Al-Razi Orthopedic and Rehabilitation Hospital, Kuwait City, Kuwait.
Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait.
Clin Rheumatol. 2019 Jan;38(1):85-95. doi: 10.1007/s10067-018-4193-0. Epub 2018 Jul 3.
Hypermobility spectrum disorders (HSDs) are conditions associated with chronic joint pain and laxity. HSD's diagnostic approach is highly subjective, its validity is not well studied, and it does not consider many of the most commonly affected joints. Strain elastography (SEL) reflects musculoskeletal elasticity with sonographic images. The study explored the impact of HSD on musculoskeletal elasticity using SEL. A cross-sectional design compared 21 participants with HSD against 22 controls. SEL was used to assess the elasticity of the deltoid, biceps brachii, brachioradialis, rectus femoris, and gastrocnemius muscles, and the patellar and Achilles tendon. SEL images were analyzed using strain index, strain ratio, and color pixels. Mean strain index (standard deviation) was significantly reduced in the HSD group compared to the control group in the brachioradialis muscle 0.43 (0.10) vs. 0.59 (0.24), patellar 0.30 (0.10) vs. 0.44 (0.11), and Achilles tendons 0.24 (0.06) vs. 0.49 (0.13). Brachioradialis muscle and patellar tendon's strain ratios were significantly lower in the HSD group compared to the control group, 6.02 (2.11) vs. 8.68 (2.67) and 5.18 (1.67) vs. 7.62 (1.88), respectively. The percentages (%) of red color (soft tissues) in the SEL images were significantly increased in the HSD group compared to the control group in the biceps brachii muscle, 34.72 (7.82) vs. 26.69 (3.89), and Achilles tendon, 18.14 (13.21) vs. 5.59 (8.23) (p ≤ 0.01). The elasticity of the musculoskeletal system seems to be lower in people with HSD. SEL could be a supplementary tool for diagnosing and monitoring HSD.
过度活动综合征（HSD）是与慢性关节疼痛和松弛相关的病症。HSD 的诊断方法高度主观，其有效性尚未得到充分研究，并且它没有考虑到许多最常受影响的关节。应变弹性成像（SEL）通过超声图像反映肌肉骨骼的弹性。本研究使用 SEL 探讨 HSD 对肌肉骨骼弹性的影响。采用横断面设计比较了 21 名 HSD 患者和 22 名对照组。使用 SEL 评估三角肌、肱二头肌、肱桡肌、股四头肌和比目鱼肌以及髌腱和跟腱的弹性。使用应变指数、应变比和彩色像素分析 SEL 图像。与对照组相比，HSD 组的肱桡肌、髌腱和跟腱的平均应变指数（标准差）显著降低，分别为 0.43（0.10）与 0.59（0.24）、0.30（0.10）与 0.44（0.11）和 0.24（0.06）与 0.49（0.13）。与对照组相比，HSD 组的肱桡肌和髌腱的应变比显著降低，分别为 6.02（2.11）与 8.68（2.67）和 5.18（1.67）与 7.62（1.88）。与对照组相比，HSD 组的 SEL 图像中红色（软组织）的百分比显著增加，分别为肱二头肌 34.72（7.82）与 26.69（3.89）和跟腱 18.14（13.21）与 5.59（8.23）（p≤0.01）。HSD 患者的肌肉骨骼系统弹性似乎较低。SEL 可能是诊断和监测 HSD 的补充工具。
