Strain sonoelastography in asymptomatic individuals and individuals with knee osteoarthritis: an evaluation of quadriceps and patellar tendon

Diane M Dickson; Stephanie L Smith; Gordon J Hendry

doi:10.1007/s00296-022-05184-3

Strain sonoelastography in asymptomatic individuals and individuals with knee osteoarthritis: an evaluation of quadriceps and patellar tendon

Rheumatol Int. 2022 Dec;42(12):2241-2251. doi: 10.1007/s00296-022-05184-3. Epub 2022 Aug 17.

Authors

Diane M Dickson¹, Stephanie L Smith^{2

3}, Gordon J Hendry²

Affiliations

¹ Research Centre for Health, Department of Podiatry and Radiography, School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK. Diane.Dickson@gcu.ac.uk.
² Research Centre for Health, Department of Podiatry and Radiography, School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK.
³ Pain Centre Versus Arthritis, Academic Rheumatology, Injury Recover and Inflammation Sciences, School of Medicine, University of Nottingham, Clinical Sciences Building, Nottingham, NG5 1PB, UK.

Abstract

An advanced ultrasound imaging technique, sonoelastography (SE) is used to evaluate tissue elasticity. To determine SE potential to detect pathological-related changes, and characteristics related to tendon pathology we aimed to (1) compare quadriceps and patellar tendon findings in individuals with knee osteoarthritis (KOA) and asymptomatic older adults (AC), and (2) explore associations between SE, participant characteristics (age, BMI, and leg circumference) and KOA status. 84 participants (47; KOA and 37; asymptomatic older adults) underwent SE examination of quadriceps (distal) and patellar (distal, proximal) tendon in a supine position with the knee bent at 30°. Colour score (CS) and Elasticity Ratio (ER) analysis were performed by a blinded experienced operator using Esaote Mylab 70 XVG Ultrasound equipment. Significantly reduced elasticity in the distal quadriceps (median (IQR) 2(2), 3(1), p = 0.033 for KOA and AC, respectively) and proximal patellar (3(1), 3(0), p = 0.001) tendons and more elastic distal patellar (1.50 (0.55), 1.87 (0.72), p = 0.034) tendons were observed in the KOA group. Significant associations) were identified between SE and participant BMI (Rs = - 0.249-0.750, p < 0.05) and leg circumference (Rs = - 0.260-0.903, p < 0.05). Age, BMI and KOA status, were independent explanatory variables of SE CS findings at the distal quadriceps tendon patellar tendon, proximal patellar tendon and distal patellar tendon, explaining 66%, 81% and 64% of variance, respectively. Age, BMI and KOA status were independent explanatory variables of SE ER findings at the distal patellar tendon explaining 19% of variance. Potentially clinically relevant altered tendon stiffness were observed between individuals with KOA and asymptomatic controls. Key KOA risk factors and participant characteristics explained variance in tendon stiffness. Findings provide context for future studies to investigate the potential for targeted SE detected early clinical management based on associated participant characteristics.

Keywords: Elastography; Knee; Osteoarthritis; Sonoelastography; Tendon.

MeSH terms

Aged
Elasticity Imaging Techniques*
Humans
Osteoarthritis, Knee* / diagnostic imaging
Patellar Ligament* / diagnostic imaging
Quadriceps Muscle / diagnostic imaging
Tendons / diagnostic imaging