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

Snoj, Žiga; Wu, Chueh-Hung; Taljanovic, Mihra S.; Dumić-Čule, Ivo; Drakonaki, Eleni E.; Klauser, Andrea

doi:10.1055/s-0039-3402746

Cited by 35 publications

(16 citation statements)

References 70 publications

(147 reference statements)

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“…Ultrasound shear-wave elastography (SWE) is a tool introduced in the last decade with the ability to quantify the elasticity and stiffness of the tissue and is now routinely used in breast and liver ultrasound [3,4]. Currently, SWE was utilized to detect quantitative properties of normal and ruptured AT, as well as for monitoring of treatment outcomes [5][6][7][8]. SWE was established as a reliable technique for assessment of mechanical properties of AT.…”

Section: Introductionmentioning

confidence: 99%

Importance of shear-wave elastography in prediction of Achilles tendon rupture

Ivanac

Lemac

Kosović

et al. 2020

International Orthopaedics (SICOT)

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Purpose It was demonstrated that about 6% of patients with a ruptured Achilles tendon experience the rupture of contralateral tendon in the future; the aim of this study was to estimate the risk for rupture of contralateral tendon in patients who underwent surgical reconstruction of ruptured Achilles tendon by using subjective questionnaires and shear-wave elastography. Methods Twenty-four patients who underwent surgical repair of the ruptured Achilles tendon and twelve age-matched healthy controls were examined with ultrasound SWE. Functional outcomes were assessed with American Orthopedic Foot and Ankle Society (AOFAS) scoring system and subjective rating system which we introduced and validated. Results The elasticity of injured tendon was markedly decreased (by 42%) compared to the contralateral tendon of the patient, as expected. Both AOFAS score and our novel subjective assessment scale positively correlate with ultrasound SWE values in ruptured Achilles tendons. The elasticity of contralateral Achilles tendons in patients was 23% lower than among healthy individuals. Conclusion Irrespective of the lack of difference in the subjective feeling assessed by AOFAS, the contralateral tendon in the patients with reconstructed Achilles tendon has significantly lower stiffness than healthy individuals. Therefore, contralateral tendons in patients who suffered from rupture are more prone to future ruptures.

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Section: Introductionmentioning

confidence: 99%

Importance of shear-wave elastography in prediction of Achilles tendon rupture

Ivanac

Lemac

Kosović

et al. 2020

International Orthopaedics (SICOT)

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“…13 Due to constant development, there are continual modifications in the workflow of radiologists. 9,[14][15][16][17][18] The landscape may change even further in the near future with implementation of artificial intelligence. 19 The future challenge for MSK radiologists will be to define the appropriate use of the new competing technologies and thus maximize the benefit of available imaging resources and optimize clinical work with a high level of pathoanatomical knowledge.…”

Section: Discussionmentioning

confidence: 99%

Present Status of Musculoskeletal Radiology in Europe: International Survey by the European Society of Musculoskeletal Radiology

Snoj

Hebar

Sconfienza

et al. 2020

Semin Musculoskelet Radiol

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No official data exist on the status of musculoskeletal (MSK) radiology in Europe. The Committee for National Societies conducted an international survey to understand the status of training, subspecialization, and local practice among the European Society of Musculoskeletal Radiology (ESSR) partner societies. This article reports the results of that survey. An online questionnaire was distributed to all 26 European national associations that act as official partner societies of the ESSR. The 24 questions were subdivided into six sections: society structure, relationship with the national radiological society, subspecialization, present radiology practice, MSK interventional procedures, and MSK ultrasound. The findings of our study show a lack of standardized training and/or accreditation methods in the field of MSK radiology at a national level. The European diploma in musculoskeletal radiology is directed to partly overcome this problem; however, this certification is still underrecognized. Using certification methods, a more homogeneous European landscape could be created in the future with a view to subspecialist training. MSK ultrasound and MSK interventional procedures should be performed by a health professional with a solid knowledge of the relevant imaging modalities and sufficient training in MSK radiology. Recognition of MSK radiology as an official subspecialty would make the field more attractive for younger colleagues as well as attracting the brightest and best, an important key to further development of both clinical and academic radiology. Key Points

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“…[7][8][9] Elastography has been proven as a useful adjunct US method in CTS evaluation. 10 Therapeutic recommendations for CTS depend on disease severity and may include anything from a conservative approach to surgical intervention. 2,3 US-guided injections have become increasingly important in the treatment of mild and moderate CTS 2,3 and, as landmark-guided injections have been proven to be less effective and cause more complications, US imaging has become the foundation of therapeutic recommendations.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided carpal tunnel injections

Tumpaj

Albano

et al. 2022

Radiology and Oncology

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Background Carpal tunnel syndrome (CTS), one of the most common entrapment neuropathies, can, in fact, be considered as a socio-economic issue that reduces work productivity, increases disability, and requires prolonged rehabilitation. The imaging modality of choice in CTS imaging is the ultrasound (US), as several morphological parameters can be used in CTS diagnosis and follow-up. In recent years, US-guided CTS injection therapy has become an established treatment option for mild to moderate CTS. The authors of this review performed a literature search that revealed several differences in US-guided carpal tunnel injection in an attempt to unify individual stages of CTS injections protocol for future guidance: patient preparation, injection approach, needle positioning, injected medications, and injectate volume. The three approaches to carpal tunnel injections described in the literature, that is, the ulnar, radial, and longitudinal, can be implemented with single or multiple deposits and different injection volumes. Medications used for injections are corticosteroids, local anaesthetics, dextrose, saline, platelet-rich plasma, and progesterone. Conclusions Although no consensus has yet been reached as to which protocol should be used, the ulnar approach with a single deposit injected in large volumes should be considered as the first choice, while dextrose should be the first-line medication option. Furthermore, as terminological differences make it difficult to draw a uniform comparison the presented steps for US-guided carpal tunnel injection might serve as a guideline for future studies.

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

Cited by 35 publications

References 70 publications

Importance of shear-wave elastography in prediction of Achilles tendon rupture

Importance of shear-wave elastography in prediction of Achilles tendon rupture

Present Status of Musculoskeletal Radiology in Europe: International Survey by the European Society of Musculoskeletal Radiology

Ultrasound-guided carpal tunnel injections

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