Ultrasound elastography of lateral epicondylosis: Clinical feasibility of quantitative elastographic measurements

Kyung Sik Ahn, Chang Ho Kang, Suk Joo Hong, Woong Kyo Jeong

    Research output: Contribution to journalArticlepeer-review

    28 Citations (Scopus)

    Abstract

    OBJECTIVE. The objective of our study was to investigate the clinical feasibility of ultrasound elastography for assessing patients with lateral epicondylosis and to establish an objective and quantitative method of elastographic measurement in the affected tendon. SUBJECTS AND METHODS. A total of 97 symptomatic and 89 asymptomatic common extensor tendons from both elbows of 79 consecutive patients with lateral epicondylosis and 14 healthy participants were prospectively examined by gray-scale sonography, color Doppler sonography, and compression-based elastography. Real-time color-coded elastography was performed and quantified with two regions of interest: the adjacent subcutis (S1) for a reference area and the common extensor tendon (S2) for the target area. The mean strain ratio (S1/S2) was used for quantitative comparisons. The difference in the mean strain ratio between symptomatic and asymptomatic tendons was assessed with conditional regression analysis. RESULTS. In symptomatic elbows, 87 of 97 tendons (89.7%) showed intratendinous hypoechogenicity, 86 of 97 (88.7%) showed swelling, and 70 of 97 tendons (72.2%) showed intratendinous hyperemia. Color-coded elastography revealed a soft area on 73 of 97 tendons (75.3%). The mean strain ratio was 1.45 (SD, 0.45) for symptomatic tendons and 2.07 (SD, 0.70) for asymptomatic tendons. The mean strain ratio of the symptomatic tendons was significantly lower than that of asymptomatic tendons (p < 0.001), indicating that the symptomatic CONCLUSION. Our results revealed that patients with lateral epicondylosis had significantly lower strain ratios in their common extensor tendon origins. Ultrasound elastography using quantitative strain ratio measurements could be a promising supplementary method to evaluate tendon abnormalities in lateral epicondylosis. tendons were softer.

    Original languageEnglish
    Pages (from-to)1094-1099
    Number of pages6
    JournalAmerican Journal of Roentgenology
    Volume202
    Issue number5
    DOIs
    Publication statusPublished - 2014 May

    Keywords

    • Elastography
    • Elbow
    • Lateral epicondylosis
    • Tennis elbow
    • Ultrasound

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging

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