Sonoelastography shows musculoskeletal promise

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CHICAGO—A global group of researchers shared research projects focused on musculoskeletal ultrasound applications during a packed subspecialty education session Monday afternoon the 94th annual meeting of the Radiological Society of North America (RSNA). Most of the researchers explored new roles for sonoelastography. Available as an advanced ultrasound technique since 1991, sonoelastography offers physicians a tool to characterize tissue and study the mechanic features of tissue.
Luca Maria Sconfienza, MD, from the department of experimental medicine at University of Genova in Italy, opened the session with a project centered on sonoelastographic evaluation of damaged Achilles tendons, attempting to use the scan to detect damage. The 16-patient study found tendon thickness and tendon color were inversely related indicating that with progressive increases in thickness tendon becomes less elastic. Sonoelastography also showed increased stiffness in symptomatic tendons. “Ultrasound could become the most widely used method for clinical estimation of elasticity,” concluded Sconfienza.
Tobias DeZordo, MD, of Medical University of Innsbruck in Austria, followed with a paper that compared real-time sonoelastography of Achilles tendons to clinical examination and conventional ultrasound. Clinical differentiation of Achilles tendinopathy can be challenging, said DeZordo. DeZordo hypothesized that detection of tissue softening could add knowledge about the early development of Achilles tendinopathy and thus impact therapeutic decision-making. The study found comparable sensitivity, specificity and accuracy between ultrasound and sonoelastography. Researchers concluded that sonoelastography could add knowledge regarding development of early Achilles tendinopathy, which might impact therapeutic decision-making.
DeZordo presented a second study analyzing real-time sonoelastography in lateral epicondylitis, comparing the technique to clinical exam, ultrasound and power Doppler ultrasound. Again, researchers found sonoelastography could add diagnostic value. The study reported a sensitivity of 100 percent and specificity of 89 percent, indicating that sonoelastography could be a useful diagnostic adjunct.
Naglaa Abdel Razek, MD, assistant professor of radiology at University of Cairo in Egypt, presented a study comparing real-time sonoelastography in rotator cuff tears to MRI. Razek reported good agreement between both modalities. In fact, ultrasound detected tendonitis in 10 percent of cases negative by MRI and changed the diagnosis from partial to complete tear in a few patients. The research concluded that sonoelastography is a sensitive method for diagnosis of rotator cuff tears, and it might predict early stage tears before MRI.
Sonelastography continues to demonstrate its diagnostic prowess in the musculoskeletal arena and could play a larger role in diagnosis of common musculoskeletal conditions in the future.