Increased Stiffness of Rotator Cuff Tendons in Frozen Shoulder on Shear Wave Elastography

Wada, Tomoki; Itoigawa, Yoshiaki; Yoshida, Koichiro; Kawasaki, Takayuki; Maruyama, Yoshihiro

doi:10.1002/jum.15078

Cited by 25 publications

(28 citation statements)

References 26 publications

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“…Other recent studies have suggested that changes in the elastic modulus of the rotator cuff tendons may also occur in adhesive capsulitis (17,31) , which we have not measured. Further studies are required to further investigate these findings in order to fully understand complex changes in the elastic properties of the rotator interval structures and rotator cuff tendons that may occur in adhesive capsulitis.…”

Section: Resultscontrasting

confidence: 48%

“…The ultrasound system propagates shear waves into tissues and assesses their elastic modulus. This has been used in a variety of musculoskeletal conditions including the rotator cuff tendons (16,17), epicondylitis (18) , and Achilles (19) . Wu et al reported that in patients with clinical findings consistent with adhesive capsulitis shear wave elastography demonstrated that the CHL was significantly stiffer in the symptomatic shoulder compared with the asymptomatic shoulder (13) .…”

Section: Introductionmentioning

confidence: 99%

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Elasticity of the coracohumeral ligament in patients with frozen shoulder following rotator interval injection: a case series

et al. 2020

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Aim of the study: To evaluate changes in the elasticity of the coracohumeral ligament in patients with adhesive capsulitis of the shoulder treated with ultrasound-guided rotator interval injections. Methods: Shear wave elastography was used to evaluate elasticity of the coracohumeral ligament in symptomatic and asymptomatic shoulders in the shoulder-neutral position and 30° external rotation. A total of 24 shoulders were assessed. Symptomatic shoulders were treated with targeted steroid injection via the rotator interval and manipulation under local anaesthetic block. Follow-up assessment of the elasticity of the coracohumeral ligament was obtained at 10 weeks post-injection. Results: In all subjects, the coracohumeral ligament elastic modulus was larger at 30° external rotation than in the neutral position. In patients with adhesive capsulitis, the coracohumeral ligament thickness and elastic modulus was significantly greater in the symptomatic shoulder in the neutral position and 30° ER. Treated patients had an excellent response with improved Oxford Shoulder Score and reduced visual analogue scale pain scores. Median Oxford Shoulder Score was 13.5 pre-injection and 34 at 10 weeks postinjection. Median visual analogue scale pain scores measured 8.5 pre-injection, 3.5 at 1 day, 2 at 1 week, and 2.5 at 10 weeks. Improved Oxford Shoulder Score and visual analogue scale pain score was associated with a trend to normalisation of the elastic modus of the coracohumeral ligament. Conclusion: In patients with adhesive capsulitis of the shoulder, shear wave elastography demonstrated the coracohumeral ligament is stiffer in the symptomatic shoulder than in the unaffected shoulder. Treatment with the ultrasound-guided rotator interval injection is associated with improved Oxford Shoulder Score, reduced visual analogue scale pain scores, and reduced stiffness in the coracohumeral ligament.

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Section: Resultscontrasting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Elasticity of the coracohumeral ligament in patients with frozen shoulder following rotator interval injection: a case series

et al. 2020

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“…15 Very recently, several studies have reported its use and proven its reproducibility for exploring ligament structures in the shoulder, knee, and lateral ankle ligaments. 20,24,53…”

Section: Introductionmentioning

confidence: 99%

“…15 Very recently, several studies have reported its use and proven its reproducibility for exploring ligament structures in the shoulder, knee, and lateral ankle ligaments. 20,24,53 The objective of this pilot study was to determine whether SWE quantifies SWS distributions and their changes with position in the deltoid ligament complex in a cohort of healthy adult volunteers.…”

Section: Introductionmentioning

confidence: 99%

A Preliminary Study to Assess the Relevance of Shear-Wave Elastography in Characterizing Biomechanical Changes in the Deltoid Ligament Complex in Relation to Ankle Position

