Clinical Correlations Between Diagnostic Assessment Methods and Functional Outcomes in Musculoskeletal...

Musculoskeletal disorders are major contributors to pain, disability, reduced participation, and health-care utilisation. Structural and digital diagnostic tools can characterise pathology, but their ability to explain functional limitations and rehabilitation prognosis is often incomplete. This narrative review aimed to synthesise representative evidence on the relationship between diagnostic and screening methods and functional outcomes in musculoskeletal rehabilitation, with emphasis on clinical interpretation and practical use in care pathways.

Peer-reviewed literature, supplemented by manual screening of relevant reference lists, was reviewed to identify publications available through March 2026. The synthesis prioritised studies linking diagnostic findings to patient-reported outcome measures (PROMs), performance-based tests, or real-world activity metrics.

Conventional imaging, including ultrasound, computed tomography, and MRI, may identify clinically relevant pathology but often shows only modest concordance with pain, disability, and performance-based function. PROMs and brief performance tests provide the most direct functional anchors, whereas interpretation using the minimal clinically important difference (MCID) or responder thresholds is needed to distinguish statistically detectable associations from clinically meaningful change. Biomarkers and AI-supported analytics remain promising but insufficiently validated for independent functional prognostication. Wearable sensors appear most clinically useful for longitudinal monitoring of real-world activity, and brief psychosocial screening helps explain the discordance between structural findings and perceived disability.

Functional prognosis in musculoskeletal rehabilitation should not rely on diagnostic findings alone. A multidimensional, function-centred first-visit bundle combining focused examination, one region-specific PROM, one brief performance test, and brief psychosocial risk screening may improve triage, patient communication, rehabilitation planning, and follow-up. Diagnostic escalation should be selective and reserved for red flags, management-changing pathology, or failure to improve on repeated standardised functional reassessment.