studies, the anterior approach was statistically associated with improved C2-C7 …

High Occurrence Of Long Bone Nonunion : Assessing Significant Biological Risk Factors And Management Results, Bimo Sasono, Aldy Dion

Journal of Health Research

Background: A comprehensive study evaluated the risk of nonunion per fracture in a population of over four million adults and determined that rates vary depending on patients' risk factors, nonunion rates can reach in excess of 10%. This study aims to address the issue by scrutinizing the demographic characteristics of patients, pinpointing the biological risk factors for long bone nonunion and evaluating the nonunion management effectiveness.

Methods: This analytical, observational retrospective cohort study used medical record data from a regional hospital in Surabaya, Indonesia (2020–2023), involving 147 eligible patients. Data were analyzed using logistic regression with a significance level of …

Early Definitive Fusion Versus Magnetic Growing Rods In "Tweeners": What Do Parents Prefer?, Sylvia Culpepper, Ravi Rajendra, Brett Lullo, Anthony A. Catanzano, Tyler C. Mcdonald, R Carter Clement

School of Medicine Faculty Publications

INTRODUCTION: In treating early-onset scoliosis (EOS), pediatric orthopaedic surgeons and families must often choose between growth-friendly interventions such as magnetically controlled growing rods (MCGR) and early definitive posterior spinal fusion (PSF). While each strategy has associated pros and cons, little is understood about the specific preferences of patients' families. Addressing potential nuances in these preferences is crucial for meaningful shared decision-making (SDM). To better understand the factors influencing family decisions, we conducted a choice-based conjoint (CBC) analysis to explore parents' preferences for PSF and MCGR as treatment options. METHODS: A survey was developed using Sawtooth Software (Lighthouse Studio version 9.2.0) …

Diagnostic Journey In The Recognition Of Oncogenic Osteomalacia, Steven B. Nagelberg, Mihaela Biscoveanu, Barbara Bix, Carrie Andrews, Srinivas Prasad

Jefferson Health - Northeast Papers (formerly Aria Health Papers)

A 73-year-old woman with a remote history of successfully treated primary hyperparathyroidism was referred to our office because of multiple skeletal fractures and proximal muscle weakness. Prior laboratory evaluation demonstrated hypocalcemia, vitamin D deficiency, elevated PTH, and elevated alkaline phosphatase. Updated evaluation in our clinic additionally showed hypophosphatemia prompting measurement of serum fibroblast growth factor 23 (FGF23). FGF23 proved to be markedly elevated prompting consideration of tumor-induced osteomalacia. Positron emission tomography with Cu-64 oxodotreotide revealed an enhancing focus in the left thoracic spine that was confirmed on magnetic resonance imaging to be a 1.5-cm extradural mass. The patient underwent surgical …

Determining Risk Factors And Rate Of Surgery After Collagenase Injections For Dupuytren Contracture, Ryan C. Cha, Juliet S. Chung, Sina Ramtin, Asif M. Ilyas

Department of Orthopaedic Surgery Faculty Papers

Purpose: Collagenase injections are a nonsurgical treatment for Dupuytren contracture, but their long-term effectiveness in preventing surgery remains unclear. This study aimed to evaluate the rate of surgical intervention following collagenase treatment and identify whether specific risk factors increase the likelihood of future surgical correction. Methods: This retrospective cohort study utilized the TriNetX US Collaborative network to identify patients diagnosed with Dupuytren contracture between January 2007 and September 2024. Patients initially treated with collagenase injections were identified using relevant current procedural terminology codes. Procedure-specific current procedural terminology codes were then used to determine which patients underwent a subsequent fasciectomy or …

Fatal Facial Necrotizing Fasciitis: A Case Report Highlighting Diagnostic And Therapeutic Challenges, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Ahsan, Austin Mitchell, Azka Asad Mirza, Joshiah Gordon, Rahmat Gul Omarzai

