Skip to main content
Erschienen in: European Radiology 9/2021

25.02.2021 | Ultrasound

Clinical applicability of shear wave elastography for the evaluation of medial epicondylitis

verfasst von: Jin-Young Bang, Seok Hahn, Jisook Yi, Yun-jung Lim, Hyun Kyung Jung

Erschienen in: European Radiology | Ausgabe 9/2021

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate the ability of shear wave elastography (SWE) in diagnosing medial epicondylitis and to compare the diagnostic performance of SWE with that of grey-scale ultrasound (GSU) and strain elastography (SE).

Methods

GSU, SE, and SWE were performed on 61 elbows of 54 patients from March 2018 to April 2019. An experienced radiologist evaluated the GSU findings (swelling, cortical irregularity, hypoechogenicity, calcification, and tear), colour Doppler findings (hyperaemia), SE findings (strain ratio [SR]), and SWE findings (stiffness and shear wave velocity [SWV]). Participants were divided in two groups: patients with clinically diagnosed medial epicondylitis and patients without medial elbow pain. Findings from the two groups were compared, and the receiver operating characteristic (ROC) curves were calculated for significant features.

Results

Of the 54 patients, 25 patients with 28 imaged elbows were clinically diagnosed with medial epicondylitis and 29 patients with 33 imaged elbows had no medial elbow pain. Cortical irregularity, hypoechogenicity, calcification, hyperaemia, SR, stiffness, and SWV were significantly different between the two groups. The areas under the ROC curves were 0.838 for hypoechogenicity, 0.948 for SR, 0.999 for stiffness, and 0.999 for SWV. The diagnostic performances of SR, stiffness, and SWV were significantly superior compared to that of hypoechogenicity. However, there were no significant differences among SR, stiffness, and SWV.

Conclusions

SWE can obtain both stiffness and SWV, which are valuable diagnostic tools in the diagnosis of medial epicondylitis. The diagnostic performance of SWE and SE is similar in detecting medial epicondylitis.