et al. 2022

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Background: The purpose of this study was (1) to evaluate the biomechanical properties of the different bundles of the deltoid ligament in various ankle positions in a cohort of healthy adult volunteers; (2) describe the impact of demographic and hindfoot morphology characteristics on their stiffness; (3) to assess the reliability and reproducibility of these measurements. Methods: Deltoid ligament complex of both ankles were assessed by shear-wave elastography (SWE) in 20 healthy patients resting on hinge support. The propagation shear-wave speed (SWS) in ligaments was measured, which is related to the tissue’s elastic modulus. The following ligaments were analyzed in a neutral position and then in varus, valgus, dorsal, and plantar flexions: tibionavicular ligament (TNL), tibiocalcaneal ligament (TCL), the superficial posterior tibiotalar ligament (SPTL), the anterior tibiotalar ligament (ATTL), and the deep posterior tibiotalar ligament (DPTTL). Results: The mean SWS increased between neutral and 20 degrees valgus position for TCL (4.08 ± 0.78 m/s vs 5.56 ± 0.62 m/s, respectively; P < .0001) and for DPTTL (2.58 ± 0.52 m/s vs 3.59 ± 0.87 m/s, respectively; P < .0001). The mean SWS increased between neutral and 30 degrees plantarflexion for ATTL (2.11 ± 0.44 m/s vs 3.1 ± 0.5 m/s, respectively; P < .0001) and TNL (2.96 ± 0.66 m/s vs 4.99 ± 0.69 m/s, respectively; P < .0001). The mean SWS increased between neutral and 20 degrees dorsal flexion for SPTL (4.2 ± 1 m/s vs 5.45 ± 0.65 m/s, respectively; P < .0001). Women had less DPTTL SWS than men in the neutral position (2.37 ± 0.35 m/s vs 2.71 ± 0.49 m/s, respectively; P = .007). Other demographics had no impact on the SWS value of other ligaments. All inter- and intraobserver agreements were good to excellent. Conclusion: This study presents a reliable and reproducible SWE measurement protocol to describe the physiological function of all bundles of the medial collateral ligament in healthy adults. Clinical relevance: This examination technique can be available to orthopaedic surgeons, allowing reliable and reproducible monitoring of the SWS of the various ligaments constituting the medial collateral plane. The biomechanical values described in this study may give insight into in what position medial ankle ligament reconstruction should be tensioned.

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“…At the same time, Young's modulus is a parameter commonly used in the expression of tissue elasticity 3,4 . The elasticity of tissue is often closely related to its functional state, and the detection of Young's modulus of tissue carries important clinical significance 5–7 . Using the acoustic radiation force of focused ultrasound beams, the supersonic shear imaging (SSI) technique generates shear waves.…”

Section: Introductionmentioning

confidence: 99%

Young's Modulus of Bilateral Infraspinatus Tendon Measured in Different Postures by Shear Wave Elastography Before and After Exercise

Hou

et al. 2021

Orthopaedic Surgery

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Objective: To investigate the Young's modulus value of infraspinatus tendons using shear wave elastography (SWE) technique in normal adults, and to analyze the influence of gender, postures, exercise, and dominant side on Young's modulus of infraspinatus tendons.Methods: This is a prospective cross-sectional study. From January 2019 to July 2020, 14 healthy subjects were identified, including seven males and seven females aged between 24 to 34, with a mean age of 27.67 AE 3.08 years. The Young's modulus of their infraspinatus tendons was measured by two operators using SWE in neutral and maximum external rotation positions of both sides before exercise and the dominant side after exercise. The Young's modulus values in different sexes, different postures, before vs after exercise, and dominant vs non-dominant side were statistically analyzed.Results: All 14 subjects completed the data collection process. The mean Young's modulus values of infraspinatus tendon for dominant sides in neutral position were 33.04 AE 3.01 kPa for males and 28.76 AE 3.09 kPa for females. And for non-dominant sides in the neutral position, the values were 33.02 AE 2.38 kPa for males and 28.86 AE 2.47 kPa for females. In the maximum external rotation position, the values for dominant sides were 50.19 AE 4.86 kPa for males and 42.79 AE 4.44 kPa for females, and for non-dominant sides were 50.95 AE 3.24 kPa for males and 42.42 AE 3.66 kPa for females. After exercise, the mean Young's modulus values of infraspinatus tendon for dominant sides in neutral position were 54.56 AE 3.76 kPa for males and 46.66 AE 5.99 kPa for females. And for the maximum external rotation position, the values were 59.13 AE 3.78 kPa for males and 54.49 AE 5.67 kPa for females. The Young's modulus of infraspinatus tendon in the neutral and maximum external rotation positions showed statistically significant differences in males and females, as well as before and after exercise (P < 0.05). However, the difference in Young's modulus between the dominant and non-dominant sides was not statistically significant (P > 0.05). Intergroup reliability between both operators was excellent (ICC > 0.85). Conclusion:There are gender-related differences and post-exercise increase in Young's modulus, yet such a difference cannot be witnessed between the dominant and non-dominant sides.

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Increased Stiffness of Rotator Cuff Tendons in Frozen Shoulder on Shear Wave Elastography

Cited by 25 publications

References 26 publications

Elasticity of the coracohumeral ligament in patients with frozen shoulder following rotator interval injection: a case series

Elasticity of the coracohumeral ligament in patients with frozen shoulder following rotator interval injection: a case series

A Preliminary Study to Assess the Relevance of Shear-Wave Elastography in Characterizing Biomechanical Changes in the Deltoid Ligament Complex in Relation to Ankle Position

Young's Modulus of Bilateral Infraspinatus Tendon Measured in Different Postures by Shear Wave Elastography Before and After Exercise

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