Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus

European Radiology volume 28, pages5338–5351(2018)Cite this article

Abstract

Objectives

To update the 2012 European Society of Musculoskeletal Radiology (ESSR) clinical consensus guidelines for musculoskeletal ultrasound referral in Europe.

Methods

Twenty-one musculoskeletal imaging experts from the ESSR participated in a consensus study based on a Delphic process. Two independent (non-voting) authors facilitated the procedure and resolved doubtful issues. Updated musculoskeletal ultrasound literature up to July 2017 was scored for shoulder, elbow, wrist/hand, hip, knee, and ankle/foot. Scoring of ultrasound elastography was included. The strength of the recommendation and level of evidence was scored by consensus greater than 67% or considered uncertain when the consensus was consensus less than 67%.

Results

A total of 123 new papers were reviewed. No evidence change was found regarding the shoulder. There were no new relevant articles for the shoulder, 10 new articles for the elbow, 28 for the hand/wrist, 3 for the hip, 7 for the knee, and 4 for the ankle/foot. Four new evidence levels of A were determined, one for the hip (gluteal tendons tears), one for the knee (meniscal cysts), one for the ankle (ankle joint instability), and one for the foot (plantar plate tear). There was no level A evidence for elastography, although for Achilles tendinopathy and lateral epicondylitis evidence level was B with grade 3 indication.

Conclusions

Four new areas of level A evidence were included in the guidelines. Elastography did not reach level A evidence. Whilst ultrasound is of increasing importance in musculoskeletal medical practice, the evidence for elastography remains moderate.

Key Points

• Evidence and expert consensus shows an increase of musculoskeletal ultrasound indications.

• Four new A evidence levels were found for the hip, knee, ankle, and foot.

• There was no level A evidence for elastography.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

US$ 39.95

Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Abbreviations

ESSR:

European Society of Musculoskeletal Radiology

References

  1. 1.

    Klauser AS, Tagliafico A, Allen GM et al (2012) Clinical indications for musculoskeletal ultrasound: a Delphi-based consensus paper of the European Society of Musculoskeletal Radiology. Eur Radiol 22:1140–1148

    PubMed  PubMed Central  Google Scholar 

  2. 2.

    European Society of Radiology (ESR) (2015) Medical imaging in personalised medicine: a white paper of the research committee of the European Society of Radiology (ESR). Insights Imaging 6:141–155

    Google Scholar 

  3. 3.

    Steurer J (2011) The Delphi method: an efficient procedure to generate knowledge. Skeletal Radiol 40:959–961

    PubMed  Google Scholar 

  4. 4.

    Messina C, Bignotti B, Tagliafico A et al (2017) A critical appraisal of the quality of adult musculoskeletal ultrasound guidelines using the AGREE II tool: an EuroAIM initiative. Insights Imaging 8:491–497

    PubMed  PubMed Central  Google Scholar 

  5. 5.

    Centre for Evidence-Based Medicine in Oxford in the UK (2017) Available via http://www.cebm.net/93452 accessed on 4 Apr 2017

  6. 6.

    Latham SK, Smith TO (2014) The diagnostic test accuracy of ultrasound for the detection of lateral epicondylitis: a systematic review and meta-analysis. Orthop Traumatol Surg Res 100:281–286

    CAS  PubMed  Google Scholar 

  7. 7.

    Dones VC 3rd, Grimmer K, Thoirs K, Suarez CG, Luker J (2014) The diagnostic validity of musculoskeletal ultrasound in lateral epicondylalgia: a systematic review. BMC Med Imaging 14:10

    PubMed  PubMed Central  Google Scholar 

  8. 8.

    Krogh TP, Fredberg U, Christensen R, Stengaard-Pedersen K, Ellingsen T (2013) Ultrasonographic assessment of tendon thickness, Doppler activity and bony spurs of the elbow in patients with lateral epicondylitis and healthy subjects: a reliability and agreement study. Ultraschall Med 34:468–474

    CAS  PubMed  Google Scholar 

  9. 9.

    Jacobson JA, Chiavaras MM, Lawton JM, Downie B, Yablon CM, Lawton J (2014) Radial collateral ligament of the elbow: sonographic characterization with cadaveric dissection correlation and magnetic resonance arthrography. J Ultrasound Med 33:1041–1048

    PubMed  Google Scholar 

  10. 10.

    Nagamoto H, Yamamoto N, Kurokawa D et al (2015) Evaluation of the thickness of the medial ulnar collateral ligament in junior high and high school baseball players. J Med Ultrason (2001) 42:395–400

    Google Scholar 

  11. 11.