Key Points

Shear wave elastography providing stiffness and shear wave velocity showed excellent performance in the diagnosis of medial epicondylitis.
• There was no significant difference in the ability of SE and SWE for diagnosing medial epicondylitis.
Literatur
1.
Zurück zum Zitat Kijowski R, De Smet AA (2005) Magnetic resonance imaging findings in patients with medial epicondylitis. Skeletal Radiol 34:196–202CrossRef Kijowski R, De Smet AA (2005) Magnetic resonance imaging findings in patients with medial epicondylitis. Skeletal Radiol 34:196–202CrossRef
2.
Zurück zum Zitat Tarpada SP, Morris MT, Lian J, Rashidi S (2018) Current advances in the treatment of medial and lateral epicondylitis. J Orthop 15:107–110CrossRef Tarpada SP, Morris MT, Lian J, Rashidi S (2018) Current advances in the treatment of medial and lateral epicondylitis. J Orthop 15:107–110CrossRef
3.
Zurück zum Zitat Walz DM, Newman JS, Konin GP, Ross G (2010) Epicondylitis: pathogenesis, imaging, and treatment. Radiographics 30:167–184CrossRef Walz DM, Newman JS, Konin GP, Ross G (2010) Epicondylitis: pathogenesis, imaging, and treatment. Radiographics 30:167–184CrossRef
4.
Zurück zum Zitat O’Dwyer KJ, Howie CR (1995) Medial epicondylitis of the elbow. Int Orthop 19:69–71PubMed O’Dwyer KJ, Howie CR (1995) Medial epicondylitis of the elbow. Int Orthop 19:69–71PubMed
5.
Zurück zum Zitat Konin GP, Nazarian LN, Walz DM (2013) US of the elbow: indications, technique, normal anatomy, and pathologic conditions. Radiographics 33:E125–E147CrossRef Konin GP, Nazarian LN, Walz DM (2013) US of the elbow: indications, technique, normal anatomy, and pathologic conditions. Radiographics 33:E125–E147CrossRef
6.
Zurück zum Zitat Aubry S, Nueffer JP, Tanter M, Becce F, Vidal C, Michel F (2015) Viscoelasticity in Achilles tendonopathy: quantitative assessment by using real-time shear-wave elastography. Radiology 274:821–829CrossRef Aubry S, Nueffer JP, Tanter M, Becce F, Vidal C, Michel F (2015) Viscoelasticity in Achilles tendonopathy: quantitative assessment by using real-time shear-wave elastography. Radiology 274:821–829CrossRef
7.
Zurück zum Zitat Chen XM, Cui LG, He P, Shen WW, Qian YJ, Wang JR (2013) Shear wave elastographic characterization of normal and torn Achilles tendons: a pilot study. J Ultrasound Med 32:449–455CrossRef Chen XM, Cui LG, He P, Shen WW, Qian YJ, Wang JR (2013) Shear wave elastographic characterization of normal and torn Achilles tendons: a pilot study. J Ultrasound Med 32:449–455CrossRef
8.
Zurück zum Zitat Hou SW, Merkle AN, Babb JS, McCabe R, Gyftopoulos S, Adler RS (2017) Shear wave ultrasound elastographic evaluation of the rotator cuff tendon. J Ultrasound Med 36:95–106CrossRef Hou SW, Merkle AN, Babb JS, McCabe R, Gyftopoulos S, Adler RS (2017) Shear wave ultrasound elastographic evaluation of the rotator cuff tendon. J Ultrasound Med 36:95–106CrossRef
9.
Zurück zum Zitat Hatta T, Giambini H, Uehara K et al (2015) Quantitative assessment of rotator cuff muscle elasticity: reliability and feasibility of shear wave elastography. J Biomech 48:3853–3858CrossRef Hatta T, Giambini H, Uehara K et al (2015) Quantitative assessment of rotator cuff muscle elasticity: reliability and feasibility of shear wave elastography. J Biomech 48:3853–3858CrossRef
10.
Zurück zum Zitat Rosskopf AB, Ehrmann C, Buck FM, Gerber C, Fluck M, Pfirrmann CW (2016) Quantitative shear-wave US elastography of the supraspinatus muscle: reliability of the method and relation to tendon integrity and muscle quality. Radiology 278:465–474CrossRef Rosskopf AB, Ehrmann C, Buck FM, Gerber C, Fluck M, Pfirrmann CW (2016) Quantitative shear-wave US elastography of the supraspinatus muscle: reliability of the method and relation to tendon integrity and muscle quality. Radiology 278:465–474CrossRef
11.
Zurück zum Zitat Kantarci F, Ustabasioglu FE, Delil S et al (2014) Median nerve stiffness measurement by shear wave elastography: a potential sonographic method in the diagnosis of carpal tunnel syndrome. Eur Radiol 24:434–440CrossRef Kantarci F, Ustabasioglu FE, Delil S et al (2014) Median nerve stiffness measurement by shear wave elastography: a potential sonographic method in the diagnosis of carpal tunnel syndrome. Eur Radiol 24:434–440CrossRef
12.
