Joint Pathology Research Articles

Protective effects of Catalpol to attenuate TNF- α and collagen-induced inflammation in vitro HFLS-RA cells and in vivo mice models for the treatment of rheumatoid arthritis.

Rheumatoid Arthritis (RA) is a prolonged autoimmune condition marked by persistent inflammation, causing joint damage and bone erosion. Catalpol (CAT), an iridoid glycoside, offers anti-inflammatory benefits, warranting its study in RA models. To investigate the anti-inflammatory effects of CAT in RA by evaluating its impact on cellular and animal RA models. In vitro biological actions of CAT were investigated by the methods of cell viability, proliferation, migration, invasion, apoptosis, ROS generation, double luciferase reporter assay for NF-κB-p65 activity, Nitrite release detection, and RT-qPCR for gene expression in Tumor Necrosis Factor-alpha (TNF-α)-induced Human Fibroblast-Like Synoviocytes from RA patients (HFLS-RA) (cellular RA model). Arthritis severity, joint cellular structure, gene expression, inflammatory factors, and joint inflammation studies were investigated in mice with collagen-induced arthritis (CIA) (animal RA model). CAT treatment groups showed significant improvements (P < 0.001) in cell viability, migration, invasion, and apoptosis compared to the TNF-α-induced group. ROS generation and the activity of NF-κB-p65 were significantly reduced (P < 0.001). Nitrite release was decreased (P < 0.01, P < 0.001) in CAT-treatment groups. Pro-inflammatory and bone-metabolizing cytokine gene expression was markedly downregulated (P < 0.05, P < 0.001) in the cellular RA model. CIA mice treated with CAT exhibited significantly reduced arthritis severity, paw edema, and arthritis index (P < 0.05, P < 0.01). Joint pathology scores showed improvement (P < 0.001) in CAT-treatment groups. In the animal RA model, bone-metabolizing and inflammatory cytokine gene expression was significantly reduced in CAT-treatment groups (P < 0.01, P < 0.001). CAT effectively reduces RA's inflammation and bone metabolism issues, suggesting its potential as a therapeutic agent for RA treatments. Key Points • Plant-derived Catalpol compound is an effective choice for rheumatoid arthritis treatment due to its anti-inflammatory potential. • CAT's effects were tested on TNF-α-induced HFLS-RA cells and in CIA mice, assessing cell viability, apoptosis, ROS generation, arthritis severity, inflammatory factors, and joint inflammation studies. • The administration of CAT could greatly enhance cell health and reduce inflammation markers and arthritis symptoms. • Observed significant reduction of RA inflammation and bone issues, confirming CAT as a therapeutic agent in RA treatment.

Dental and temporomandibular joint pathology of the North American river otter (Lontra canadensis)

Dental and temporomandibular joint pathology of the North American river otter (Lontra canadensis)

Multi-Scale Analysis of Knee Joint Acoustic Signals for Cartilage Degeneration Assessment

This study focuses on the diagnostic analysis of cartilage damage in the knee joint based on acoustic signals generated by the joint. The research utilizes a combination of advanced signal processing techniques, specifically empirical mode decomposition (EEMD) and detrended fluctuation analysis (DFA), alongside convolutional neural networks (CNNs) for classification and detection tasks. Acoustic signals, often reflecting the mechanical behavior of the joint during movement, serve as a non-invasive diagnostic tool for assessing the cartilage condition. EEMD is applied to decompose the signals into intrinsic mode functions (IMFs), which are then analyzed using DFA to quantify the scaling properties and detect irregularities indicative of cartilage damage. The separation of individual frequency components allows for multi-scale analysis of the signals, with each of the functions resulting from the analysis reflecting local variations in the amplitude and frequency over time and allowing for effective removal of noise present in the signal. The CNN model is trained on features extracted from these signals to accurately classify different stages of cartilage degeneration. The proposed method demonstrates the potential for early detection of knee joint pathology, providing a valuable tool for preventive healthcare and reducing the need for invasive diagnostic procedures. The results suggest that the combination of EEMD-DFA for feature extraction and CNN for classification offers a promising approach for the non-invasive assessment of cartilage damage.

The role of facet joint degeneration in the treatment success of transforaminal epidural steroid injection: a retrospective clinical study.

