Paediatric orthopaedics is currently witnessing a profound evolution, transitioning from traditional mechanical fixation toward a future defined by biological restoration and digital precision. The dynamic nature of the growing skeleton necessitates a “growth-aware” surgical philosophy to mitigate the lifelong burden on the child. This narrative review synthesises advancements across pivotal domains: advanced 3D imaging, virtual surgical planning, regenerative biotechnology (the “Diamond Concept”), and smart implant design, based on a rigorous analysis of 76 contemporary sources verified against Medline/PubMed databases. Innovations such as the EOS imaging system and AI-driven diagnostics have significantly reduced cumulative radiation exposure and inter-observer variability. The integration of 3D-printed patient-specific instrumentation and robotic assistance has elevated surgical fidelity in complex spinal and pelvic reconstructions. In the biological realm, the synergy of mesenchymal stem cells, BMPs, and bioactive scaffolds is providing solutions for recalcitrant defects. Furthermore, the advent of bioabsorbable magnesium alloys and internal motorized lengthening nails is effectively eliminating the need for secondary surgeries. The convergence of the “Digital Twin” paradigm with regenerative medicine offers a personalised trajectory for paediatric care. By embracing these advancements, clinicians can restore function while rigorously minimising the physical and psychological burden on the developing child.

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Precision Spine Care integrates individualized diagnostics and interventions tailored to the unique anatomical and clinical characteristics of each patient. Recent advances in artificial intelligence (AI) and machine learning are addressing these challenges by enabling automated image interpretation, tissue segmentation, quantitative analysis of muscular and fascial features, and longitudinal tracking of structural and functional changes. These AI-driven capabilities support objective assessment, early detection of pathology, personalized rehabilitation planning, and continuous monitoring of treatment response. This approach becomes increasingly complex when incorporating advanced interventional techniques such as ultrasound-guided pain injections and AI tools. AI facilitates automated image interpretation, tissue characterization, and structure recognition, improving efficiency and diagnostic consistency. Augmented reality (AR) and mixed reality (MR) technologies enhance spatial orientation, procedural guidance, and anatomy education, while tele-ultrasound expands access to expert consultation, imaging support, and training in underserved regions. Although ultrasound remains operator dependent and AI outputs require ongoing physician oversight, the integration of ultrasound with AI, AR/MR, and telemedicine represents a significant advancement in spine care. These technologies complement traditional anatomical and clinical approaches, improving diagnostic accuracy, procedural precision, and personalized rehabilitation strategies. As healthcare systems face increasing demand and workforce constraints, technology-assisted ultrasound is positioned to play a pivotal role in advancing spine assessment, education, and comprehensive spine-focused musculoskeletal management. Ultimately, AI, ultrasound, and telemedicine serve to augment, not replace clinicians, enabling precision spine care that is safe, effective, and patient-centered.

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The popliteus is a thin, flat, triangular muscle that originates from the lateral condyle of the femur and inserts on the posterior surface of the tibia and soleal line. Injury to the popliteus musculotendinous unit is an infrequent cause of posterolateral knee pain. This can result from a traumatic event or as a result of cumulative overload. This report describes posterior knee pain from a popliteal injury that resulted from an unusual low-velocity mechanism while performing a dance movement, which can be easily missed. Clinical and ultrasonographic features that lead to the diagnosis are described. The patient was able to return to dancing after physical rehabilitation and adjustment to dance technique. The report provides an account of popliteus injury through an unusual mechanism and treatment that can aid the clinician in the diagnosis and management of popliteus injury.

