A Novel Application of Musculoskeletal Ultrasound Imaging

Abstract

Ultrasound is an attractive modality for imaging muscle and tendon motion during dynamic tasks and can provide a complementary methodological approach for biomechanical studies in a clinical or laboratory setting. Towards this goal, methods for quantification of muscle kinematics from ultrasound imagery are being developed based on image processing. The temporal resolution of these methods is typically not sufficient for highly dynamic tasks, such as drop-landing. We propose a new approach that utilizes a Doppler method for quantifying muscle kinematics. We have developed a novel vector tissue Doppler imaging (vTDI) technique that can be used to measure musculoskeletal contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities using ultrasound. The goal of this preliminary study was to investigate the repeatability and potential applicability of the vTDI technique in measuring musculoskeletal velocities during a drop-landing task, in healthy subjects. The vTDI measurements can be performed concurrently with other biomechanical techniques, such as 3D motion capture for joint kinematics and kinetics, electromyography for timing of muscle activation and force plates for ground reaction force. Integration of these complementary techniques could lead to a better understanding of dynamic muscle function and dysfunction underlying the pathogenesis and pathophysiology of musculoskeletal disorders.

Structural and Functional Changes in the Coupling of Fascial Tissue, Skeletal Muscle, and Nerves During Aging

“…Elastographic methods are increasingly used to assess the viscoelastic properties of muscle in aging but, as with echo-based measures, their widespread implementation in clinical and research settings is currently limited by low reproducibility (Zaidman et al, 2012;Alfuraih et al, 2018). Although other emerging ultrasound-based approaches including speckle-tracking (Frich et al, 2019), tissue Doppler imaging (Eranki et al, 2013), and axial transmission techniques (Wearing et al, 2016) arguably provide more direct measures of the contractile quality of the muscle-tendon unit in vivo, these techniques also suffer from limitations, including susceptibility to decorrelation (speckle tracking), user intervention (feature-based tracking), and dependence on insonation angle (tissue Doppler) (Sikdar et al, 2014). Nonetheless, ultrasound-based measures appear to be promising approaches for quantifying contractile properties of myofascial tissues and have the potential to enhance our understanding of musculoskeletal function with aging and pathology.…”

Dynamic Ultrasound Imaging Applications to Quantify Musculoskeletal Function

“…Velocity estimation methods that do not require visual tracking of the underlying features are attractive for applications where there is inadequate visualization or fast motion (16). Doppler methods have been used clinically for several decades to estimate blood flow velocities (26).…”

“…To that purpose, vector Doppler methods can be applied to quantify peripheral muscle dynamic changes (e.g., contraction velocity, strain) during fatigue processes that may be leading to altered movement patterns, changes in patterns of recruitment among different muscle groups, and decreased muscle's ability to contract. We have also applied vector Doppler methods to quantify muscle contraction velocity and muscle strain during weight bearing activities to examine quadriceps femoris muscle dynamics (16). The aim was to comprehend the potential muscle contribution to increased knee joint moments (e.g., knee adduction moment) (31).…”

Curvelet based automatic segmentation of supraspinatus tendon from ultrasound image: a focused assistive diagnostic method

“…Ultrasound is a medical imaging modality preferred by radiologist and physicians due to its capability to produce real time imaging data, reduced time in diagnosis, and high patient acceptability. Musculoskeletal (MSK) ultrasound is rapidly gaining importance for the assessment of joints and soft tissue disorders [ 1 , 2 ]. Occurrence of MSK disorders are mostly found in sports, adulthood (>30 years of age) or in accidents due to sudden impact which leads to reduced functions of daily life.…”

“…In one study [ 12 ], quantitative ultrasound techniques were employed wherein it computes structural measurements and mean echogenicity to discriminate between muscle pathologies and healthy conditions. In another recently published research, musculoskeletal ultrasound was used to quantify muscle kinematics during dynamic activities such as drop landing in healthy subjects [ 1 ]. Reliability study was conducted for the use of ultrasound as a quantitative information tool by a research group for inter-rater and intra-rater reliability, the study reveals that appropriately designed protocol will allow radiologist to identify structural changes within tendons [ 13 , 14 ].…”