Transforaminal epidural steroid injection (TFESI) is highly effective in alleviating radicular back pain. While predictive factors for TFESI treatment outcomes have been previously studied, there is a lack of data on the relationship between facet joint degeneration and TFESI efficacy. This study is aimed at studying the impact of facet joint degeneration on TFESI treatment outcomes for unilateral radicular pain. A retrospective analysis was conducted on patients with unilateral radicular pain who underwent lumbosacral TFESI. Pain severity was assessed using the Numerical Rating Scale (NRS) at baseline, 1h post-procedure, and 3weeks post-procedure. Degree of facet joint degeneration was evaluated via MRI. Patients were categorized into two groups: low-grade facet joint degeneration group (group 1) and high-grade facet joint degeneration group (group 2). A total of 147 patients were included in the study. NRS scores were significantly higher in group 2 compared to group 1 at the 3rd week follow-up. Treatment success, defined as a ≥ 50% reduction in NRS scores, was also significantly higher in group 1. Facet joint degeneration adversely impacts the treatment success of TFESI. A comprehensive evaluation of facet joint pathologies prior to procedure planning is imperative for optimizing treatment outcomes.

Interposition Arthroplasty with Meniscal Allograft for the Treatment of Sternoclavicular Joint Pathology; The SC Calamari Technique.

Painful degeneration of the sternoclavicular joint refractory to nonoperative treatment has historically been managed with resection of the degenerative segment of the medial clavicle. Although this has produced good results with improvement in symptoms, recurrent pain necessitating revision surgery is not an infrequently encountered outcome. To reduce the occurrence of recurrent postoperative pain, a novel technique to reconstruct the intra-articular disc at the time of medial clavicle resection was developed. 10 patients whom underwent medial clavicle excision and interposition arthroplasty with a lateral meniscus allograft were retrospectively reviewed. Functional results were based on VAS pain scores and subjective shoulder scores. VAS pain score improved from 7.5 (5-10) preoperatively to 1.2 (0-2; p = .005, W-value = 0) postoperatively, with an average improvement of 6.3. The mean preoperative SSV score improved from 54.5 (25-70) preoperatively to 88.5% (80-95%; p = .005; W-value = 0) postoperatively, with a mean increase of 34 percentage points. No patients experienced a complication and or recurrence of pain at most recent follow-up. Minimal excision of the medial clavicle and interposition arthroplasty with lateral meniscal allograft successfully reduces pain and restores stability and function for the treatment of painful degeneration of the SC joint.

Advancement of 3D biofabrication in repairing and regeneration of cartilage defects.

Three-dimensional (3D) bioprinting, an additive manufacturing technology, fabricates biomimetic tissues that possess natural structure and function. It involves precise deposition of bioinks, including cells, and bioactive factors, on basis of computer-aided 3D models. Articular cartilage injurie, a common orthopedic issue. Current repair methods, for instance microfracture procedure (MF), Autologous chondrocyte implantation (ACI), and Osteochondral Autologous Transfer Surgery (OATS) have been applied in clinical practice. However, each procedure has inherent limitation. For instance, microfracture surgery associates with increased subchondral cyst formation and brittle subchondral bone. ACI procedure involves two surgeries, and associate with potential risks infection and delamination of the regenerated cartilage. In addition, chondrocyte implantation's efficacy depends on the patient's weight, joint pathology, gender-related histological changes of cartilage, and hormonal influences that affect treatment and prognosis. So far, it is a still a grand challenge for achieving a clinical satisfactory in repairing and regeneration of cartilage defects using conditional strategies. 3D biofabrication provide a potential to fabricate biomimetic articular cartilage construct that has shown promise in specific cartilage repair and regeneration of patients. This review reported the techniques of 3D bioprinting applied for cartilage repair, and analyzed their respective merits and demerits, and limitations in clinical application. A summary of commonly used bioinks has been provided, along with an outlook on the challenges and prospects faced by 3D bioprinting in the application of cartilage tissue repair. It provided an overall review of current development and promising application of 3D biofabrication technology in articular cartilage repair.

Wnt signaling drives stromal inflammation in inflammatory arthritis.

