Efficacy of ultrasound elastography in detecting active myositis in children: can it replace MRI?

Abstract

Compression-strain US elastography does not accurately detect active myositis in children with juvenile idiopathic inflammatory myopathy and cannot replace MRI as the imaging standard for detecting myositis in these children. The association between abnormal US elastography and increased muscle echogenicity suggests that elastography is capable of detecting muscle derangement in patients with myositis; however further studies are required to determine the clinical significance of these findings.

Muscle shear wave elastography in idiopathic inflammatory myopathies: a case–control study with MRI correlation

“…Potential underlying mechanisms include increased intra- and extra-cellular water content in the case of oedema and loss of myofibre contractile properties in atrophy. However, this association is in contrast to the findings of Song et al [ 16 ] and Berko et al [ 17 ], who reported no statistically significant correlation using strain elastography. The technical and mechanical factors of strain elastography may have limited its capability to detect the myositis-induced elasticity changes.…”

“…The failure of muscle elastography to correlate with IIM disease activity was reported by Song et al [ 16 ] and Berko et al [ 17 ]. The latter, however, used the physician’s grading of disease activity as the measure instead of CK.…”

“…A previous study used magnetic resonance elastography (MRE) [ 14 ] and reported a significantly decreased muscle stiffness. In contrast, strain elastography studies [ 15 – 17 ] reported increased muscle stiffness [ 16 ] and correlations with muscle enzymes [ 15 ] and echogenicity [ 17 ]. However, these studies are difficult to compare owing to their varying design and methodologies.…”

Emerging Technological Advances in Musculoskeletal Ultrasound

“…This information was then used to guide botulinum toxin injections [6]. Elastography has also been applied in the evaluation of inflammatory myopathies [35,36]. Botar‐Jid et al evaluated patients with inflammatory muscle diseases including dermatomyositis and polymyositis and found concordance between the elastography colorgram and serum creatine kinase and lactic dehydrogenase markers [36].…”

“…Botar-Jid et al evaluated patients with inflammatory muscle diseases including dermatomyositis and polymyositis and found concordance between the elastography colorgram and serum creatine kinase and lactic dehydrogenase markers [36]. However, other studies have suggested that sonoelastography does not accurately detect active myositis in children with juvenile idiopathic inflammatory myopathy as compared to the gold standard of MRI [35]. Sonoelastography has more established literature supporting its use in the evaluation of tendon disorders; further studies are needed to define its role in the evaluation of muscle disorders.…”