Sonoelastography in the musculoskeletal system: Current role and future directions

Winn, Naomi; Lalam, Radhesh; Cassar‐Pullicino, Victor N.

doi:10.4329/wjr.v8.i11.868

Cited by 76 publications

(57 citation statements)

References 58 publications

(48 reference statements)

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“…17,22 Soft Tissue Masses USE has been extensively explored in tumors outside the MSK system and was found useful in differentiating benign and malignant lesions mainly in the breast. 26 However, the value of USE in the differentiation of MSK tumors is not straightforward because a much greater variation in grade and histologic types occurs in sarcomas compared with breast lesions. [26][27][28][29] One of the early articles on this topic was a short pictorial essay by Lalitha et al They briefly reported that hemangiomas and neurofibromas demonstrate soft to firm consistency, typical of benign lesions (►Fig.…”

Section: Nervesmentioning

confidence: 99%

“…accessibility, susceptibility to pathology, and relatively large size. 26 Two other important sites in USE tendon research are the rotator cuff and the common extensor and flexor tendons of the elbow. [52][53][54] In Achilles tendinopathy evaluation, the studies showed moderate to perfect correlation between the USE and Bmode US and excellent correlation with functional scores.…”

Section: Tendonmentioning

confidence: 99%

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Ultrasound Elastography in Musculoskeletal Radiology: Past, Present, and Future

Snoj

Taljanovic

et al. 2020

Semin Musculoskelet Radiol

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Ultrasound elastography (USE) is becoming an important adjunct tool in the evaluation of various musculoskeletal (MSK) traumatic conditions and diseases, with an increasing number of applications and publications in recent years. This rapidly evolving technique enhances the conventional ultrasound (US) examination by providing information on the elastic properties of tissue alongside the morphological and vascular information obtained from B-mode US and Doppler imaging. Those performing USE must have basic knowledge of its proper imaging techniques and limitations. In this review article, we place the USE in historical perspective and discuss basic techniques and current applications of USE in the evaluation of various traumatic and pathologic conditions of fasciae, nerves, muscles, tendons, ligaments, and MSK soft tissue masses.

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Section: Nervesmentioning

confidence: 99%

Section: Tendonmentioning

confidence: 99%

Ultrasound Elastography in Musculoskeletal Radiology: Past, Present, and Future

Snoj

Taljanovic

et al. 2020

Semin Musculoskelet Radiol

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“…Ultrasound (US) elastography measures tissue elasticity by using high‐frequency sound waves to assess static or dynamic deformation behavior of tissue after a stimulus is applied 1 . This technique has been described most commonly in the context of isotropic tissues, such as the liver, and in neoplastic diseases 2 but is now becoming of more interest in anisotropic tissues, such as those in the musculoskeletal system 3,4 …”

Section: Introductionmentioning

confidence: 99%

Shear wave elastography of the median nerve: A mechanical study

et al. 2020

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Background: Shear wave elastography (SWE) shows promise in peripheral neuropathy evaluation but has potential limitations due to tissue size and heterogeneity. We tested SWE sensitivity to elasticity change and the effect of probe position in a median nerve cadaver model. Methods: Ten specimens were used to measure median nerve elasticity under increasing loads using SWE and indentation. Measurements were compared using repeated-measures analysis of variance. Results: Indentation and SWE-based longitudinal nerve elasticity increased with tensile loading (P < .01), showing a similar relationship. Acquisition in a transverse plane showed lower values compared with longitudinal measurements, mostly under higher loads (P = .03), as did postdissection elasticity (P = .02). Elasticity did not change when measured proximal to the carpal tunnel. Conclusions: Longitudinal SWE is sensitive to changes in median nerve elasticity. Measuring elasticity of peripheral nerves noninvasively could elucidate intra-neural pathology related to compression neuropathies, and proof to be of added value as a diagnostic or prognostic tool. K E Y W O R D S carpal tunnel syndrome, elastography, nerve elasticity, neurodynamics, peripheral neuropathy

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“…[18] Shear wave elastography (SWE) is a non-invasive and dynamic method of quantifying changes in tendon elasticity, involving application of a focused ultrasound pulse to the tissue being imaged. [19][20][21] SWE is a type of US elastography that uses shear waves generated by a remote radiation force of focused ultrasonic beams to assess tissue elasticity. It measures the velocity of shear waves (in metres per second) moving through tissue, and displays these in a quantitative manner via a real-time elastogram, in which elasticity is portrayed as a colour-coded representation over a B-mode image.…”

Section: Introductionmentioning

confidence: 99%

Differences in Achilles tendon stiffness in people with gout: a pilot study

Otter

Payne

Jones

et al. 2020

Preprint

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Background: Gout has been associated with weaker foot/leg muscles and altered gait patterns. There is also evidence of on-going foot pain and an increased risk of tendinopathy, with the Achilles and patella tendons most frequently affected in gout. Additionally, the inflammation associated with gout may change tissue elasticity. Ultrasound imaging utilising shear wave elastography (SWE) offers a non-invasive method of quantifying changes in tendon stiffness. SWE findings have not previously been reported in individuals with gout. We sought to determine differences in Achilles tendon stiffness in people with gout compared to controls (non-gout).Methods: A cross sectional study comparing 24 people with gout and 26 age/sex-matched controls. Clinical and demographic data were collated, and US imaging used to determine tendon thickness, presence of gouty tophi and/or aggregates and levels of angiogenesis. Ten shear wave elastography (SWE) measures were taken along the centre of a longitudinal section of the mid-portion of each Achilles tendon. Prior to data collection, intra-observer error was good (0.75). Data were summarised using descriptive statistics and a repeated measures ANCOVA was used to compare SWE measures between the two groups for the left and right foot separately after accounting for Body Mass Index (BMI).Results: A small proportion of those with gout presented with intra-tendon aggregates and/or intra-tendon tophi in one or both tendons. There was no statistically significant difference in tendon thickness between groups. Neo-vascularity was present in a third of gout participants. SWE findings demonstrated significantly reduced tendon stiffness in those with gout compared to controls: right Achilles mdiff =1.04m/s (95% CI (0.38 to 1.7) p=0.003 and left Achilles mdiff = 0.7m/s (95% CI 0.09 to 1.32) p=0.025. No relationship between the presence of tophi and SWE values were detected. Conclusion: Subjects with chronic gout show significantly reduced Achilles tendon stiffness compared to non-gout controls. From a clinical standpoint, our findings were similar to SWE measurements in subjects with Achilles tendinopathy and who did not have gout.

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Sonoelastography in the musculoskeletal system: Current role and future directions

Cited by 76 publications

References 58 publications

Ultrasound Elastography in Musculoskeletal Radiology: Past, Present, and Future

Ultrasound Elastography in Musculoskeletal Radiology: Past, Present, and Future

Shear wave elastography of the median nerve: A mechanical study

Differences in Achilles tendon stiffness in people with gout: a pilot study

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