Department of Medicine Faculty Papers

BACKGROUND: Facial Necrotizing Fasciitis (FNF) is a rare but aggressive, life-threatening infection involving the face's subcutaneous tissues and underlying musculature. It can rapidly progress to septic shock and multi-organ failure if not promptly recognized and treated. The clinical course, including severe pain, disproportionate tenderness, and systemic signs, is often the most crucial factor in diagnosis. While computed tomography (CT) can aid in identifying early signs such as soft tissue swelling and gas formation, clinical suspicion remains paramount and should not be delayed by reliance on imaging alone. Without early intervention, FNF may lead to devastating outcomes, including disfigurement, blindness, or …

Development Of Emerin Mrna Lipid Nanoparticles To Rescue Myogenic Differentiation., Nicholas Marano, Liza Elif Guner, Rachel S Riley, James M Holaska

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Emery-Dreifuss muscular dystrophy 1 (EDMD1) arises from mutations in EMD. Most EDMD1 patients lack detectable emerin expression. They experience symptoms such as skeletal muscle wasting, joint contractures, and cardiac conduction defects. Currently, physicians rely on treating patient symptoms without addressing the underlying cause-lack of functional emerin protein. Thus, there is a need for therapeutic approaches that restore emerin protein expression to improve patient outcomes. One way would be to deliver emerin mRNA or protein directly to affected tissues to restore tissue homeostasis. Here, we evaluated the utility of lipid nanoparticles (LNPs) to deliver emerin mRNA to diseased cells. LNPs …

Discontinuation Rates And Predictors Of Medical Cannabis Cessation For Chronic Musculoskeletal Pain, Mohammad Khak, Sina Ramtin, Juliet Chung, Asif M. Ilyas, Ari Greis

Rothman Institute Papers

Medical cannabis (MC) is increasingly used as a treatment for chronic musculoskeletal pain, but there is limited data on factors influencing its discontinuation. This study aims to investigate the rates of MC discontinuation and explore factors influencing it in patients with chronic musculoskeletal pain. A retrospective analysis was conducted on 78 patients certified for medical cannabis over a 2 year period. Patient demographics, pain origin, and Global Physical Health (GPH) and Global Mental Health (GMH) scores were collected before intervention. Discontinuation rates were measured at three-month and one-year follow-up. Statistical analyses, including Fisher's Exact Test and two-sample t-tests, were performed …

The Articularis Genu As A Surrogate For Structural Determinants Of Peri-Articular Myopenia In Osteoarthritis, Davis Martin, José A.Cruz Ayala, Mary C. Gatterer, Tara Soria, Ryan Schroeder, Vinod Dasa, Luis Marrero

School of Medicine Faculty Publications

The functional limitations associated with the painful stiffness of knee osteoarthritis (kOA) can affect the muscles of the knee, such as the quadriceps femoris (QF) and articularis genu (AG). The vastus medialis oblique (VMO) of the QF complex is particularly sensitive to kOA. The AG, which can be sampled during total knee arthroplasty (TKA) for kOA, can provide information about the condition of the QF when affected by patient-reported disuse, helping to identify indicators of muscle weakness in the synovial fluid. This study compares the structural and gene expression changes between the VMO and the AG collected from patients with …

Bone Marrow Aspirate Concentrate Adjunct For Acetabular Labral Tear Repair: A Systematic Review And Meta-Analysis, Seth Spicer, Hanna Brancaccio, Ashley Sundin, Jamie Bono, John Desrochers, Brandon Goodwin, Nicholas Averell, Seungkyu Park, Alexandra Goodwin, William Diciurcio, Richard Jermyn

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: The objective of this study was to determine the effect of bone marrow aspirate concentrate (BMAC) on long-term patient outcomes when used as an adjuvant to acetabular repair of the labrum.

METHODS: A systematic review and meta-analysis were completed following PRISMA 2020 guidelines. Included in the analysis were controlled studies which assessed functional outcomes via the International Hip Outcome Tool-33 (iHOT-33) 12 or 24 months after acetabular repair with BMAC adjunct. Four studies totaling 315 participants were analysed.