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Work-related musculoskeletal disorders (WMSDs) are a major occupational health burden, yet early functional alterations are often difficult to capture with symptom-only screening or with predominantly structural imaging. Infrared thermography (IRT) provides a noncontact, nonionizing, physiologically grounded readout of superficial heat exchange that is strongly influenced by microperfusion and autonomic vasomotor control. We conducted an integrative narrative review with traceable study-level compilation to synthesize physiological foundations for thermal-signal interpretation, minimum requirements for acquisition standardization and Quality Control, and occupational applications for screening, risk characterization, and longitudinal monitoring, including multimodal integration. The final included corpus comprised 247 studies spanning diverse designs and contexts, with substantial heterogeneity in devices, regions of interest (ROIs), environmental conditions, thermal metrics, and reporting completeness. Across the evidence, interpretability was consistently dependent on protocol stability and on ROI-based, within-subject metrics [bilateral asymmetry, task-induced temperature difference (ΔT), and recovery dynamics] rather than isolated absolute thresholds. Occupational applications have most often targeted repetitive upper-limb demands, computer-based work, and cold challenge/rewarming paradigms in vibration-exposed populations. We provide an operational checklist aligned with guideline recommendations and propose a pragmatic multimodal workflow integrating IRT with functional measures [surface electromyography (sEMG), strength], structural/perfusion modalities (ultrasonography), and patient-reported outcomes. Future priorities include multicenter harmonization, occupation- and task-specific reference profiles, and prospective validation of decision rules under real-world conditions.

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Interstitial lung disease (ILD) is one of the most important extra-articular manifestations of rheumatoid arthritis (RA) due to its associated significant mortality. The availability of pharmacological treatments capable of slowing its progression, especially when initiated early, makes early diagnosis an essential part of its management. The low sensitivity of chest X-ray or lung function tests to identify RA-ILD in the early stages of the disease, together with the cost, accessibility, and ionizing radiation limitations of high-resolution computed tomography (HRCT), especially when serial screening or follow-up studies are required, has prompted the study of lung ultrasound (LUS) as an additional aid for the screening, diagnosis, and/or follow-up of RA-ILD. Based on the safety, low cost, and accessibility of LUS, and the encouraging results of research into this technique in ILD associated with systemic sclerosis, progress has been made in its validation process with research addressing aspects such as its accuracy, feasibility, and reliability. Negative predictive value and sensitivity values exceeding 80–90% have been reported, suggesting its potential utility. Feasibility has been suggested since LUS scan can be performed in less than 10 minutes, and intra- and inter-observer or examiner reliability shows values in the good to excellent range. However, there are still aspects that require further investigation, such as the standardization of the LUS scanning protocol or the requirements to ensure an effective learning curve before applying the technique in clinical practice. It is necessary to recognize the inherent limitations of LUS and understand that it should be considered a tool to aid in the early identification of patients who require HRCT, which is currently the diagnostic gold standard.

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Paediatric orthopaedics has evolved as a specialized branch of orthopaedics, reflecting the understanding of child development and paediatric musculoskeletal disorders. The push for creative ideas and innovations has expanded its scope and indications to a wide group of musculoskeletal disorders in children. This review discusses some of the most impactful innovations of the late 20th and 21st centuries in the field of paediatric orthopaedic surgery and highlights their relevance in the management of complex problems. It includes their evolution over time, current strengths and challenges, and the scope of further improvement in the future. In addition, it discusses the future perspective and possibilities for similar groundbreaking innovations in the field of paediatric orthopaedics.

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Work-related musculoskeletal disorders (WMSDs) are a major global occupational health concern, causing substantial pain, disability, and economic burden. They affect muscles, tendons, nerves, joints, and related structures, arising from or being aggravated by workplace factors. This narrative mini-review synthesizes evidence from targeted searches of peer-reviewed occupational health and ergonomics literature, focusing on epidemiological studies, systematic reviews, and recent advances in risk assessment. The review summarizes current knowledge on the prevalence and risk factors of WMSDs across sectors such as healthcare, manufacturing, construction, transport, and office work, where the lower back, neck, shoulders, and upper limbs are most frequently affected. Physical risk factors include repetitive motion, forceful exertion, awkward postures, prolonged static positions, and vibration exposure, while psychosocial factors such as high job demands, low control, inadequate support, and job dissatisfaction further increase risk. Individual characteristics, including age, gender, body mass index, and genetics, also influence susceptibility and highlight the need for tailored prevention, for example, interventions that accommodate women’s double work burden and age-sensitive strategies that help older workers maintain functional capacity. Advances in biomechanical modeling, wearable sensors, and multifactorial risk assessment now allow more precise exposure quantification and earlier detection of WMSD risk. Effective prevention requires multidisciplinary strategies that combine ergonomic workplace redesign, worker training, organizational policies addressing psychosocial risks, health promotion, and early clinical intervention. By consolidating epidemiological evidence, key risk factors, and prevention approaches from an occupational health perspective, this review supports evidence-informed prevention and underscores that coordinated occupational health policies and participatory workplace practices are essential to achieve sustainable reductions in the global burden of WMSDs.