    Marshall NE, Keller RA, Van Holsbeeck M, Moutzouros V (2015) Ulnar collateral ligament and elbow adaptations in high school baseball pitchers. Sports Health 7:484–488

    PubMed  PubMed Central  Google Scholar 

  12. 12.

    Harada M, Takahara M, Maruyama M, Takagi M (2014) Characteristics and prognosis of medial epicondylar fragmentation of the humerus in male junior tennis players. J Shoulder Elb Surg 23:1514–1520

    Google Scholar 

  13. 13.

    Kim JH, Won SJ, Rhee WI, Park HJ, Hong HM (2015) Diagnostic cutoff value for ultrasonography in the ulnar neuropathy at the elbow. Ann Rehabil Med 39:170–175

    PubMed  PubMed Central  Google Scholar 

  14. 14.

    Radhika S, Lee YL, Low SF et al (2015) Role of high resolution ultrasound in ulnar nerve neuropathy. Med J Malaysia 70:158–161

    CAS  PubMed  Google Scholar 

  15. 15.

    Kang JH, Joo BE, Kim KH, Park BK, Cha J, Kim DH (2017) Ultrasonographic and electrophysiological evaluation of ulnar nerve instability and snapping of the triceps medial head in healthy subjects. Am J Phys Med Rehabil 96:e141–e146

    PubMed  Google Scholar 

  16. 16.

    Lu Y, Meng Z, Pan X, Qin L, Wang G (2015) Value of high-frequency ultrasound in diagnosing carpal tunnel syndrome. Int J Clin Exp Med 8:22418–22424

    CAS  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Kasehagen B, Ellis R, Mawston G, Allen S, Hing W (2016) Assessing the reliability of ultrasound imaging to examine radial nerve excursion. Ultrasound Med Biol 42:1651–1659

    PubMed  Google Scholar 

  18. 18.

    Vreju FA, Ciurea ME, Popa D et al (2016) Ultrasonography in the diagnosis and management of non inflammatory conditions of the hand and wrist. Med Ultrason 18:90–95

    PubMed  Google Scholar 

  19. 19.

    Kapuścińska K, Urbanik A (2015) High-frequency ultrasound in carpal tunnel syndrome: assessment of patient eligibility for surgical treatment. J Ultrason 15:283–291

    PubMed  PubMed Central  Google Scholar 

  20. 20.

    Kapuścińska K, Urbanik A (2016) Efficacy of high frequency ultrasound in postoperative evaluation of carpal tunnel syndrome treatment. J Ultrason 16:16–24

    PubMed  PubMed Central  Google Scholar 

  21. 21.

    Marschall A, Ficjian A, Stradner MH et al (2016) The value of median nerve sonography as a predictor for short- and long-term clinical outcomes in patients with carpal tunnel syndrome: a prospective long-term follow-up study. PLoS One 11:e0162288

    PubMed  PubMed Central  Google Scholar 

  22. 22.

    Arend CF, da Silva TR (2014) The role of US in the evaluation of clinically suspected ulnar collateral ligament injuries of the thumb: spectrum of findings and differential diagnosis. Acta Radiol 55:814–823

    PubMed  Google Scholar 

  23. 23.

    Daneff M, Casalis C, Bruno CH, Bruno DA (2015) Bone age assessment with conventional ultrasonography in healthy infants from 1 to 24 months of age. Pediatr Radiol 45:1007–1015

    PubMed  Google Scholar 

  24. 24.

    Melville D, Jacobson JA, Haase S, Brandon C, Brigido MK, Fessell D (2013) Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited. Skeletal Radiol 42:667–673

    PubMed  Google Scholar 

  25. 25.

    Lee KM, Kim HJ (2016) Relationship between electrodiagnosis and various ultrasonographic findings for diagnosis of carpal tunnel syndrome. Ann Rehabil Med 40:1040–1047

    PubMed  PubMed Central  Google Scholar 

  26. 26.

    Gitto S, Messina C, Mauri G, Aliprandi A, Sardanelli F, Sconfienza LM (2017) Dynamic high-resolution ultrasound of intrinsic and extrinsic ligaments of the wrist: How to make it simple. Eur J Radiol 87:20–35

    PubMed  Google Scholar 

  27. 27.

    Spicer PJ, Romesberg A, Kamineni S, Beaman FD (2016) Ultrasound of extensor carpi ulnaris tendon subluxation in a tennis player. Ultrasound Q 32:191–193

    PubMed  Google Scholar 

  28. 28.

