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Diagnostic Consistency between Sonoelastography and Conventional Sonography of Long Head of the Biceps

  • Yoon, Sunghyun (Department of Orthopedic Surgery, Dankook University Medical College) ;
  • Seo, Joong-Bae (Department of Orthopedic Surgery, Dankook University Medical College) ;
  • Yoo, Jae-Sung (Department of Orthopedic Surgery, Dankook University Medical College) ;
  • Ryu, Jee-Won (Department of Orthopedic Surgery, Dankook University Medical College)
  • Received : 2014.05.18
  • Accepted : 2014.07.23
  • Published : 2014.09.30

Abstract

Background: Sonoelastography (SE) is a new technique that can assess differences in tissue stiffness, the purpose of this study was to evaluate the ability of SE to assess the long head of biceps tendon alteration. Methods: Forty shoulders of 36 consecutively registered patients with clinical symptoms and conventional ultrasonography findings of biceps tendinitis or tendinosis, and 40 asymptomatic shoulders of 20 healthy volunteers were assessed with SE. Transverse and longitudinal images of long head of biceps tendon were obtained using SE. SE images were performed by one orthopedic surgeon and evaluated by two orthopedic surgeons using an experimentally proven color grading system. Results: The transverse images of SE showed a sensitivity of 87.5%, a specificity of 95.0% and a accuracy of 91.3%, the longitudinal images of SE showed a sensitivity of 92.5%, a specificity of 90.0% and a accuracy of 91.3%. Inter-observer reliability of SE was in 'almost perfect agreement' with a weighted kappa coefficient of 0.83. Conclusions: SE is valuable in the detection of the intratendinous and peritendinous alterations of biceps tendon, and has excellent accuracy and excellent correlation with conventional ultrasound findings.

Keywords

References

  1. Patton WC, McCluskey GM 3rd. Biceps tendinitis and subluxation. Clin Sports Med. 2001;20(3):505-29. https://doi.org/10.1016/S0278-5919(05)70266-0
  2. Abrams JS. Special shoulder problems in the throwing athlete: pathology, diagnosis, and nonoperative management. Clin Sports Med. 1991;10(4):839-61.
  3. Kibler WB. Scapular involvement in impingement: signs and symptoms. Instr Course Lect. 2006;55:35-43.
  4. Sethi N, Wright R, Yamaguchi K. Disorders of the long head of the biceps tendon. J Shoulder Elbow Surg. 1999;8(6):644-54. https://doi.org/10.1016/S1058-2746(99)90105-2
  5. Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology. 2006;239(2):341-50. https://doi.org/10.1148/radiol.2391041676
  6. Frey H. Realtime elastography. A new ultrasound procedure for the reconstruction of tissue elasticity. Radiologe. 2003;43(10):850-5. https://doi.org/10.1007/s00117-003-0943-2
  7. Garra BS, Cespedes EI, Ophir J, et al. Elastography of breast lesions: initial clinical results. Radiology. 1997;202(1):79-86. https://doi.org/10.1148/radiology.202.1.8988195
  8. Lyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005;237(1):202-11. https://doi.org/10.1148/radiol.2363041248
  9. Pallwein L, Mitterberger M, Struve P, et al. Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection. Eur Radiol. 2007;17(9):2278-85. https://doi.org/10.1007/s00330-007-0606-1
  10. Lyshchik A, Higashi T, Asato R, et al. Cervical lymph node metastases: diagnosis at sonoelastography--initial experience. Radiology. 2007;243(1):258-67. https://doi.org/10.1148/radiol.2431052032
  11. Zanetti M, Hodler J. Imaging of degenerative and posttraumatic disease in the shoulder joint with ultrasound. Eur J Radiol. 2000;35(2):119-25. https://doi.org/10.1016/S0720-048X(00)00227-8
  12. Seo JB, Yoo JS, Ryu JW. Sonoelastography findings of biceps tendinitis and tendinosis. J Ultrasound. 2014. doi: 10.1007/s40477-014-0075-8.
  13. Armstrong A, Teefey SA, Wu T, et al. The efficacy of ultrasound in the diagnosis of long head of the biceps tendon pathology. J Shoulder Elbow Surg. 2006;15(1):7-11. https://doi.org/10.1016/j.jse.2005.04.008
  14. Arroyo JS, Hershon SJ, Bigliani LU. Special considerations in the athletic throwing shoulder. Orthop Clin North Am. 1997;28(1):69-78. https://doi.org/10.1016/S0030-5898(05)70265-0
  15. Fredberg U, Stengaard-Pedersen K. Chronic tendinopathy tissue pathology, pain mechanisms, and etiology with a special focus on inflammation. Scand J Med Sci Sports. 2008;18(1):3-15. https://doi.org/10.1111/j.1600-0838.2007.00746.x
  16. Khan KM, Forster BB, Robinson J, et al. Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two year prospective study. Br J Sports Med. 2003;37(2):149-53. https://doi.org/10.1136/bjsm.37.2.149
  17. Mohtadi NG, Vellet AD, Clark ML, et al. A prospective, double-blind comparison of magnetic resonance imaging and arthroscopy in the evaluation of patients presenting with shoulder pain. J Shoulder Elbow Surg. 2004;13(3):258-65. https://doi.org/10.1016/j.jse.2004.01.003
  18. Ahrens PM, Boileau P. The long head of biceps and associated tendinopathy. J Bone Joint Surg Br. 2007;89(8):1001-9.
  19. King LJ, Healy JC. Imaging of the painful shoulder. Man Ther. 1999;4(1):11-8. https://doi.org/10.1016/S1356-689X(99)80004-6
  20. Lecoq B, Levasseur R, Fournier L, Schmutz G, Marcelli C. Atypical pattern of acute severe shoulder pain: contribution of sonography. Joint Bone Spine. 2004;71(6):592-4. https://doi.org/10.1016/j.jbspin.2004.05.016
  21. Martinoli C, Bianchi S, Prato N, et al. US of the shoulder: nonrotator cuff disorders. Radiographics. 2003;23(2):381-401;quiz 534. https://doi.org/10.1148/rg.232025100
  22. Parameswaran K, Willems-Widyastuti A, Alagappan VK, Radford K, Kranenburg AR, Sharma HS. Role of extracellular matrix and its regulators in human airway smooth muscle biology. Cell Biochem Biophys. 2006;44(1):139-46. https://doi.org/10.1385/CBB:44:1:139
  23. Khoury V, Cardinal E. "Tenomalacia": a new sonographic sign of tendinopathy? Eur Radiol. 2009;19(1):144-6. https://doi.org/10.1007/s00330-008-1112-9
  24. De Zordo T, Chhem R, Smekal V, et al. Real-time sonoelastography: findings in patients with symptomatic achilles tendons and comparison to healthy volunteers. Ultraschall Med. 2010; 31(4):394-400. https://doi.org/10.1055/s-0028-1109809
  25. De Zordo T, Lill SR, Fink C, et al. Real-time sonoelastography of lateral epicondylitis: comparison of findings between patients and healthy volunteers. AJR Am J Roentgenol. 2009; 193(1):180-5. https://doi.org/10.2214/AJR.08.2020