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. 2018 Jan 10;7(3):467-477.
doi: 10.11138/mltj/2017.7.3.467. eCollection 2017 Jul-Sep.

Real-time sonoelastography: principles and clinical applications in tendon disorders. A systematic review

Federico Fusini  1 , Francesco Langella  2 , Alberto Busilacchi  3 , Cosimo Tudisco  4 , Antonio Gigante  3 , Alessandro Massé  1 , Salvatore Bisicchia  5
Affiliations

Real-time sonoelastography: principles and clinical applications in tendon disorders. A systematic review

Federico Fusini et al. Muscles Ligaments Tendons J. .

Abstract

Background: Sonoelastography (SE) is a new ultrasound-based method adopted in an increased number of scientific reports to analyse normal and pathological tendons. The aim of this study is to provide a systematic overview of clinical applications of SE in normal and pathological tendons.

Methods: A systematic research of PubMed, Ovid, and Cochrane Library electronic databases was performed according to PRISMA guideline. Two Authors searched and evaluated the articles independently; a third Author was involved to solve any disagreement. The Oxford Level of Evidence (LoE) was used to assess each article.

Results: There is an increasing interest in the application of SE in the evaluation of healthy and diseased tendons. Many different tendons are amenable for SE evaluation, such as the Achilles and patellar tendons, rotator cuff, common extensor tendons, quadriceps tendon, and the plantar fascia.

Conclusion: SE appears to be a very useful diagnostic tool, in particular in tendon pathology. This is a dynamic examination, provides an immediate evaluation of the tissue elasticity, and may be useful in recognizing tendon abnormalities and in implementing the information available with conventional US.

Level of evidence: IV.

Keywords: elastography; elastosonography; epicondylitis; plantar fasciitis; tendinopathy; tendon healing.

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Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) flow diagram of studies screened, selected and included in systematic review.
Figure 2
Figure 2
US examination (left side) and RTSE (right side) of normal Achilles tendon of a healthy volunteer. Healthy Achilles tendon showed a prevalence of blue/green pattern. AT, Achilles tendon; C, calcaneous; FP, Kager’s fat pat.
Figure 3
Figure 3
US examination (left side) and RTSE (right side) of the right shoulder of a 65-year-old woman, right hand dominant, 2 years after arthroscopic rotator cuff repair. The red circle is located in the bone, while the green circle represents tendon degeneration. SA, suture anchor; D, deltoid; GT, greater tuberosity; HH, humeral head.
Figure 4
Figure 4
US examination (left side) and RTSE (right side) of the right shoulder of a 64-year-old man, right hand dominant, with a rotator cuff tear. US showed a 2 cm supraspinatus tendon tear (asterisks). The red circle is located in the bone, while the green circle is located in the torn tendon. D, deltoid; GT, greater tuberosity; HH, humeral head.
Figure 5
Figure 5
US examination (left side) and RTSE (right side) of the right shoulder of a 58-year-old man, right hand dominant, operated on the right shoulder, who developed a re-tear/non-healing (asterisks) after surgery. The red circle represents is located in the bone, while the green circle is located in the torn tendon. SA, suture anchor; D, deltoid; GT, greater tuberosity; HH, humeral head.
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