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Reliability of ultrasound shear-wave elastography in assessing tensor fascia latae, gluteus medius, and iliotibial band elasticity in health individuals

Yıl 2024, Cilt: 49 Sayı: 3, 632 - 638, 30.09.2024
https://doi.org/10.17826/cumj.1432600

Öz

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.

Kaynakça

  • 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.
  • Whittaker JL, Emery CA. Sonographic measures of the gluteus medius, gluteus minimus, and vastus medialis muscles. J Orthop Sports Phys Ther. 2014;44:627-32.
  • Chang KV, Wu WT, Lew HL, Ozcakar L. Ultrasound imaging and guided injection for the lateral and posterior hip. Am J Phys Med Rehabil. 2018;97:285-91.
  • Gyaran IA, Spiezia F, Hudson Z, Maffulli N. Sonographic measurement of iliotibial band thickness: An observational study in healthy adult volunteers. Knee Surg Sports Traumatol Arthrosc. 2011;19:458-61.
  • Deshmukh S, 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;48:1315-21.
  • Vallat R. Pingouin: Statistics in python. Journal of Open Source Software. 2018;3:1026.
  • Umehara J, Ikezoe T, Nishishita S, Nakamura M, Umegaki H, Kobayashi T et al. Effect of hip and knee position on tensor fasciae latae elongation during stretching: An ultrasonic shear wave elastography study. Clin Biomech (Bristol, Avon). 2015;30:1056-9.

Sağlıklı bireylerde tensör fasya lata, gluteus medius ve iliotibial bant elastikiyetinin değerlendirilmesinde shear-wave elastografinin güvenilirliği

Yıl 2024, Cilt: 49 Sayı: 3, 632 - 638, 30.09.2024
https://doi.org/10.17826/cumj.1432600

Öz

Amaç: Gluteus medius (GMed), tensör fasya lata (TFL) ve iliotibial bant (İTB) kalça ekleminin stabilizasyonunda önemli rol oynayan kaslardandır ve büyük trokanterik ağrı sendromu ve koşucu dizi gibi aşırı kullanım sendromlarında sıklıkla tutulabilir. Shear-wave elastografisi (SWE), bu yapıların kliniklerde hızlı bir şekilde değerlendirilmesi için yeni bir yol sunar. Bu çalışma, GMed, TFL ve İTB'nin değerlendirilmesinde SWE'nin gözlemci içi ve gözlemciler arası güvenilirliğini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: On iki sağlıklı gönüllü (6 erkek ve 6 kadın) iki fiziyatrist tarafından SWE kullanılarak muayene edildi. Gözlemciler arası güvenilirliği değerlendirmek için her iki fiziyatrist de GMed, TFL ve proksimal ve distal İTB'nin kalınlığını, hızını ve sertliğini ölçtü. Bir fiziyatrist, gözlemci içi güvenilirliği değerlendirmek için aynı ölçümleri bir hafta sonra aynı koşullar altında tekrarladı. Güvenilirliği değerlendirmek için sınıf içi korelasyon katsayıları (ICC) hesaplandı.
Bulgular: Gözlemciler arası ölçümler, orta derecede güvenilir olan GMed kalınlığı (ICC=0.412) dışında tüm parametreler için zayıf güvenilirlik (ICC< 0.4) gösterdi. Gözlemci içi ölçümler, orta derecede güvenilirlik gösteren TFL kalınlığı (ICC=0.733), proksimal İTB kalınlığı (ICC=0.592), distal İTB hızı (ICC=0.634) ve distal İTB (ICC=0.701) sertliği ile değişen derecelerde güvenilirlik gösterdi. Ancak hem gözlemciler arası hem de gözlemciler arası değerlendirmelerde mükemmel ICC puanları gözlenmedi.
Sonuç: SWE, kalça stabilizatörlerinin değerlendirilmesinde umut verici olsa da, farklı parametrelerdeki tutarsız güvenilirliği daha fazla araştırmaya duyulan ihtiyacı vurgulamaktadır. SWE'nin klinik ortamlarda uygulanabilirliğinin daha iyi anlaşılması için sağlıklı ve patolojik grupları içeren karşılaştırmalı çalışmalara ihtiyaç vardır.

Kaynakça

  • 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.
  • Whittaker JL, Emery CA. Sonographic measures of the gluteus medius, gluteus minimus, and vastus medialis muscles. J Orthop Sports Phys Ther. 2014;44:627-32.
  • Chang KV, Wu WT, Lew HL, Ozcakar L. Ultrasound imaging and guided injection for the lateral and posterior hip. Am J Phys Med Rehabil. 2018;97:285-91.
  • Gyaran IA, Spiezia F, Hudson Z, Maffulli N. Sonographic measurement of iliotibial band thickness: An observational study in healthy adult volunteers. Knee Surg Sports Traumatol Arthrosc. 2011;19:458-61.
  • Deshmukh S, 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;48:1315-21.
  • Vallat R. Pingouin: Statistics in python. Journal of Open Source Software. 2018;3:1026.
  • Umehara J, Ikezoe T, Nishishita S, Nakamura M, Umegaki H, Kobayashi T et al. Effect of hip and knee position on tensor fasciae latae elongation during stretching: An ultrasonic shear wave elastography study. Clin Biomech (Bristol, Avon). 2015;30:1056-9.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi
Bölüm Araştırma
Yazarlar

Mahir Topaloğlu 0000-0002-9364-4512

Zeynep Turan 0000-0001-8142-3467

Deniz Sarıkaya 0000-0002-4922-5847

Özden Özyemişçi Taşkıran 0000-0002-2052-6072

Yayımlanma Tarihi 30 Eylül 2024
Gönderilme Tarihi 6 Şubat 2024
Kabul Tarihi 7 Ağustos 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 49 Sayı: 3

Kaynak Göster

MLA Topaloğlu, Mahir vd. “Reliability of Ultrasound Shear-Wave Elastography in Assessing Tensor Fascia Latae, Gluteus Medius, and Iliotibial Band Elasticity in Health Individuals”. Cukurova Medical Journal, c. 49, sy. 3, 2024, ss. 632-8, doi:10.17826/cumj.1432600.