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Keywords:
Extremities, Musculoskeletal soft tissue, Trauma, Ultrasound, Elastography, MR, Comparative studies, Diagnostic procedure, Efficacy studies, Athletic injuries, Tissue characterisation, Pathology
Authors:
V. Gazhonova, M. Emelianenko, M. Onishchenko; Moscow/RU
DOI:
10.1594/ecr2017/B-0119
Purpose
Rotator cuff tears (RCTs) are common upper extremity injuries the incidence of which continues to rise [1]. Small and medium-sized RCTs usually treated with nonsurgical management initially,
while massive tears are the subject for primary surgery.
Despite the development of arthroscopic techniques,
clinical success rates in treating RCTs have remained relatively constant.
Many factors contribute to the success of a rotator cuff repair.
Muscle quality appears to have a major role in determining clinical outcomes [2].
Massive tears have been found to be associated with atrophy,
fibrosis,
and fatty degeneration (FD) of the muscles. Clinically,
supraspinatus (SS) muscle atrophy (MA) and fatty degeneration (FD) have been correlated with poor functional outcomes following RCT repair [3].
MRI is the gold standard for detecting RC injury as well as SS MA and FD.
SS MA is graded by the transverse size of the muscle belly Fig. 1 relative to the supraspinatus fossa according to the Thomazeau 3-point staging scale [4].
FD is graded based on the modified Goutallier classification it is qualitative and depends on the amount of fat in the muscle itself [5].
Ultrasound elastography is a new technique being used for characterizing tissue stiffness in breast,
thyroid,
prostate and lymph nodes [6]. Musculoskeletal pathology was one of the first applications of sonoelastography,
but,
nevertheless the method is not yet standardized. Sonoelastography is an US method evaluating tissue stiffness which can be useful for evaluation of SSM FD.
A combination of MRI with real-time high resolution ultrasound (US) known as Fusion imaging may improve understanding of sports medicine injuries,
and may provide more accurate measurements of musculoskeletal (MSK) disorders.
The objective of our study was to investigate the possibilities of US sonoelastography (SE) in detection of supraspinatus muscle atrophy (SS MA) and fatty degeneration (FD) with reference to MRI