The concept that fibroblasts are critical mediators of inflammation is an emerging paradigm. In rheumatoid arthritis (RA), they are the main producers of IL-6 as well as a host of other cytokines and chemokines. Their pathologic activation also directly causes cartilage and bone degradation. Yet, therapeutic agents specifically targeting fibroblasts are not available. Here, we find that Wnt receptors and modulators are predominantly expressed in stromal populations in the synovium. Importantly, non-canonical Wnt activation induces robust inflammatory gene expression including an abundance of cytokines and chemokines in synovial fibroblasts in vitro . Strikingly, the addition of Wnt ligands or inhibition of Wnt secretion exacerbates or reduces arthritis severity, respectively, in vivo in a murine model of inflammatory arthritis. These observations are relevant in human disease, as Wnt activation signatures are enhanced in fibroblasts derived from inflamed RA synovial tissue as well as fibroblasts across other inflammatory diseases. Together, these findings implicate Wnt signaling as a major driver of fibroblast-mediated inflammation and joint pathology. They further suggest that targeting the Wnt pathway is a therapeutically relevant approach to rheumatoid arthritis, particularly in patients who do not respond to conventional treatments and who often express fibroblast-predominant synovial phenotypes.

Radiographic Severity of Knee Osteoarthritis in Adult Spinal Deformity: the Effect on Rod Fracture after Long Spinal Fusion in Deformity Correction.

Instrumentation failure, notably rod fracture (RF), may occur even after ideal spinal deformity correction in adult spinal deformity (ASD). As RF is the major reason behind a revision surgery, various risk factors of RF are reported in literature, including pedicle subtraction osteotomy (PSO) technique itself. However, whether hip and knee joint diseases serve as another risk factor for RF remains unexplored. To investigate the effects of lower-extremity joint diseases on RF in ASD patients who underwent deformity correction through long-segment fixation with PSO. Retrospective study PATIENT SAMPLE: 96 consecutive ASD patients (mean age, 71.2 years) who underwent deformity correction through PSO and long-segment fixation from T10 to S1 between 2008 and 2019 were included. Those with radiographic data less than 2 years were excluded. RF was confirmed on radiograph, computed tomography (CT) and bone scan or SPECT images. Coronal and sagittal spinopelvic parameters, lower-extremity osteoarthritis (OA) parameters and clinical outcomes (Oswestry Disability Index [ODI] and Visual Analog Scale [VAS]) were analyzed. Radiographic measurements were performed at preoperative, postoperative, and last follow-up visits. Patients were divided into two groups: non-RF (n = 60) and RF (n = 36). Radiographic factors were assessed, correlations between parameters were examined, and multivariate logistic regression analysis was performed to evaluate risk factors for RF. Structural and functional leg length discrepancies (LLDs), pelvic obliquity (PO), and the differences of mechanical axis (MAD) between both extremities had significantly differed between the groups (P < 0.05). The between-knee differences in the extent of OA, clinically significant MAD and PO, and the incidences of both structural and functional LLD were significantly greater in the RF group than in the non-RF group (P<0.05). On correlation analysis, PO was not correlated with coronal radiographic parameters but was correlated with structural and functional LLDs and MAD (P<0.05). Logistic analysis revealed that the difference in OA grade between the knee joints, functional LLD, and preoperative lower extremity surgery were significantly associated with RF (P<0.05). ASD in the elderly often presents alongside degenerative changes in the lower-extremities, and even with ideal spinal deformity correction, RF may still occur if pre-existing joint pathologies are not resolved. In the deformity correction of ASD, it is essential that we not only pursue the restoration of spinopelvic harmony, but also apply perioperative measures for lower-extremity degenerative joint diseases.

Magnetic resonance imaging findings of intra articular hip pathology in collegiate american football players

Numerous studies of intra articular hip disorders have been performed, many revealing anterosuperior joint pathology However we have encountered hip injuries in less common locations in American Football players

Diagnostic capacity of magnetic resonance imaging in studying dysplastic-dependent pathology of temporomandibular joint

Diagnostic capacity of magnetic resonance imaging in studying dysplastic-dependent pathology of temporomandibular joint

