Reply to Kiral, B.S. Ultrasonographic Evaluation of Superior Cluneal Nerve Entrapment: Methodological Considerations. Comment on "Iudicelli et al. The Role of Musculoskeletal Ultrasound in Detecting Superior Cluneal Nerve Entrapment: Biomechanical Insights in Chronic Low Back Pain-A Pilot Study. Diagnostics 2026, 16, 469".

We thank Dr. Kiral for a thoughtful and constructive commentary, with which we largely agree. Surrogate biomechanical markers and direct visualisation of the SCN are complementary rather than competing: the markers were intended to extend diagnostic support to the many settings and patients in whom direct visualisation is not easy to achieve, whether for patient-related reasons or because high-resolution equipment and dedicated expertise are not universally available. We agree that these findings are supportive rather than primary diagnostic markers, and that their value may lie in the triad within a clinically pre-selected population rather than in any single sign. The nociceptive-neuropathic distinction the author emphasises is itself one of the central conclusions of our study.