Mapping of lumbar multifidus stiffness Quantification in ankylosing spondylitis with shear-wave elastography

Abstract

Background Lower back pain and stiffness are the typical symptoms of ankylosing spondylitis (AS). In this study, muscle mass was assessed by muscle density, mechanical elasticity, and area. We investigated the characteristics of lumbar paraspinal-muscle (PSM) mass using muscle ultrasound shear-wave elastography (SWE), as well as the validity of this method for identifying patients with AS. Methods We recruited a representative cohort of 30 AS patients, and 27 healthy volunteers who were age- and sex-matched to the patient study group, investigated the Young’s modulus (YM), cross-sectional area (CSA) and thickness of lumbar multifidus (LM) muscle using SWE. This study did not need to be randomized. Data were collected at the department of ultrasonography of Guangdong Provincial Hospital of Chinese Medicine. We analyzed the data using SPSS version 18.0 (IBM Corp, Armonk, NY, USA). Normal distribution was evaluated by the Shapiro–Wilk test and Q–Q plots. Demographic and baseline data will be analyzed with standard descriptive statistics. Data will be presented as the mean ± standard deviation (SD). Non-normally distributed data are presented as medians with interquartile ranges (IQR). Results Young’s modulus (YM) of SWE in AS patients was significantly higher than that in volunteers. Percentage change in lumbar multifidus (LM) muscle cross-sectional area (CSA) and thickness were significantly lower in AS patients than in healthy volunteers on the left side of the body. Correlation analysis showed a positive correlation between percentage change in CSA and thickness in both volunteers and AS patients. In AS patients, YM was negatively correlated with percentage change of CSA and thickness on the right side, while increased disease duration in AS was associated with increased YM on the left. Conclusion AS patients showed reductions in LM muscle mass and function as the disease progressed, SWE could reflect these changes well. Trial registration. Chinese Clinical Trial Registry, ChiCTR2000031476. Registered 02/04/2020. http://www.chictr.org.cn/index.aspx.

Is musculoskeletal pain associated with increased muscle stiffness? Evidence map and critical appraisal of muscle measurements using shear wave elastography

“…Perhaps the values were reported in the wrong unit or the decimal point was incorrect. References: [1] (Alfuraih et al, 2020), [2] (Aljinović et al, 2020), [3] (Botanlioglu et al, 2013), [4] (Botanlıoğlu et al, 2019), [5] (Dieterich et al, 2020), [6] (Ertekin et al, 2021), [7] (Gao et al, 2020), [8] (Gökşen et al, 2021), [9] (Hashimoto et al, 2022), [10] (Hvedstrup et al, 2020), [11] (Klauser et al, 2022), [12] (Kolding et al, 2018), [13] (Koppenhaver et al, 2020), [14] (Leong et al, 2016), [15] (Li et al, 2021), [16] (Lin et al, 2022), [17] (Masaki et al, 2017), [18] (Masaki et al, 2019), [19] (Murillo et al, 2019), [20] (Pinto et al, 2022), [21] (Sedlackova et al, 2021), [22] (Takashima et al, 2017), [23] (Taş et al, 2018), [24] (Valera‐Calero et al, 2021), [25] (Wang, Cui, et al, 2022), [26] (Wang, Liu, et al, 2022) and [27] (Zhang et al, 2022).…”

“…In six further reports (20.0%), the settings can be obtained from the published images (Botanlıoğlu et al, 2019; Itoigawa et al, 2022; Li et al, 2021; Lin et al, 2022; Sedlackova et al, 2021; Takashima et al, 2017). Solely five articles (16.6%) reported precisely how sufficient image quality was monitored and ascertained (Dieterich et al, 2020; Gao et al, 2020; Koppenhaver et al, 2020; Li et al, 2021; Zhang et al, 2022) and six articles (20.0%) provided imprecise information on quality assurance (Friede et al, 2020; Hashimoto et al, 2022; Klauser et al, 2022; Murillo et al, 2019; Valera‐Calero et al, 2021; Wang, Liu, et al, 2022).…”

“…Two studies (6.6%) conducted a fully computed and therefore reliable image analysis (Dieterich et al, 2020; Wolff et al, 2022). Twenty‐six studies (86.6%) used repeated measurements while three studies (10.0%) used only a single repetition per measurement and subject for the statistical analysis (Masaki et al, 2019; Takashima et al, 2017; Wang, Liu, et al, 2022). The number of measurement repetitions was not reported by Hashimoto et al (2022).…”

“…Thirteen studies (43.3%) included a reliability analysis (Alfuraih et al, 2020;Aljinović et al, 2020;Dieterich et al, 2020;Ertekin et (Wang, Cui, et al, 2022), [26] (Wang, Liu, et al, 2022) and [27] (Zhang et al, 2022). Leong et al, 2016;Li et al, 2021;Masaki et al, 2017;Valera-Calero et al, 2021;Wang, Cui, et al, 2022;Zhang et al, 2022).…”

“…No difference or higher stiffness in symptomatic individuals was identified in eleven studies (36.6%) that investigated chronic neck pain (Taş et al, 2018), migraine (Hvedstrup et al, 2020), cervicogenic headache (Sedlackova et al, 2021), myofascial pain syndrome in the neck region (Valera-Calero et al, 2021), rotator cuff tendinopathy (Leong et al, 2016), posterior shoulder pain (Itoigawa et al, 2022), low back pain (Masaki et al, 2017;Masaki et al, 2019;Murillo et al, 2019), patellofemoral pain syndrome (Botanlıoğlu et al, 2019) and medial tibial stress syndrome (Zhang et al, 2022). Higher stiffness in the symptomatic group was reported by nine studies (30.0%) that investigated whiplash injury (Aljinović et al, 2020), cervicogenic headache (Lin et al, 2022), temporomandibular disorder (Takashima et al, 2017), myofascial pain syndrome in the neck region (Ertekin et al, 2021), low back pain (Gao et al, 2020;Koppenhaver et al, 2020;Wang, Liu, et al, 2022), piriformis syndrome (Hashimoto et al, 2022) and knee osteoarthritis (Li et al, 2021).…”