PREOPERATIVE PLANNING OF ARTHROSCOPIC SYNOVECTOMY IN PATIENTS WITH KNEE INJURIES AND CONCOMITANT PATHOLOGY

Knee joint pathology poses a significant challenge in modern orthopaedics, driven by the rising incidence of traumatic injuries and their frequent association with comorbid conditions. Epidemiological data report an annual knee injury incidence of 5.3 per 1,000 population, with approximately 40% of cases progressing to synovitis. The presence of comorbidities significantly influences disease progression and treatment outcomes, underscoring their clinical importance. This study aimed to identify key factors affecting the quality of preoperative planning for arthroscopic synovectomy, with a focus on individual patient characteristics and the specific nature of concomitant pathologies. This study included 97 patients (2020–2024), categorized into two groups: traumatic pathology (n = 50) and degenerative pathology (n = 47). The assessment protocol comprised clinical evaluation using the Knee Injury and Osteoarthritis Outcome Score, magnetic resonance imaging analysis based on the Whole-Organ Magnetic Resonance Imaging Score and the Boston Knee Osteoarthritis Scoring System, inflammatory marker measurements, and comorbidity profiling. Statistical analysis revealed significant variations in synovitis severity and functional parameters correlating with comorbidity patterns. The concurrent presence of grade II- III hypertension and diabetes mellitus demonstrated the most adverse clinical profile, characterized by maximum synovitis scores (2.0 points by the Whole-Organ Magnetic Resonance Imaging Score) and severely compromised functional parameters (35.9±1.2 points by the Pain subscale of Knee Injury and Osteoarthritis Outcome Score). The study has established key risk factors for severe synovitis and developed a comprehensive risk stratification system, categorizing patients into low-, moderate-, and high-risk groups, facilitating the implementation of individualized preoperative management strategies tailored to their comorbidity profiles.

Surgical correction of Hip-spine syndrome in a child with mucopolysaccharidosis type IVb: 10 years follow-up

Relevance. According to the results of surgical treatment, the sagittal imbalance of the spine was eliminated, the pain syndrome was stopped, and the patient’s independent movement was restored without the use of auxiliary devices (walkers). Results. In patients with combined pathology of the spine and hip joints, violations of the X-ray anatomical indices of the trunk balance lead to the development of severe pain syndrome, reduces exercise tolerance, and the quality of life. Correction of sagittal imbalance of the trunk becomes particularly relevant in this group of patients. Conclusion. If it is impossible to perform hip replacement to correct sagittal imbalance of the trunk in patients with combined pathology of the hip joint and spine corrective osteotomy of the lumbar spine is a non-standard treatment method, is potent of improving prognosis and quality of life in patients.

Pathology of the temporomandibular joint in dental diseases

Temporomandibular joint diseases (TMJ) significantly reduce the quality of life, causing such unpleasant symptoms as orofacial pain, joint sound, limited mouth opening, tinnitus, insomnia. TMJ pathology can be a consequence of both the dental interventions themselves and diseases of the oral cavity, including complete or partial edentia, malocclusion, dominance of one chewing side, periodontitis, etc. The purpose of this review was to study, based on literature data, possible disorders in the temporomandibular joint (TMJ) in dental pathology. The risk factors for the development of TMJ, the most common symptoms, clinical picture, features of differential diagnostics, the relationship with the use of general anesthesia, age-related changes are considered. The relationship of TMJ with dental diseases is considered in detail. The mutual influence of changes in the TMJ and the dentition has been confirmed. A conclusion has been made about the need for constant attention to the pathology of the TMJ in dental diseases.

Total-body positron emission tomography: a tool for systemic, quantitative evaluation of the inflammatory burden of psoriatic arthritis.

To test the hypothesis that recently-developed total body-positron emission tomography (TB-PET) imaging with integrated computed tomography (CT) will enable low-dose, quantitative, domain-specific evaluation of the total inflammatory burden of psoriatic arthritis (PsA), and associate with established outcome measures of the clinical domains of PsA. Seventy-one adult participants (40 with PsA, 16 with rheumatoid arthritis (RA), and 15 with osteoarthritis (OA)) underwent 20-min TB-PET/CT scans using [18F]FDG, a glucose analogue radiotracer. [18F]FDG uptake was assessed qualitatively and quantitatively. Rheumatological examinations were performed prior to the scan. For both evaluations, domain-specific assessments included 68 joints, 6 entheses, 20 nails, axial disease and dactylitis. [18F]FDG PET uptake consistent with joint involvement and enthesitis were noted in 100% of participants with PsA. Other features included nail matrix pathology (53%), spinal involvement (60%), active sacroiliitis (13%) and dactylitis (10%). Patterns of [18F]FDG uptake in PsA differed from those in participants with RA or OA. There was a high concordance between TB-PET measures and the domain-specific assessments of joint (75%), entheseal (79%) and nail (65%) pathology. TB-PET was positive for an additional 15% joints, 20% entheses and 13% nails that were negative on clinical assessments. TB-PET/CT identified inflammatory pathologies characteristic to all clinical domains of PsA and thus provided an in vivo evaluation of systemic PsA inflammatory burden. This promising tool may further contribute to identifying pathologies that may be occult, provide biomarkers to diagnose and differentiate PsA at an early stage, and to monitor early treatment response.

