Comparison of median nerve stiffness with and without rheumatoid arthritis by ultrasound real-time tissue elastography: A propensity score matching study

Anno, S.; Okano, Tadashi; Mamoto, K.; Sugioka, Y.; Takeda, Setsuko; Hashimoto, Ayumi; Yamashita, Emi; Morinaka, Rika; Ueda, Hatsue; Inui, Kentaro; Koike, Tatsuya; Nakamura, Hiroaki

doi:10.1080/14397595.2019.1602914

Cited by 9 publications

(8 citation statements)

References 37 publications

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“…4. ), similar to increased tendon stiffness in patellar tendons of soccer players reported by Zhang et al 18 All MN showed elastograms of green-blue (80%), or predominantly blue (20%) patterns, with mean SR ¼ 2.2 (Table .3), very similar to average SR of 2.1 in 222 MN controls obtained by Anno et al 19…”

Section: Discussionsupporting

confidence: 84%

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REAL-TIME strain elastography: Applications in musculoskeletal system

Dilip¹,

Khaladkar²,

Chanabasanavar³

et al. 2022

Journal of Clinical Orthopaedics and Trauma

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Background: Strain or compression sonoelastography (CE) provides a colour-coded elastogram representing tissue elasticity by measuring tissue deformability after repeated probe compression. Elastographic ultrasound (EUS) is a valuable tool for screening diagnosis and follow-up of inflammatory, degenerative, benign and malignant neoplastic pathologies of skin, subcutaneous tissue, muscles, tendons, ligaments, fascia and nerves; help in targeted biopsy; monitor healing tendons after surgery or nerve stiffness changes during physiotherapy. Objectives: To assess stiffness of normal tendons, muscles and nerve. To diagnose cellulitis, fasciitis, abscess, tendinopathy, myositis, muscle/tendon rupture/contusion and differentiate between benign and malignant soft tissue tumours. To derive elastic score (ES) and strain ratio (SR) in cases and controls. To correlate B-mode findings with CE. Materials and methods: A prospective study on 50 healthy subjects between 25 and 30 years and 50 cases of diffuse and focal musculoskeletal pathologies was done using B-mode and CE over 2 years. Statistical analysis of distribution, mean, associations, sensitivity, specificity, area under Receiver Operating Characteristic curve (AUROC) for B-mode, ES, SR combined B-mode/CE and their comparison was done. Results: Significant association was noted between SR in muscles and tendons with sex. Significant correlation was noted between ES/SR with B-mode. CE and B-mode had 100% and 52.4% sensitivity respectively for diagnosing diffuse pathologies. For differentiating benign and malignant masses sensitivity, specificity, and diagnostic accuracy of B-mode was 71.43%, 86.36% and 82.76%; of SR was 71.43%, 90.91% and 86.21%; of Combined B-mode with CE was 100%, 90.91% and 93.1% respectively. Elastographic pattern had highest diagnostic accuracy and largest AUROC. Conclusion: CE as a screening test had higher diagnostic accuracy, supporting need for standardizing it for clinical use in MSK. EUS being a widely available, fast and affordable modality, can aid follow up of chronic MSK pathologies, response to medication, physiotherapy and surgery and mitigate the need for MRI.

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Section: Discussionsupporting

confidence: 84%

“…Both had increased MN stiffness with mean SR ¼ 3.88 (Fig. 8), corroborating with studies by Anno et al 19 and Emara et al, 26 who suggested MN SR > 2.2 for diagnosing CTS. Similar to our findings, Ogur et al found increased MN SR despite normal CSA values in pregnant women.…”