Zurück zum Zitat Andrade RJ, Nordez A, Hug F et al (2016) Non-invasive assessment of sciatic nerve stiffness during human ankle motion using ultrasound shear wave elastography. J Biomech 49:326–331CrossRef Andrade RJ, Nordez A, Hug F et al (2016) Non-invasive assessment of sciatic nerve stiffness during human ankle motion using ultrasound shear wave elastography. J Biomech 49:326–331CrossRef
13.
Zurück zum Zitat Wu CH, Chen WS, Wang TG (2016) Elasticity of the coracohumeral ligament in patients with adhesive capsulitis of the shoulder. Radiology 278:458–464CrossRef Wu CH, Chen WS, Wang TG (2016) Elasticity of the coracohumeral ligament in patients with adhesive capsulitis of the shoulder. Radiology 278:458–464CrossRef
14.
Zurück zum Zitat Tavare AN, Alfuraih AM, Hensor EMA, Astrinakis E, Gupta H, Robinson P (2019) Shear-wave elastography of benign versus malignant musculoskeletal soft-tissue masses: comparison with conventional US and MRI. Radiology 290:410–417CrossRef Tavare AN, Alfuraih AM, Hensor EMA, Astrinakis E, Gupta H, Robinson P (2019) Shear-wave elastography of benign versus malignant musculoskeletal soft-tissue masses: comparison with conventional US and MRI. Radiology 290:410–417CrossRef
15.
Zurück zum Zitat Taljanovic MS, Gimber LH, Becker GW et al (2017) Shear-wave elastography: basic physics and musculoskeletal applications. Radiographics 37:855–870CrossRef Taljanovic MS, Gimber LH, Becker GW et al (2017) Shear-wave elastography: basic physics and musculoskeletal applications. Radiographics 37:855–870CrossRef
16.
Zurück zum Zitat Bamber J, Cosgrove D, Dietrich CF et al (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: basic principles and technology. Ultraschall Med 34:169–184CrossRef Bamber J, Cosgrove D, Dietrich CF et al (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: basic principles and technology. Ultraschall Med 34:169–184CrossRef
17.
Zurück zum Zitat Hodgson RJ, O’Connor PJ, Grainger AJ (2012) Tendon and ligament imaging. Br J Radiol 85:1157–1172CrossRef Hodgson RJ, O’Connor PJ, Grainger AJ (2012) Tendon and ligament imaging. Br J Radiol 85:1157–1172CrossRef
18.
Zurück zum Zitat Ollivierre CO, Nirschl RP, Pettrone FA (1995) Resection and repair for medial tennis elbow. A prospective analysis. Am J Sports Med 23:214–221CrossRef Ollivierre CO, Nirschl RP, Pettrone FA (1995) Resection and repair for medial tennis elbow. A prospective analysis. Am J Sports Med 23:214–221CrossRef
19.
Zurück zum Zitat Klauser AS, Pamminger MJ, Halpern EJ et al (2017) Sonoelastography of the common flexor tendon of the elbow with histologic agreement: a cadaveric study. Radiology 283:486–491CrossRef Klauser AS, Pamminger MJ, Halpern EJ et al (2017) Sonoelastography of the common flexor tendon of the elbow with histologic agreement: a cadaveric study. Radiology 283:486–491CrossRef
20.
Zurück zum Zitat Shin M, Hahn S, Yi J, Lim YJ, Bang JY (2019) Clinical application of real-time sonoelastography for evaluation of medial epicondylitis: a pilot study. Ultrasound Med Biol 45:246–254CrossRef Shin M, Hahn S, Yi J, Lim YJ, Bang JY (2019) Clinical application of real-time sonoelastography for evaluation of medial epicondylitis: a pilot study. Ultrasound Med Biol 45:246–254CrossRef
21.
Zurück zum Zitat Vinod AV, Ross G (2015) An effective approach to diagnosis and surgical repair of refractory medial epicondylitis. J Shoulder Elbow Surg 24:1172–1177CrossRef Vinod AV, Ross G (2015) An effective approach to diagnosis and surgical repair of refractory medial epicondylitis. J Shoulder Elbow Surg 24:1172–1177CrossRef
22.
Zurück zum Zitat Park GY, Lee SM, Lee MY (2008) Diagnostic value of ultrasonography for clinical medial epicondylitis. Arch Phys Med Rehabil 89:738–742CrossRef Park GY, Lee SM, Lee MY (2008) Diagnostic value of ultrasonography for clinical medial epicondylitis. Arch Phys Med Rehabil 89:738–742CrossRef
23.
Zurück zum Zitat Connell D, Burke F, Coombes P et al (2001) Sonographic examination of lateral epicondylitis. AJR Am J Roentgenol 176:777–782CrossRef Connell D, Burke F, Coombes P et al (2001) Sonographic examination of lateral epicondylitis. AJR Am J Roentgenol 176:777–782CrossRef
24.
Zurück zum Zitat Bodor M, Fullerton B (2010) Ultrasonography of the hand, wrist, and elbow. Phys Med Rehabil Clin N Am 21:509–531CrossRef Bodor M, Fullerton B (2010) Ultrasonography of the hand, wrist, and elbow. Phys Med Rehabil Clin N Am 21:509–531CrossRef
25.
Zurück zum Zitat Tran N, Chow K (2007) Ultrasonography of the elbow. Semin Musculoskelet Radiol 11:105–116CrossRef Tran N, Chow K (2007) Ultrasonography of the elbow. Semin Musculoskelet Radiol 11:105–116CrossRef
