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Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with vertebral compressive fractures (VCFs) that may occur as a consequence. Vertebral compression fractures (VCFs) can lead to severe acute and chronic pain, impaired mobility, reduced quality of life and an increased risk of mortality due to decreased mobility and pulmonary dysfunction. When painful VCFs do come to clinical attention, they are typically treated with optimal pain management (OPM). Although the natural course of pain due to vertebral fractures decreases within the first weeks in the majority of patients, a number of them remain with persistent pain and/or ongoing vertebral collapse. Facet joint injections are an emerging procedure as possible treatment for a subgroup of patients with persistent pain after VCFs. In case of vertebral collapse or persistent pain after facet joint injections, patients have to be treated with percutaneous vertebroplasty (PVP) or percutaneous balloon kyphoplasty (BKP). PVP is a minimally invasive surgical procedure in which bone cement is injected into a fractured vertebra under radiological guidance using fluoroscopy. BKP is a variation of this approach, in which an inflatable balloon tamp is placed in the collapsed vertebra prior to cement injection, in order to create a cavity allowing low pressure injection. For peo- ple with painful osteoporotic VCFs refractory to analgesic treatment, PVP and BKP perform significantly better in unblinded trials than OPM in terms of improving quality of life and reducing pain and disability. It is possible that BKP and PVP may lead to reductions in mortality. In small subgroup of patients with neurological injury related to an osteoporotic fracture, different open surgical techniques were used to suit different fracture patterns, with good clinical and radiological results.

Low back pain (LBP) is a very common condition with high costs of patient care. Medical doctors of various specialties from Croatia have brought an up-to-date review and guidelines for diagnosis and conservative treatment of low back pain, which should result in the application of evidence-based care and eventually better outcomes. As LBP is a multifactorial disease, it is often not possible to identify which factors may be responsible for the onset of LBP and to what extent they aggravate the patient's symptoms. In the diagnostic algorithm, patient's history and clinical examination have the key role. Furthermore, most important is to classify patients into those with nonspecific back pain, LBP associated with radiculopathy (radicular syndrome) and LBP potentially associated with suspected or confirmed severe pathology. Not solely a physical problem, LBP should be considered through psychosocial factors too. In that case, early identification of patients who will develop chronic back pain will be helpful because it determines the choice of treatment. In order to make proper assessment of a patient with LBP (i.e. pain, function), we should use validated questionnaires. Useful approach to a patient with LBP is to apply the principles of content management. Generally, acute and chronic LBP cases are treated differently. Besides providing education, in patients with acute back pain, advice seems to be crucial (especially to remain active), along with the use of drugs (primarily in terms of pain control), while in some patients spinal manipulation (performed by educated professional) or/and short-term use of lumbosacral orthotic devices can also be considered. The main goal of treating patients with chronic LBP is renewal of function, even in case of persistent pain. For chronic LBP, along with education and medical treatment, therapeutic exercise, physical therapy and massage are recommended, while in patients with a high level of disability intensive multidisciplinary biopsychosocial approach has proved to be effective.

Spinal pain, especially chronic low-back pain is one of the most prominent health and healthcare problems. Better understanding of pain pathophysiology and more precise visualization using modern imaging techniques help us to focus our intervention and obtain better outcome. In most patients with spine conditions symptoms and function resolve with conservative treatment. In this article we report on novelties in pathophysiology of spinal pain, magnetic resonance imaging and conservative treatment options (medications, therapeutic exercise, physical therapy and orthoses) of painful spine conditions and scoliosis. Apart from being informative, together with the corresponding article about novelties in invasive/surgical treatment, this special focus article on recent developments in this area can be used as an aid in decision making when approaching these patients.

Synovial chondromatosis is an uncommon benign disorder of the synovial membrane ofjoints, tendon sheaths, or bursae characterized by the formation of multiple cartilaginous nodules or osseus loose bodies. It is usually a monoarticular disease, and 33 different localizations have been described until now. The aim of this review article is to present the newest knowledge on the etiology, diagnosis, differential diagnosis, and management of synovial chondromatosis. Malignant transformation to chondrosarcoma is an unusual but possible complication. It is closely connected with recurrence rate and usually occurs many years after surgical treatment. More specific details related to surgical treatment of most often affected joints, i.e. shoulder, elbow, hip, knee, and ankle are reported as well at the end of this review article.

Rheumatic diseases represent one of the most common health problems for which patients visit the doctor. This fact imposes the need for verification of clinical symptoms and clear presentation ofpathomorphyology changes primarily because of the best methods of treatment selection. A wide range of diagnostic imaging modalities are available today: conventional radiography, conventional myelography, computed tomography (CT), CT myelography, magnetic resonance imaging (MRI), MR or CT artrography, spinal cord angiography, ultrasound and scintigraphy, and combined radiological methods and scintigraphy (PET-CT). Each of the above methods has its own importance, advantages and limitations. Sometimes a method excludes the other, and often support each another in setting the final diagnosis. For the proper choice of radiological imaging methods that will give us insight into the problem, a good knowledge of their capabilities, and a clear clinical inquiry are necessary. But most of all, good cooperation of clinicians and radiologists who should be diagnostic team responsible for that sets the indication for radiological examination is essential.

Purpose: The aim of this study was to determine the efficacy of the microfracture method in the treatment of symptomatic osteochondral lesion of the talus., Materials and Methods: 24 patients operated by the mentioned method were prospectively followed-up. Standard radiological treatment was performed in all patients, ankle CT was performed in 10 patients, and MR was performed in 8 patients. Patients' subjective satisfaction with operation was assessed by SANE and Martin's score, while the objective function was assessed by AOFAS and Freiburg's score., Results: The mean preoperative AOFAS score was 53 (from 31 to 61), while the mean postoperative AOFAS score was 87.5 (from 81 to 100). Postoperative Freiburg's score was 89.5 (from 76 to 100). The distribution of treatment outcomes was evaluated by the Martin's score and it revealed excellent, good and satisfying results in 94.5% patients, while the distribution of outcomes by the SANE questionnaire revealed excellent and good result in 91.8% patients., Conclusion: The arthroscopy of the ankle with microfractures is safe, cheap and effective method in the treatment of osteochondral lesions.