Section: Diffuse Pathologies Affecting Msk -supporting

confidence: 88%

REAL-TIME strain elastography: Applications in musculoskeletal system

Dilip¹,

Khaladkar²,

Chanabasanavar³

et al. 2022

Journal of Clinical Orthopaedics and Trauma

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“…and compensates for the limitations of conventional ultrasound in the detection of tumors and other diseases. 63,64 Few studies have assessed changes in the elasticity of the peripheral nerves in diabetic patients with or without diabetic neuropathy, although some studies have demonstrated that such assessment has potential for characterizing diabetic neuropathy. The value of SWE in detecting DPN of the tibial nerve in diabetic DPN patients has been shown to be higher than that of HRU.…”

Section: Improving the Diagnostic Value In Dpn By Shear Wave Sonoelasmentioning

confidence: 99%

Application of High-Resolution Ultrasound on Diagnosing Diabetic Peripheral Neuropathy

Huang¹,

Wu²

2021

DMSO

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Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus (DM). The typical manifestation is a length-dependent "glove and sock" sensation. At present, diagnosis is mainly dependent on clinical manifestations. Since the pathogenesis is not clear, there are no effective treatment measures. Management consists mainly of glucose control, peripheral nerve nutrition, and other measures to delay the progress of the disease; early diagnosis is therefore crucial to improving prognosis and quality of life for patients with DPN. Due to the lack of obvious symptoms in 50% of patients and the low sensitivity of neuro-electrophysiology to small fibers, the missed diagnosis rate is high. Highresolution ultrasound (HRU), as a convenient noninvasive tool, has been proven by many studies to have excellent clinical value in diagnosing DPN. With the development of related new technology, HRU shows promise for the screening, diagnosing, and follow-up of DPN, which could serve as a biomarker and provide new diagnostic insights. In this paper, we review the ability of HRU to detect nerve cross-sectional area and blood flow, and echo and other image changes, and in showing the characteristics of peripheral nerve morphological changes in patients with DPN. We also explore the application of two other recent technological developments-shear wave elastography (SWE) and ultrasound scoring systems-in improving the diagnostic efficiency of HRU in peripheral neuropathy.

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“…It is still premature to infer that exercise may be able to chronically modulate peripheral nerve stiffness; however, mechanical elongation seemingly has some effects. Future studies should consider these less investigated aspects since nerve stiffness increases either following incorrect postures [ 116 ] or in more severe pathological conditions such as carpal tunnel syndrome [ 117 ], diabetic peripheral neuropathy [ 118 ], rheumatoid arthritis [ 119 ] or systemic sclerosis [ 120 ].…”

Section: Resultsmentioning

confidence: 99%

Effects of Different Long-Term Exercise Modalities on Tissue Stiffness

et al. 2022

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Stiffness is a fundamental property of living tissues, which may be modified by pathologies or traumatic events but also by nutritional, pharmacological and exercise interventions. This review aimed to understand if specific forms of exercise are able to determine specific forms of tissue stiffness adaptations. A literature search was performed on PubMed, Scopus and Web of Science databases to identify manuscripts addressing adaptations of tissue stiffness as a consequence of long-term exercise. Muscular, connective, peripheral nerve and arterial stiffness were considered for the purpose of this review. Resistance training, aerobic training, plyometric training and stretching were retrieved as exercise modalities responsible for tissue stiffness adaptations. Differences were observed related to each specific modality. When exercise was applied to pathological cohorts (i.e. tendinopathy or hypertension), stiffness changed towards a physiological condition. Exercise interventions are able to determine tissue stiffness adaptations. These should be considered for specific exercise prescriptions. Future studies should concentrate on identifying the effects of exercise on the stiffness of specific tissues in a broader spectrum of pathological populations, in which a tendency for increased stiffness is observed.

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Comparison of median nerve stiffness with and without rheumatoid arthritis by ultrasound real-time tissue elastography: A propensity score matching study

Cited by 9 publications

References 37 publications

REAL-TIME strain elastography: Applications in musculoskeletal system

REAL-TIME strain elastography: Applications in musculoskeletal system

Application of High-Resolution Ultrasound on Diagnosing Diabetic Peripheral Neuropathy

Effects of Different Long-Term Exercise Modalities on Tissue Stiffness

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