26.
Zurück zum Zitat Krogh TP, Fredberg U, Christensen R, Stengaard-Pedersen K, Ellingsen T (2013) Ultrasonographic assessment of tendon thickness, Doppler activity and bony spurs of the elbow in patients with lateral epicondylitis and healthy subjects: a reliability and agreement study. Ultraschall Med 34:468–474CrossRef Krogh TP, Fredberg U, Christensen R, Stengaard-Pedersen K, Ellingsen T (2013) Ultrasonographic assessment of tendon thickness, Doppler activity and bony spurs of the elbow in patients with lateral epicondylitis and healthy subjects: a reliability and agreement study. Ultraschall Med 34:468–474CrossRef
27.
Zurück zum Zitat Dirrichs T, Quack V, Gatz M, Tingart M, Kuhl CK, Schrading S (2016) Shear wave elastography (SWE) for the evaluation of patients with tendinopathies. Acad Radiol 23:1204–1213CrossRef Dirrichs T, Quack V, Gatz M, Tingart M, Kuhl CK, Schrading S (2016) Shear wave elastography (SWE) for the evaluation of patients with tendinopathies. Acad Radiol 23:1204–1213CrossRef
28.
Zurück zum Zitat Zhu B, You Y, Xiang X, Wang L, Qiu L (2020) Assessment of common extensor tendon elasticity in patients with lateral epicondylitis using shear wave elastography. Quant Imaging Med Surg 10:211–219CrossRef Zhu B, You Y, Xiang X, Wang L, Qiu L (2020) Assessment of common extensor tendon elasticity in patients with lateral epicondylitis using shear wave elastography. Quant Imaging Med Surg 10:211–219CrossRef
29.
Zurück zum Zitat Şendur HN, Cindil E, Cerit M, Demir NB, Şendur AB, Oktar S (2019) Interobserver variability and stiffness measurements of normal common extensor tendon in healthy volunteers using shear wave elastography. Skeletal Radiol 48:137–141CrossRef Şendur HN, Cindil E, Cerit M, Demir NB, Şendur AB, Oktar S (2019) Interobserver variability and stiffness measurements of normal common extensor tendon in healthy volunteers using shear wave elastography. Skeletal Radiol 48:137–141CrossRef
30.
Zurück zum Zitat Yun SJ, Jin W, Cho NS et al (2019) Shear-wave and strain ultrasound elastography of the supraspinatus and infraspinatus tendons in patients with idiopathic adhesive capsulitis of the shoulder: a prospective case-control study. Korean J Radiol 20:1176–1185CrossRef Yun SJ, Jin W, Cho NS et al (2019) Shear-wave and strain ultrasound elastography of the supraspinatus and infraspinatus tendons in patients with idiopathic adhesive capsulitis of the shoulder: a prospective case-control study. Korean J Radiol 20:1176–1185CrossRef
31.
Zurück zum Zitat Drakonaki EE, Allen GM, Wilson DJ (2012) Ultrasound elastography for musculoskeletal applications. Br J Radiol 85:1435–1445CrossRef Drakonaki EE, Allen GM, Wilson DJ (2012) Ultrasound elastography for musculoskeletal applications. Br J Radiol 85:1435–1445CrossRef
32.
Zurück zum Zitat Klauser AS, Miyamoto H, Bellmann-Weiler R, Feuchtner GM, Wick MC, Jaschke WR (2014) Sonoelastography: musculoskeletal applications. Radiology 272:622–633CrossRef Klauser AS, Miyamoto H, Bellmann-Weiler R, Feuchtner GM, Wick MC, Jaschke WR (2014) Sonoelastography: musculoskeletal applications. Radiology 272:622–633CrossRef
33.
Zurück zum Zitat Lee MH, Cha JG, Jin W et al (2011) Utility of sonographic measurement of the common tensor tendon in patients with lateral epicondylitis. AJR Am J Roentgenol 196:1363–1367CrossRef Lee MH, Cha JG, Jin W et al (2011) Utility of sonographic measurement of the common tensor tendon in patients with lateral epicondylitis. AJR Am J Roentgenol 196:1363–1367CrossRef
34.
Zurück zum Zitat Mulabecirovic A, Vesterhus M, Gilja OH, Havre RF (2016) In vitro comparison of five different elastography systems for clinical applications, using strain and shear wave technology. Ultrasound Med Biol 42:2572–2588CrossRef Mulabecirovic A, Vesterhus M, Gilja OH, Havre RF (2016) In vitro comparison of five different elastography systems for clinical applications, using strain and shear wave technology. Ultrasound Med Biol 42:2572–2588CrossRef
Metadaten
Titel
Clinical applicability of shear wave elastography for the evaluation of medial epicondylitis
verfasst von
Jin-Young Bang
Seok Hahn
Jisook Yi
Yun-jung Lim
Hyun Kyung Jung
Publikationsdatum
25.02.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 9/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-07791-3

Weitere Artikel der Ausgabe 9/2021

European Radiology 9/2021 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.