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. 2020 Apr;39(2):114-120.
doi: 10.14366/usg.19032. Epub 2019 Aug 1.

Glenohumeral joint capsular tissue tension loading correlates moderately with shear wave elastography: a cadaveric investigation

Charles W Nichols  1 , Jean-Michel Brismée  2 , Troy L Hooper  2 , Antony Bertrand-Grenier  3   4   5 , Kerry K Gilbert  2 , Marc-Olivier St-Pierre  6 , Jeegisha Kapila  7 , Stéphane Sobczak  6   8
Affiliations

Glenohumeral joint capsular tissue tension loading correlates moderately with shear wave elastography: a cadaveric investigation

Charles W Nichols et al. Ultrasonography. 2020 Apr.

Abstract

Purpose: The purpose of this study was to investigate changes in the mechanical properties of capsular tissue using shear wave elastography (SWE) and a durometer under various tensile loads, and to explore the reliability and correlation of SWE and durometer measurements to evaluate whether SWE technology could be used to assess tissue changes during capsule tensile loading.

Methods: The inferior glenohumeral joint capsule was harvested from 10 fresh human cadaveric specimens. Tensile loading was applied to the capsular tissue using 1-, 3-, 5-, and 8-kg weights. Blinded investigators measured tissue stiffness and hardness during loading using SWE and a durometer, respectively. Intraobserver reliability was established for SWE and durometer measurements using intraclass correlation coefficients (ICCs). The Pearson product-moment correlation was used to assess the associations between SWE and durometer measurements.

Results: The ICC3,5 for durometer measurements was 0.90 (95% confidence interval [CI], 0.79 to 0.96; P<0.001) and 0.95 (95% CI, 0.88 to 0.98; P<0.001) for SWE measurements. The Pearson correlation coefficient values for 1-, 3-, and 5-kg weights were 0.56 (P=0.095), 0.36 (P=0.313), and -0.56 (P=0.089), respectively. When the 1- and 3-kg weights were combined, the ICC3,5 was 0.72 (P<0.001), and it was 0.62 (P<0.001) when the 1-, 3-, and 5-kg weights were combined. The 8-kg measurements were severely limited due to SWE measurement saturation of the tissue samples.

Conclusion: This study suggests that SWE is reliable for measuring capsular tissue stiffness changes in vitro at lower loads (1 and 3 kg) and provides a baseline for the non-invasive evaluation of effects of joint loading and mobilization on capsular tissues in vivo.

Keywords: Elasticity; Elastography; Hardness; Joint capsule; Reliability.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.. Testing frame set-up.
A standing frame with custom clamps secured superiorly and inferiorly with a suspended 3-kg weight and stabilizing bar. The arrow indicates the location of the glenohumeral joint capsular tissue prior to application of the gelatin pad.
Fig. 2.
Fig. 2.. Measurement set-up for tissue.
The shear wave elastography measurements of capsular tissue were made using a linear transducer over tissue surrounded by gelatin and secured by Opsite Flexifix material.
Fig. 3.
Fig. 3.. Shear wave elastography Q-box measurements.
A. The display demonstrates statistical information and a non-saturated display within the region of interest, which is identified within the dotted line. B. The display demonstrates statistical information and a saturated display within the region of interest, which is identified within the dotted line.
Fig. 4.
Fig. 4.. Shore A durometer.
The arrow indicates the device indenter.
See this image and copyright information in PMC

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