Background and purpose Sonoelastography (SE) is a new technique that can assess differences in tissue stiffness. This study investigated the performance of SE for the differentiation of supraspinatus (SSP) tendon alterations of tendinopathy compared to magnetic resonance imaging (MRI) and conventional ultrasonography (US). Methods One hundred and eighteen consecutively registered patients with symptoms and MRI findings of SSP tendinopathy were assessed with US and SE. Coronal images of the SSP tendon were obtained using US and SE. Increased signal intensity on T2-weighted images in the coronal planes were graded according to the extent of the signal changes from ventral to dorsal. SE images were evaluated by reviewers using an experimentally proven color grading system. Results Using SE, 7.6 % of the SSP tendons were categorized as grade 0, 30.5 % as grade 1, 19.5 % as grade 2, and 42.4 % as grade 3. Evaluation of the interobserver reliability of the SE findings showed ''almost perfect agreement'', with a weighted kappa coefficient of 0.83. By comparing the MRI findings with the SE findings, grades of MRI and SE had a positive correlation (r = 0.829, p = \0.001). Furthermore, grades of US and SE also had a positive correlation (r = 0.723, p = \0.001). Conclusions SE is valuable in the detection of the intratendinous and peritendinous alterations of the SSP tendon and has excellent interobserver reliability and excellent correlation with MRI findings and conventional ultrasonography findings.Keywords Rotator cuff Á Tendinopathy Á Ultrasonography Á Sonoelastography Riassunto Obiettivi La sonoelastografia (SE) è una nuova tecnica in grado di valutare le differenze di rigidità dei tessuti. Questo studio ha valutato le capacità della SE nella differenziazione delle alterazioni tendinee da tendinopatia del sovraspinato (SSP) rispetto a risonanza magnetica (MRI) ed ecografia convenzionale (US). Materiali e Metodi Centoventuno pazienti con sintomi e reperti MRI di tendinopatia del SSP sono stati valutati con US e SE. Si sono realizzate immagini coronali del tendine SSP utilizzando US e SE. Sono state valutate immagini T2-pesate, per la maggiore intensità del segnale, nei piani coronali, da ventrale a dorsale. Immagini di SE sono state valutate da revisori che utilizzavano un sistema di grading di colore sperimentale. Risultati Utilizzando la SE, 7,4 % dei tendini SSP sono stati classificati come di grado 0, 29,8 % di grado 1, 19,8 % di grado 2, e 43,0 % di grado 3. La valutazione inter-osservatori dei risultati SE ha mostrato ''accordo quasi perfetto'', con un coefficiente kappa pesato di 0,83. Confrontando i risultati della risonanza magnetica con i risultati della SE, risonanza magnetica e SE hanno avuto una correlazione positiva (r = 0,849, p = \ 0.001). Inoltre, anche US e SE hanno avuto una correlazione positiva (r = 0,706, p = \ 0,001). Conclusioni La SE è valida nella rilevazione delle alterazioni intra-tendinee e peri-tendinee del tendine SSP e ha un'ottima affidabilità inter-osservatori e un'eccellente ...

SE is valuable in the quantitative assessment of the severity of the fatty atrophy of the supraspinatus and has an excellent accuracy, an excellent correlation with MRI and the conventional US, and an excellent interobserver reliability.