Polyneuropathy in Rheumatoid Arthritis (literature review)

Rheumatoid arthritis is the most common rheumatological disease. In addition to joint pathology, it often causes damage of other organs and tissues. This article discusses the possibility of diffuse damage of the peripheral nervous system in rheumatoid arthritis - frequency, mechanisms of damage, peculiarities of the clinical symptoms. The relevance of this problem is due to the possibility of subclinical course of polyneuropathy in rheumatoid arthritis, and, consequently, the lack of diagnosis, while one of its variants - autonomic neuropathy, is a life-threatening pathology. In the presence of pain in the clinical picture of polyneuropathy, problems arise in its interpretation (neuropathic, nociceptive - joint pain), and, therefore, errors in dose adjustment of disease-modifying drugs are possible. For neurologists the problem of polyneuropathy in rheumatoid arthritis is interesting from the point of view of diagnosing the etiology of this disease, which is always a difficult task.

CSF1-R inhibition attenuates posttraumatic osteoarthritis and quadriceps atrophy following ligament injury.

Knee osteoarthritis contributes substantially to worldwide disability. Post-traumatic osteoarthritis (PTOA) develops secondary to joint injury, such as ligament rupture, and there is increasing evidence suggesting a key role for inflammation in the aetiology of PTOA and associated functional deficits. Colony stimulating factor 1 receptor (CSF1-R) has been implicated in the pathogenesis of musculoskeletal degeneration following anterior cruciate ligament (ACL) injury. We sought to assess the efficacy of CSF1-R inhibition to mitigate muscle and joint pathology in a mouse model of PTOA. Four-month-old mice were randomized to receive a CSF1-R inhibitor and studied for 7 or 28days after joint injury. Additionally, we profiled synovial fluid samples for CSF1-R from patients with injury to their ACL. Transcriptomic analysis of quadriceps muscle and articular cartilage in CSF1-R inhibitor-treated animals at 7days after injury revealed elevated chondrocyte differentiation within articular cartilage and enhanced metabolic and contractile gene expression within skeletal muscle. At 28days post-injury, CSF1-R inhibition attenuated PTOA severity and mitigated skeletal muscle atrophy. Patient synovial fluid CSF1-R levels correlated with matrix metalloproteinase 13, a prognostic marker and molecular effector of PTOA. Our findings support an opportunity for CSF1-R targeting to mitigate the severity of PTOA and muscle atrophy after joint injury. KEY POINTS: Posttraumatic osteoarthritis (PTOA) of the knee commonly results from direct injury to the joint, which is characterized by pain, weakness, and disability. Induction of colony stimulating factor one receptor (CSF1-R) is positively associated with knee trauma severity, and the initial acute inflammatory state suppresses muscle recovery and degrades articular cartilage. Skeletal muscle and articular cartilage transcriptomic response following direct joint injury in a murine model of PTOA is rescued by pharmacological inhibition of CSF1-R. CSF1-R inhibition mitigated skeletal muscle atrophy and attenuated PTOA severity and synovitis. Patient synovial fluid CSF1-R levels correlated with matrix metalloproteinase 13, a prognostic marker and molecular effector of PTOA, offering further evidence for CSF1-R as a therapeutic target across musculoskeletal tissues after injury.

Accuracy and reliability of tibial torsion measurement using radiography and ultrasound in dogs.

Tibial torsion assessment is crucial for understanding deformities and malalignments that can lead to joint pathologies in dogs. Different methods such as radiography, computed tomography (CT), and three-dimensional (3D) volume-rendering techniques have been employed to measure tibial torsion. This study compared the accuracy and reliability of tibial torsion angle (TTa) measurements obtained using radiography and ultrasound tilting techniques against those obtained using the 3D volume-rendering method in small-to-medium-sized non-chondrodystrophic dogs. Seven dogs with 11 hind limbs were included in this study. Descriptive statistics revealed mean TTa values for radiography (1.6° ± 5.14°), ultrasound (2.92° ± 3.98°), CT (4.57° ± 3.44°), and 3D volume-rendering method (5.29° ± 3.30°). Intraclass correlation coefficient (ICC) analysis indicated excellent intra- and interobserver agreement between the radiography and ultrasound methods. Correlation analysis showed positive correlations between all the methods. These findings demonstrate that radiography and the ultrasound tilting technique are reliable alternatives for measuring TTa. Although slightly lower ICC values were observed than those of the 3D volume-rendering technique, the radiography and ultrasound methods still exhibited good to excellent reliability, suggesting that these alternative methods could be effective diagnostic tools for assessing TTa in clinical settings with high accuracy and reliability.