    Kara A, Celik H, Bankaoglu M, Oc Y, Bulbul M, Sugun TS (2016) Ultrasonic evaluation of the flexor pollicis longus tendon following volar plate fixation for distal radius fractures. J Hand Surg Am 41:374–380

    PubMed  Google Scholar 

  29. 29.

    Nanno M, Kodera N, Tomori Y, Takai S (2016) Transverse ultrasound assessment of the flexor pollicis longus tendon movement on the distal radius during wrist and finger motion in distal radius fracture with volar plating. J Med Ultrason 43:29–36

    Google Scholar 

  30. 30.

    Guerini H, Morvan G, Vuillemin V et al (2015) Ultrasound of wrist and hand masses. Diagn Interv Imaging 96:1247–1260

    CAS  PubMed  Google Scholar 

  31. 31.

    Zeidenberg J, Aronowitz JG, Landy DC, Owens PW, Jose J (2016) Ultrasound-guided aspiration of wrist ganglions: a follow-up survey of patient satisfaction and outcomes. Acta Radiol 57:481–486

    PubMed  Google Scholar 

  32. 32.

    Draghi F, Bortolotto C, Draghi AG, Gregoli B (2015) Musculoskeletal sonography for evaluation of anatomic variations of extensor tendon synovial sheaths in the wrist. J Ultrasound Med 34:1445–1452

    PubMed  Google Scholar 

  33. 33.

    Herren C, Sobottke R, Ringe MJ et al (2015) Ultrasound-guided diagnosis of fractures of the distal forearm in children. Orthop Traumatol Surg Res 101:501–505

    CAS  PubMed  Google Scholar 

  34. 34.

    Klauser AS, Abd Ellah MM, Halpern EJ et al (2015) Sonographic cross-sectional area measurement in carpal tunnel syndrome patients: can delta and ratio calculations predict severity compared to nerve conduction studies? Eur Radiol 25:2419–2427

    PubMed  Google Scholar 

  35. 35.

    Tessaro MO, McGovern TR, Dickman E, Haines LE (2015) Point-of-care ultrasound detection of acute scaphoid fracture. Pediatr Emerg Care 31:222–224

    PubMed  Google Scholar 

  36. 36.

    Mohseny B, Nijhuis TH, Hundepool CA, Janssen WG, Selles RW, Coert JH (2015) Ultrasonographic quantification of intrinsic hand muscle cross-sectional area; reliability and validity for predicting muscle strength. Arch Phys Med Rehabil 96:845–853

    PubMed  Google Scholar 

  37. 37.

    Sato J, Ishii Y, Noguchi H (2016) Diagnostic performance of the extensor carpi ulnaris (ECU) synergy test to detect sonographic ECU abnormalities in chronic dorsal ulnar-sided wrist pain. J Ultrasound Med 35:7–14

    PubMed  Google Scholar 

  38. 38.

    Meng S, Tinhofer I, Weninger WJ, Grisold W (2014) Anatomical and ultrasound correlation of the superficial branch of the radial nerve. Muscle Nerve 50:939–942

    PubMed  Google Scholar 

  39. 39.

    Dezfuli B, Taljanovic MS, Melville DM, Krupinski EA, Sheppard JE (2016) Accuracy of high-resolution ultrasonography in the detection of extensor tendon lacerations. Ann Plast Surg 76:187–192

    CAS  PubMed  Google Scholar 

  40. 40.

    Botchu R, Bianchi S (2014) Sonography of trapezial ridge fractures. J Clin Ultrasound 42:241–244

    PubMed  Google Scholar 

  41. 41.

    Yıldırım A, Unlüer EE, Vandenberk N, Karagöz A (2013) The role of bedside ultrasonography for occult scaphoid fractures in the emergency department. Ulus Travma Acil Cerrahi Derg 19:241–245

    PubMed  Google Scholar 

  42. 42.

    Aksay E, Kilic TY, Yesılaras M, Tur FC, Sever M, Kalenderer O (2016) Accuracy of bedside ultrasonography for the diagnosis of finger fractures. Am J Emerg Med 34:809–812

    PubMed  Google Scholar 

  43. 43.

    Williams D, Singh J, Heidari N, Ahmad M, Noorani A, Di Mascio L (2016) Assessment of penetration of dorsal screws after fixation of the distal radius using ultrasound: cadaveric study. Ann R Coll Surg Engl 98:138–142

    CAS  PubMed  PubMed Central  Google Scholar 

  44. 44.

    Mervak BM, Morag Y, Marcantonio D, Jacobson J, Brandon C, Fessell D (2012) Paralabral cysts of the hip: sonographic evaluation with magnetic resonance arthrographic correlation. J Ultrasound Med 31:495–500

    PubMed  Google Scholar 

  45. 45.

