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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Osteoporosis is a systemic skeletal disease characterized by low bone mineral density (BMD) and poor bone quality, leading to reduced bone strength and increased risk of fracture. In rheumatic and musculoskeletal diseases (RMD), including rheumatoid arthritis (RA) and spondyloarthritides (SpA), such as axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA), generalized bone loss associated with traumatic and non-traumatic fractures, such as insufficiency fractures (IF), is known to occur with the RANK-RANKL-osteoprotegerin axis and the Wnt-β-catenin signalling pathway playing a pathogenetic role. RA has been included in the Fracture Risk Assessment Tool (FRAX) system to be able to more precisely calculate the 10-year fracture risk associated with the disease. Various definitions for IF have been proposed; a recent paper by the EMA has defined fragility fractures as fractures occurring with low trauma at the hip, spine, pelvis, distal femur, proximal tibia, humerus, forearm, and multiple ribs. However, IF of the feet are currently not considered osteoporotic fractures. So-called stress fractures, which are known to often occur in athletes, have a similar MRI appearance. However, these are rather due to repetitive strain than to minor trauma. Also, based on recent data, this manuscript concentrates on the significance of fragility fractures in RMD.

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Immune checkpoint inhibitors (ICIs) have transformed cancer care, but their use is frequently complicated by immune-related adverse events (irAEs), including rheumatic manifestations such as arthritis. Distinguishing between inflammatory and non-inflammatory musculoskeletal symptoms is challenging, yet critical for appropriate management. Musculoskeletal ultrasound (MSKUS) provides unique advantages in this context by enabling the detection of subclinical synovitis, periarticular pathology, and crystal deposition, while also facilitating treatment decisions, including targeted corticosteroid injections. We present four cases that highlight the utility of MSKUS as a frontline tool in the evaluation of musculoskeletal irAEs.

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In the past decade, the metabolic syndrome has been recast as a chronic inflammatory disease whose mechanisms involve macrophage and neutrophil activation, initiation of the nod-like receptor protein 3 (NLRP3) inflammasome, and IL-1β secretion. Colchicine, an inhibitor of NLRP3, has been linked to the prevention or amelioration of diseases associated with the metabolic syndrome, including diabetes and cardiovascular disease. Its underlying therapeutic mechanisms extend beyond direct suppression of NLRP3, and include sirtuin and AMP-activated protein kinase (AMPK) pathway regulation, and downregulation of cellular stress signals, which promote atherosclerotic plaque rupture, insulin resistance, and obesity. Colchicine’s proven efficacy in preventing cardiovascular disease is a promising new development recognized by its inclusion in the 2023 American College of Cardiology treatment guidelines. As colchicine’s effects are better understood, along with a clearer understanding of metabolic syndrome’s pathophysiology, promising new applications and uses for this old drug may be on the horizon and are worthy of further investigation. In this review, we discuss colchicine’s pharmacology and explore its established and emerging anti-inflammatory mechanisms, and the role these could play in disrupting the chronic inflammation in metabolic syndrome and associated diseases.

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Gout is a chronic inflammatory arthritis driven by monosodium urate crystal deposition and the NACHT, LRR, and PYD domains-containing protein 3 (NLRP3) inflammasome activation, leading to interleukin-1β (IL-1β)-mediated inflammation. Recent studies reveal that hyperuricemia induces a state of immunological memory in innate immune cells through persistent epigenetic and metabolic reprogramming of monocytes and macrophages. These alterations enhance the responsiveness of innate immune cells, leading to exaggerated inflammatory reactions upon subsequent stimulation. This review synthesizes recent studies that elucidate how metabolic shifts (e.g., increased glycolysis and fumarate accumulation) and epigenetic changes (e.g., altered histone methylation and DNA methylation) reinforce this pathogenic memory. Importantly, these mechanistic insights provide the rationale for emerging therapeutic strategies: IL-1β inhibitors aim to interrupt the central inflammatory axis; metabolic modulators (e.g., metformin, statins) seek to reverse the trained metabolic state; and epigenetic therapies [e.g., histone deacetylase (HDAC) or DNA methyltransferase (DNMT) inhibitors] hold potential to reset dysregulated immune programming. Collectively, this review argues that multi-layered intervention, such as cytokine blockade for acute control, coupled with metabolic or epigenetic remodeling for long-term reprogramming, could yield sustained disease suppression and reduced flare frequency in gout.

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