Kocyigit Figen, Kuyucu Ersin, Kocyigit Ali, Herek Duygu Tuncer, Savkin Raziye, Aslan Ummuhan Bas, Karabulut Nevzat
School of Physical Therapy and Rehabilitation, Pamukkale University, 20070, Denizli, Turkey.
Department of Orthopedics and Traumatology, Faculty of Medicine, Medipol University, Istanbul, Turkey.
Rheumatol Int. 2016 Jan;36(1):91-100. doi: 10.1007/s00296-015-3356-4. Epub 2015 Sep 5.
The objective of this study was to investigate the role of real-time sonoelastography (RTSE) in patients with lateral epicondylitis (LE) and whether it is associated with clinical parameters. Seventeen patients with unilateral LE were enrolled in the study. The healthy elbows of the participants constituted the control group. Using B-mode ultrasound, color Doppler ultrasound, and RTSE, we prospectively examined 34 common extensor tendon elbows of 17 patients. Both color scales and strain ratio were used for evaluating RTSE images. Two radiologists evaluated the RTSE images separately. Elbow pain was scored on a 100-mm visual analog scale (VAS). Symptom duration and the presence of nocturnal pain were questioned. Quick disabilities of arm shoulder and hand (DASH) Questionnaire was applied to assess the pain, function, and disability. Nottingham health profile (NHP) was used to determine and quantify perceived health problems. Both color scales and strain ratios of the affected tendon portions were significantly different from that of healthy tendons (p < 0.001). There was no significant association between NHP, VAS, Quick DASH scores, and color scales and strain ratio. Strain ratio of the medial portion of the affected tendon was significantly correlated with symptom duration (rho = -0.61 p = 0.010) and nocturnal pain (rho = 0.522 p = 0.031). Interobserver agreement was substantial for color scales (κ = 0.74, p = 0.001) and strain ratio (ICC = 0.61, p = 0.031). RTSE may facilitate differentiation between healthy and affected elbows as a feasible and practical supplementary method with substantial interobserver agreement. RTSE was superior to B-mode ultrasound and color Doppler ultrasound in discriminating tendons with LE. Strain ratio of the medial portion of the tendon is associated moderately with nocturnal pain and symptom duration. No other associations were present between RTSE findings and clinical or functional parameters.
本研究的目的是探讨实时弹性成像（RTSE）在外侧 epicondylitis（LE）患者中的作用，以及它是否与临床参数相关。17 例单侧 LE 患者纳入本研究。参与者的健康肘部构成对照组。使用 B 型超声、彩色多普勒超声和 RTSE，我们前瞻性地检查了 17 例患者的 34 个常见伸肌腱肘部。彩色量表和应变率均用于评估 RTSE 图像。两位放射科医生分别评估 RTSE 图像。肘部疼痛采用 100 毫米视觉模拟量表（VAS）评分。询问症状持续时间和夜间疼痛情况。应用手臂、肩部和手部快速残疾（DASH）问卷评估疼痛、功能和残疾情况。使用诺丁汉健康概况（NHP）来确定和量化感知到的健康问题。患侧肌腱部分的彩色量表和应变率与健康肌腱相比均有显著差异（p < 0.001）。NHP、VAS、快速 DASH 评分与彩色量表和应变率之间无显著关联。患侧肌腱内侧部分的应变率与症状持续时间（rho = -0.61，p = 0.010）和夜间疼痛（rho = 0.522，p = 0.031）显著相关。观察者间对彩色量表（κ = 0.74，p = 0.001）和应变率（ICC = 0.61，p = 0.031）的一致性较高。RTSE 作为一种可行且实用的补充方法，观察者间一致性较高，可能有助于区分健康肘部和患侧肘部。在鉴别 LE 肌腱方面，RTSE 优于 B 型超声和彩色多普勒超声。肌腱内侧部分的应变率与夜间疼痛和症状持续时间中度相关。RTSE 结果与临床或功能参数之间不存在其他关联。
