Reliability of ultrasound shear-wave elastography in assessing tensor fascia latae, gluteus medius, and iliotibial band elasticity in health individuals
Abstract
Purpose: Gluteus medius (GMed), tensor fascia latae (TFL), and iliotibial band (ITB) play important roles in stabilizing the hip joint and are often prone to overuse syndromes such as greater trochanteric pain syndrome and runner’s knee. Shear-wave elastography (SWE) presents a new avenue for rapidly assessing these structures in an out-patient setting. This study aims to assess the intra- and interobserver reliability of sWE in evaluating the GMed, TFL, and ITB.
Materials and Methods: Twelve healthy volunteers (6 men and 6 women) were examined by two physiatrists using SWE. To assess inter-observer reliability, both physiatrists measured the thickness, velocity, and stiffness of GMed, TFL, and proximal and distal ITB. One physiatrist repeated the same measurements under identical conditions one week later to assess intra-observer reliability. Intra-class correlation coefficients (ICC) were calculated to evaluate reliability.
Results: Inter-observer measurements showed poor reliability (ICC < 0.4) for all parameters, except for GMed thickness (ICC=0.412), which was moderately reliable. Intra-observer measurements showed varying degrees of reliability, with TFL thickness (ICC=0.733), ITBP thickness (ICC=0.592), ITBD velocity (ICC=0.634), and ITBD stiffness (ICC=0.701) demonstrating moderate reliability. However, no excellent ICC scores were observed across both intra- and inter-observer assessments.
Conclusion: While SWE demonstrates promise in assessing hip stabilizers, its inconsistent reliability across different parameters highlights the need for further research. Comparative studies involving healthy and pathological groups are needed for better understanding of SWE’s applicability in clinical settings.
Keywords
Elastography, Shear-wave, Ultrasound, Musculoskeletal, Hip Muscles, Reliability
References
- Speers CJ, Bhogal GS. Greater trochanteric pain syndrome: A review of diagnosis and management in general practice. Br J Gen Pract. 2017;67:479-80.
- Bierma-Zeinstra S, Bohnen A, Ginai A, Prins A, Verhaar J. Validity of american college of rheumatology criteria for diagnosing hip osteoarthritis in primary care research. J Rheumatol. 1999;26:1129-33.
- Mastenbrook MJ, Commean PK, Hillen TJ, Salsich GB, Meyer GA, Mueller MJ, et al. Hip abductor muscle volume and strength differences between women with chronic hip joint pain and asymptomatic controls. J Orthop Sports Phys Ther. 2017;47:923-30.
- Huang BK, Campos JC, Michael Peschka PG, Pretterklieber ML, Skaf AY, Chung CB, et al. Injury of the gluteal aponeurotic fascia and proximal iliotibial band: Anatomy, pathologic conditions, and mr imaging. Radiographics. 2013;33:1437-52.
- Creze M, Nordez A, Soubeyrand M, Rocher L, Maître X, Bellin MF. Shear wave sonoelastography of skeletal muscle: Basic principles, biomechanical concepts, clinical applications, and future perspectives. Skeletal Radiol. 2018;47:457-71.
- Klauser AS, de-Koekkoek F, Schwabl C, Fink C, Friede M, Csapo R. Intraobserver assessment of shear wave elastography in tensor fasciae latae and gluteus maximus muscle: The importance of the hip abductor muscles in runners knee compared to healthy controls. J Clin Med. 2022;11:3605.
- Besomi M, Salomoni SE, Hug F, Tier L, Vicenzino B, Hodges PW. Exploration of shear wave elastography measures of the iliotibial band during different tasks in pain-free runners. Phys Ther Sport. 2021;50:121-9.
- Temel GO, Erdoğan S. Determining the sample size in agreement studies. Marmara Medical Journal. 2017;30:101-12.
- Alfuraih AM, Tan AL, O'Connor P, Emery P, Wakefield RJ. The effect of ageing on shear wave elastography muscle stiffness in adults. Aging Clin Exp Res. 2019;31:1755-63.
- Deshmukh SD, Abboud SF, Grant T, Omar IM. High-resolution ultrasound of the fascia lata iliac crest attachment: Anatomy, pathology, and image-guided treatment. Skeletal Radiol. 2019:1-7.