Objective The purpose of this study was to evaluate sonoelastography (SE) in the assessment of the long head of biceps tendon (LHBT) in patients with symptoms of biceps tendinitis or tendinosis and in patients without biceps lesion. The findings were compared with those obtained at clinical examination, using ultrasonography (US). Materials and methods 36 shoulders of 34 consecutively registered patients with clinical symptoms and US findings of biceps tendinitis or tendinosis, and 114 shoulders of 98 patients without biceps lesions were assessed with SE. Transverse and longitudinal images of LHBT were obtained using SE. SE images were evaluated by reviewers using an experimentally proven color grading system. Results The transverse images of SE showed a mean sensitivity of 69.4 %, a mean specificity of 95.6 % and a mean accuracy of 89.3 %. Good correlation of conventional ultrasound findings was found (p \ 0.001, r = 0.763). The longitudinal images of SE showed a mean sensitivity of 94.4 %, a mean specificity of 92.1 % and a mean accuracy of 92.7 %. Good correlation of conventional ultrasound findings was found (p \ 0.001, r = 0.585). Inter-observer reliability of SE was in ''almost perfect agreement'' with a weighted kappa coefficient of 0.84. Conclusions SE has potential to be clinically useful in the detection of the intratendinous and peritendinous alterations of LHBT and has excellent accuracy and excellent correlation with conventional ultrasound findings.Keywords Biceps Á Tendinitis Á Tendinosis Á Sonoelastography Riassunto Obiettivo Lo scopo di questo studio è stato quello di valutare l'efficacia della elastosonografia (SE) nello studio del tendine del capo lungo del bicipite (LHBT) in pazienti con sintomi quali tendiniti o tendinosi del muscolo bicipite ed in pazienti asintomatici. I risultati ottenuti sono stati messi a confronto con i dati derivanti dall'esame clinico del paziente e dall'ultrasonografia (US). Materiali e metodi Mediante SE sono state studiate 36 spalle di 34 pazienti sintomatici con evidenza all'ecografia di segni di tendinite o tendinosi del muscolo bicipite e 114 spalle di 98 pazienti che non presentavano lesioni del muscolo bicipite. Alla SE, sono state ottenute immagini con scansioni trasversali ed assiali del tendine del capo lungo del muscolo bicipite. Le immagini ottenute mediante SE sono state valutate da alcuni revisori che utilizzano un sistema comprovato di gradazione del colore. Risultati Le immagini SE ottenute secondo una scansione trasversale hanno mostrato sensibilità media del 69.4 %, una specificità media del 95.6 % ed una accuratezza media del 89.3 %. E' stata riscontrata una buona correlazione con i dati ottenuti mediante US (p \ 0.001, r = 0.763). Le immagini SE ottenute secondo una scansione longitudinale hanno mostrato una sensibilità media del 94.4 %, una specificità media del 92.1 % ed una accuratezza media del 92.7 %. E' stata ottenuta una buona correlazione con i dati ultrasonografici (p \ 0.001, r = 0.585). La variabilità interosservatore della SE ...

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Purpose: Using magnetic resonance imaging (MRI) as the standard of reference, the purpose of this study was to evaluate the accuracy of sonoelastography (SE) for assessment of fatty degeneration of suprasupinatus (SSP). Materials and Methods: A retrospective analysis was conducted in 131 shoulders of 126 consecutive patients who underwent shoulder MRI, and SE. Oblique sagittal images of SSP were obtained using SE; the SE images were evaluated by two orthopedic surgeons using a 256 degree color map image. Results: When the supraspinatus fatty degenerations were based on MRI findings, the sensitivity of SE was 89.47%, specificity 92.85%, and accuracy 91.60%. The interobserver reliability of the SE findings was 'almost perfect agreement' with a weighted kappa coefficient of 0.81. By comparison of MRI with the SE findings, the grades of MRI and SE showed positive correlation (r=0.85, p≤0.001). In addition, the occupation ratio and blue region area ratio also showed positive correlation (r=0.69, p≤0.001). Conclusion: SE is valuable in quantitative assessment of the severity of fatty atrophy of the supraspinatus and has excellent accuracy, excellent correlation with MRI and conventional ultrasonography, and excellent interobserver reliability.

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Glomus tumor is a kind of hemangioma that occurs at the glomerulus in the subcutaneous layer. It mainly occurs at the distal hand and subungual area, and rarely at the knee joint. Pain, tenderness, and cold intolerance are known symptoms; however, symptoms in practice are not so easily detectable, and the diagnosis can be delayed if it is presented at areas other than the hand. If the diagnosis is delayed, patients could suffer extreme pain. Therefore, early diagnosis and surgical treatment are important. Ultrasound and magnetic resonance imaging were used to diagnose glomus tumor in our cases, which were found in subcutaneous tissue and muscle fascia. We claim that, for patients with persistent pain, known symptoms-extreme pain, cold intolerance, and tenderness-should be examined carefully and rule out glomus tumor. We report 2 cases of glomus tumors around the knee joint, which is not a common location of occurrence.