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The most common clinical manifestation of hyperlipidemia is the formation of xanthomas, which are most often localized subcutaneously, sometimes involving tendons and ligaments, and are usually asymptomatic. A fairly rare manifestation of hyperlipidemia is hypercholesterolemic arthritis caused by cholesterol crystals. In this article, we present a case of atypical xanthoma formation in a patient in the area of the first metatarsophalangeal joint, which resembled a gouty tophus. Taking into account the presence of hyperuricemia in the blood and the “classic” lesion of the first metatarsophalangeal joint, gout was primarily suspected in the patient. The diagnosis of arthritis associated with cholesterol crystals was confirmed using the “gold standard” diagnosis of microcrystalline arthritis—crystal detection using polarization microscopy. This case gives a clear idea of how important it is not to rely solely on the clinical picture when diagnosing gout.

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Antioxidant and anti-inflammatory compound whose biological properties have been linked to modulation of oxidative stress, cytokine signaling, and bone metabolism. Given the central role of oxidative and inflammatory mechanisms in rheumatic diseases, lycopene has emerged as a potential nutraceutical adjunct. This narrative review summarizes current evidence regarding lycopene supplementation and its effects on rheumatic and musculoskeletal disorders, integrating clinical, preclinical, and mechanistic data into a single comprehensive synthesis. A literature search was conducted in PubMed, SciELO, and LILACS up to July 2024, focusing on studies evaluating lycopene in rheumatic or musculoskeletal contexts. Three human studies met the inclusion criteria, all conducted in postmenopausal women, and demonstrated beneficial effects on bone metabolism and oxidative stress markers without adverse effects. Additional experimental evidence supports lycopene’s antioxidant, anti-inflammatory, and bone-protective actions, reinforcing its potential biological relevance in rheumatology. Overall, the available evidence suggests that lycopene may represent a promising, safe, and accessible adjunct for oxidative stress modulation and bone preservation, particularly in osteoporosis. However, the magnitude and durability of these effects remain to be clarified in larger, well-designed randomized trials, especially in inflammatory rheumatic diseases.

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Scleroderma, also known as systemic sclerosis, is a rare connective tissue disorder with an unclear and poorly understood pathogenesis. While it primarily affects the skin and internal organs through mechanisms involving vascular dysfunction, immune dysregulation, and fibrosis, its effects on the peripheral nervous system may also be substantial. We report the case of a 36-year-old male with a known history of scleroderma who presented with chronic, diffuse burning pain throughout the body. His symptoms included daily asthenia, dizziness, nausea, headaches, and limb pain exacerbated by cold, compression, or stretching. Diagnostic ultrasound confirmed multiple peripheral nerve entrapments, which were treated with ultrasound-guided 5% dextrose hydrodissection. This intervention provided significant relief of pain, paresthesia, and motor symptoms, which improved his quality of life. This case highlights the potential of dextrose hydrodissection as a safe, minimally invasive, and cost-effective symptomatic treatment for peripheral neuropathies in patients with scleroderma. Further studies are warranted to establish its broader therapeutic role in treating scleroderma-related neuropathies.

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Adhesive capsulitis, or frozen shoulder, is characterized by pain and progressive restriction of both active and passive shoulder range of motion. The pathophysiology involves an initial inflammatory phase with elevated cytokines, followed by pathological fibrosis, capsular thickening, and contracture involving both intra- and extra-articular structures, including the coracohumeral ligament and rotator cuff interval. Diagnosis is primarily clinical. The traditional three-stage model, freezing, frozen, and thawing, has been challenged by recent evidence showing that spontaneous recovery is uncommon and that many patients do not fully regain shoulder function without active treatment. This paradigm change emphasizes the necessity of early and focused interventions to maximize functional recovery. While physiotherapy remains the mainstay of management, interventional procedures have gained prominence for their ability to reduce pain and facilitate rehabilitation. Interventional options include intra-articular corticosteroid injections, hydrodilatation, and suprascapular nerve blocks. This narrative review summarizes current evidence on interventional procedures for adhesive capsulitis, highlighting their mechanisms, techniques, and comparative efficacy.

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