RESULTS: Pooled effect sizes for iHOT-33 scores were not significantly different between control and treatment groups at 12 (p = …

Detecting Early Changes In Cartilage Collagen And Proteoglycans Distribution Gradients In Mice Harboring The R992c Collagen Ii Mutant Using 2d Correlation Infrared Spectroscopy, Jolanta Fertala, Andrzej Steplewski, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

Collagen II is a vital structural component in developing bones and mature cartilage. Muta- tions in this protein cause spondyloepiphyseal dysplasia, a disease characterized primarily by altered skeletal growth and manifesting with a range of phenotypes, from lethal to mild. This study examined transgenic mice harboring the R992C (p.R1124C) substitution in colla- gen II. Previous research demonstrated significant growth abnormalities and disorganized growth plate structure in these mice, and histological signs of osteoarthritic changes in the knee joints of 9-month-old mice with the R992C mutation. Our study focuses on detecting early structural changes in the articular cartilage that occur before …

Economic Value Of Intra-Articular Knee Oa Therapies: A U.S. Perspective, Vinod Dasa, Wilson Ngai, Kevin Steele, Ronald Preblick, Heather Watson, Kevin L. Ong

School of Medicine Faculty Publications

AIMS: This study compared the six-month medical/pharmacy costs and healthcare resource utilization (HCRU) for knee OA patients undergoing intra-articular therapy with different classes of hyaluronic acid (HA) (by molecular weight) or corticosteroid (ICS). MATERIALS AND METHODS: Patients across high molecular weight (HMW) HA, medium molecular weight (MMW) HA, low molecular weight (LMW) HA, and ICS therapy groups were matched from a U.S. claims database (Optum's de-identified Clinformatics Data Mart Database), with a final size of 6,234 patients per group. Adjusted six-month medical/prescription costs per patient per month (PPPM), and HCRU rates and costs, were determined. Secondary endpoints included complication rates …

Biomarker-Guided Imaging And Ai-Augmented Diagnosis Of Degenerative Joint Disease, Rahul Kumar, Kyle Sporn, Aryan Borole, Akshay Khanna, Chirag Gowda, Phani Paladugu, Alex Ngo, Ram Jagadeesan, Nasif Zaman, Alireza Tavakkoli

Department of Medicine Faculty Papers

Degenerative joint disease remains a leading cause of global disability, with early diagnosis posing a significant clinical challenge due to its gradual onset and symptom overlap with other musculoskeletal disorders. This review focuses on emerging diagnostic strategies by synthesizing evidence specifically from studies that integrate biochemical biomarkers, advanced imaging techniques, and machine learning models relevant to osteoarthritis. We evaluate the diagnostic utility of cartilage degradation markers (e.g., CTX-II, COMP), inflammatory cytokines (e.g., IL-1β, TNF-α), and synovial fluid microRNA profiles, and how they correlate with quantitative imaging readouts from T2-mapping MRI, ultrasound elastography, and dual-energy CT. Furthermore, we highlight recent developments …

Efficacy Of Platelet Rich Plasma On Thumb Basal Joint Osteoarthritis: A Narrative Review, Vrushank Shah, Alexander King

Rowan-Virtua Research Day

Platelet-rich plasma (PRP) has emerged as a potential treatment for carpometacarpal (CMC) joint osteoarthritis, with studies suggesting it may offer more durable symptom relief compared to corticosteroids. A comprehensive review of four studies, including two randomized controlled trials (RCTs), a retrospective study, and a pilot study, revealed that both PRP and corticosteroid injections led to short-term improvements in pain and function. However, PRP demonstrated significantly better long-term outcomes, with VAS scores decreasing from 75 to 20 in the PRP group at 12 months, compared to a modest reduction from 70 to 65 in the corticosteroid group. Additionally, PRP showed a …