Measurement of ground reaction forces in cats after total hip replacement.

The aim of this study was to evaluate ground reaction forces (GRFs) in cats after unilateral total hip replacement (THR) and compare them with cats after femoral head and neck ostectomy (FHO). The databases of the Small Animal Clinic of the Veterinary University in Vienna and three referral clinics were searched for cats that had undergone unilateral THR with the BioMedtrix Micro total hip system or FHO more than 6 months previously. Owners were invited to complete a survey and bring their cats for re-examination, inlcuding clinical and orthopaedic examinations, hip radiography and a gait analysis using a pressure-sensitive plate. Nine cats were included in each group. Cats after THR showed larger GRF values (peak vertical force [PFz] and vertical impulse [IFz] normalised to total force [%TF]) on the operated limb. The resulting symmetry indices (SIs) were lower in terms of vertical force in 7/9 (78%) cats and vertical impulse in 6/9 (67%) cats between the hindlimbs in cats after THR compared with FHO - SI (PFz) = 3.31% ± 2.19% (THR) vs 4.84% ± 2.99% (FHO) and SI (IFz) = 5.17% ± 3.66% (THR) vs 8.27% ± 3.12% (FHO). Cats after FHO showed significantly lower muscle circumference and range of motion (ROM) at the operated hindlimb compared with the contralateral side, whereas cats after THR showed no statistically significant differences between their hindlimbs. Owner surveys revealed significant differences in their subjective assessment of activity and change in gait between the two groups, with better values for cats after THR. This was the first study that measured GRFs in cats after THR. PFz (%TF) and IFz (%TF) values were higher in the operated limb of the THR group than in those of the FHO group, resulting in lower symmetry indices (indicating better symmetry) and better loading of the corresponding hindlimb. This finding is clinically relevant and can help in making decisions regarding the treatment of hip joint pathologies in cats.

β-hydroxybutyrate suppresses pathological changes of blood-induced arthropathy in rats

Arthropathy is a common complication in haemophilia and decreases quality of life. It has been known that concentrations of β-hydroxybutyrate (BHB) in blood are increased by a ketogenic diet, and elevated levels of circulating BHB restricts the progression of inflammation-mediated joint pathological changes. We hypothesized that elevation of blood BHB concentrations could be effective for reducing the progression of bleeding-induced arthropathy by moderating the inflammatory responses of macrophages. In this study, we investigated whether BHB alleviates the arthropathy caused by repeated intra-articular blood injection in rats. To increase blood BHB levels, rats were fed with ketogenic diet. Repeated intra-articular blood injection induced significant joint swelling, whereas ketogenic diet intake significantly increased blood BHB concentrations and ameliorated the joint swelling. The periarticular tissue-fibrosis observed in the control diet intake group appeared to be significantly alleviated in the ketogenic diet intake group. In addition, the IL-1β, which is involved in the progression of arthropathy, levels in the supernatants of blood-exposed macrophages derived from THP-1 cell line were significantly suppressed by BHB supplementation. In summary, BHB moderated the pathological joint changes caused by intra-articular blood exposure.

Advancing Diagnostics: The Role of Ultrasound and MR Imaging in Evaluating Musculotendinous Pathologies of the Shoulder Joint – A Comprehensive Literature Review

Musculotendinous pathologies of the shoulder joint are a common source of pain and functional impairment, often requiring precise imaging for accurate diagnosis and management. This review explores the roles of ultrasound (US) and magnetic resonance imaging (MRI) in evaluating these conditions, focusing on their diagnostic strengths, limitations, and clinical applications. Ultrasound offers dynamic, real-time assessment with high accuracy for superficial structures, making it a cost-effective option for evaluating rotator cuff tears and tendinopathies. MRI, on the other hand, is the gold standard for comprehensive imaging of deep soft tissues, labral injuries, and subtle intra-articular abnormalities. Recent advances in both modalities, including AI-powered ultrasound and faster MRI sequences, have enhanced diagnostic capabilities. This review synthesizes evidence from the past decade, comparing the sensitivity, specificity, and cost-effectiveness of US and MRI while discussing scenarios where their integration can provide the most benefit. The findings emphasize the need for modality selection tailored to clinical presentations, the expertise of practitioners, and healthcare resource availability. Future research should aim to standardize imaging protocols and explore innovative multimodal approaches to improve diagnostic accuracy further.