Hormonal fluctuations significantly influence the human musculoskeletal system. In particular, rapid changes in hormone levels, including estrogen, can induce a variety of physiological alterations. The increased prevalence of musculoskeletal pain in periand postmenopausal women is well-documented, and is thought to arise through multiple mechanisms, encompassing both structural changes in the musculoskeletal system and modifications in the pain modulation pathways. For clinicians, accurate identification and differentiation of the underlying causes of pain are critical for effective management. This review aims to examine the diverse symptoms and etiologies associated with musculoskeletal pain in peri- and postmenopausal women, while providing an overview of key considerations for clinical practice, grounded in recent guidelines.

Frozen shoulder is characterized by progressive stiffness and pain, often leading to significant functional impairments. While its clinical features are well-documented, the literature presents considerable divergence regarding its natural history, with many sources treating it as a self-limiting condition. This review article seeks to explore the natural history of frozen shoulder and reassess the commonly held belief that it resolves spontaneously without intervention. Additionally, by examining the historical and current perspectives on its terminology and reviewing the pathophysiology, this paper aims to enhance understanding of the disorder within the medical community.

Wrist pain, while not the most common musculoskeletal complaint, is frequently encountered by clinicians in outpatient settings.Its prevalence is notably higher among individuals with high daily physical demands, such as manual laborers and athletes.Ultrasound-guided diagnosis and intervention around the wrist joint can be challenging due to the small and superficial nature of the anatomical structures involved. This review provides a detailed overview of various ultrasound-guided injection techniques used in the management of pathology around the wrist joint, highlighting their efficacy and procedural considerations.

Calcific tendinitis, which occurs especially in the shoulder area, is a representative disease that causes shoulder pain due to single or multiple calcium deposits in the rotator cuff tendon or subacromial bursa. In most cases, this disease improves naturally and can be managed with conservative treatment, but some patients continue to experience shoulder pain for a long time without any signs of the deposits resolving. In such cases, new conservative treatment methods such as barbotage and extracorporeal shock wave therapy have emerged as additional management options in recent years. Here, we discuss the classification of calcific tendinitis and the appropriate treatment strategies according to the status of the calcific deposits.

Radicular pain due to spinal degeneration is commonly managed with transforaminal epidural steroid injections (TFESI) to reduce inflammation. However, in cases where pain persists due to central sensitization, pulsed radiofrequency (PRF) stimulation presents a promising adjunctive therapy. PRF avoids the high temperatures of continuous radiofrequency (CRF) stimulation, using a controlled electrical field that reduces the risk of nerve damage while modulating central sensitization pathways. Studies suggest that PRF can provide effective, prolonged pain relief, especially in patients with refractory radicular pain unresponsive to repeated TFESI. PRF’s mechanism involves subthreshold stimulation that induces long-term depression through α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and N-Methyl-D-Aspartate (AMPA) and N-Methyl-D-Aspartate (NMDA) receptor modulation, decreasing pain sensitivity without significant heat generation. Additionally, PRF’s combination with local anesthetics has shown enhanced pain control up to six months. Given the complex interplay between inflammation and central sensitization in chronic radicular pain, PRF may serve as a clinically valuable option, potentially delaying or reducing the need for surgery. Further research is needed to refine PRF protocols and optimize its use in conjunction with conventional therapies.

Knee osteoarthritis (OA) is a common disease, particularly among the elderly, that can cause functional disability due to impaired joint function and pain. Recent studies have shown that extracorporeal shockwave therapy (ESWT) can accelerate the healing of meniscal degeneration and plays a chondroprotective role in OA. However, there can be doubts as to whether ESWT’s effect on knee osteoarthritis is strong enough to offset disease progression, given the difficulty of ESWT in penetrating deep tissues in the human body, the impossibility of exposing the entire knee cartilage and subchondral bone to ESWT, and the nature of the progressive knee OA. In this paper, the author will review the literature published so far to introduce the effectiveness of ESWT in the treatment of knee OA and help readers gain an objective perspective.

Steroids and local anesthetics are the most commonly used agents for treatment of inflammation and diagnostic evaluation of lesions caused by musculoskeletal disorders. They have various duration of effect, potency, and side effects depending on each chemical characteristic. This review compares steroids and local anesthetics commonly used in musculoskeletal disorders and suggests recommended type of steroid according to the type, size, and depth of the lesion. In addition, in this review, caution is considered when using a mixture of steroids and local anesthetics.

Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.

Frozen shoulder, also known as adhesive capsulitis, is a shoulder joint disorder characterized by decreased range of motion without abnormalities on simple radiographs. Pathologically, it involves inflammatory changes and fibrosis of the joint synovium, leading to contracture of the synovial joint of shoulder. The stages of frozen shoulder progress through inflammatory, freezing, frozen, and thawing stages, each requiring different therapeutic approaches. While initial stages may respond to conservative treatments like NSAIDs, steroid injections, and exercises, more advanced stages often require interventions such as scapular nerve blocks, hydrodistension, and manipulation under anesthesia. Among these, ultrasound-guided hydrodistension is highlighted as an effective and safe method, combining potent anti-inflammatory effects with mechanical expansion of the contracted capsule. Clinicians should review the efficacy and safety of various interventional treatments for frozen shoulder, considering the importance of selecting appropriate methods based on the clinical stage of frozen shoulder.

Sarcopenia is an age-related condition which is characterized by a decrease in the mass and function of skeletal muscle and can affect the muscles of the trunk and extremities and the muscles to be used in swallowing. Early diagnosis and appropriate intervention of sarcopenic dysphagia is very crucial for older adults. Sarcopenic dysphagia can be diagnosed by measuring the function, strength, and mass of the affected muscle. In addition, dietary function assessments, functional eating scales and food swallow level scales, video fluoroscopic assessments, and electromyography or manometry can be used to diagnose the sarcopenic dysphagia. Although studies have been published using ultrasound to determine the amount and function of muscle in the body and physical function in sarcopenia, few studies have used ultrasound to diagnose sarcopenia.This paper aims to introduce the use of ultrasonography to assess sarcopenic dysphagia and suggest future research directions.