    Jin W, Kim KI, Rhyu KH et al (2012) Sonographic evaluation of anterosuperior hip labral tears with magnetic resonance arthrographic and surgical correlation. J Ultrasound Med 31:439–447

    PubMed  Google Scholar 

  46. 46.

    Westacott DJ, Minns JI, Foguet P (2011) The diagnostic accuracy of magnetic resonance imaging and ultrasonography in gluteal tendon tears—a systematic review. Hip Int 21:637–645

    PubMed  Google Scholar 

  47. 47.

    Riecke BF, Christensen R, Torp-Pedersen S, Boesen M, Gudbergsen H, Bliddal H (2014) An ultrasound score for knee osteoarthritis: a cross-sectional validation study. Osteoarthritis Cartil 22:1675–1691

    CAS  Google Scholar 

  48. 48.

    Männicke N, Schöne M, Oelze M, Raum K (2014) Articular cartilage degeneration classification by means of high-frequency ultrasound. Osteoarthritis Cartil 22:1577–1582

    Google Scholar 

  49. 49.

    Cook JL, Cook CR, Stannard JP et al (2014) MRI versus ultrasonography to assess meniscal abnormalities in acute knees. J Knee Surg 27:319–324

    PubMed  Google Scholar 

  50. 50.

    Okano T, Filippucci E, Di Carlo M et al (2016) Ultrasonographic evaluation of joint damage in knee osteoarthritis: feature-specific comparisons with conventional radiography. Rheumatology (Oxford) 55:2040–2049

    Google Scholar 

  51. 51.

    Nogueira-Barbosa MH, Gregio-Junior E, Lorenzato MM et al (2015) Ultrasound assessment of medial meniscal extrusion: a validation study using MRI as reference standard. AJR Am J Roentgenol 204:584–588

    PubMed  Google Scholar 

  52. 52.

    Wareluk P, Szopinski KT (2012) Value of modern sonography in the assessment of meniscal lesions. Eur J Radiol 81:2366–2369

    PubMed  Google Scholar 

  53. 53.

    Dai H, Huang ZG, Chen ZJ, Liu JX (2015) Diagnostic accuracy of ultrasonography in assessing meniscal injury: meta-analysis of prospective studies. J Orthop Sci 20:675–681

    PubMed  Google Scholar 

  54. 54.

    Arnoldner MA, Gruber M, Syré S et al (2015) Imaging of posterior tibial tendon dysfunction--Comparison of high-resolution ultrasound and 3T MRI. Eur J Radiol 84:1777–1781

    PubMed  Google Scholar 

  55. 55.

    Klein EE, Weil L Jr, Weil LS Sr, Knight J (2012) Magnetic resonance imaging versus musculoskeletal ultrasound for identification and localization of plantar plate tears. Foot Ankle Spec 5:359–365

    PubMed  Google Scholar 

  56. 56.

    Xu Z, Duan X, Yu X, Wang H, Dong X, Xiang Z (2015) The accuracy of ultrasonography and magnetic resonance imaging for the diagnosis of Morton's neuroma: a systematic review. Clin Radiol 70:351–358

    CAS  PubMed  Google Scholar 

  57. 57.

    Lee KT, Park YU, Jegal H, Park JW, Choi JP, Kim JS (2014) New method of diagnosis for chronic ankle instability: comparison of manual anterior drawer test, stress radiography and stress ultrasound. Knee Surg Sports Traumatol Arthrosc 22:1701–1707

    PubMed  Google Scholar 

  58. 58.

    Ağladıoğlu K, Akkaya N, Güngör HR, Akkaya S, Ök N, Özçakar L (2016) Effects of cigarette smoking on elastographic strain ratio measurements of patellar and Achilles tendons. J Ultrasound Med 35:2431–2438

    PubMed  Google Scholar 

  59. 59.

    Ahn KS, Kang CH, Hong SJ, Jeong WK (2014) Ultrasound elastography of lateral epicondylosis: clinical feasibility of quantitative elastographic measurements. AJR Am J Roentgenol 202:1094–1099

    PubMed  Google Scholar 

  60. 60.

    Akkaya S, Akkaya N, Agladıoglu K, Gungor HR, Ok N, Özçakar L (2016) Real-time elastography of patellar tendon in patients with auto-graft bone-tendon-bone anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg 136:837–842

    PubMed  Google Scholar 

  61. 61.

    Akkaya S, Akkaya N, Güngör HR, Ağladıoğlu K, Ök N, Özçakar L (2016) Sonoelastographic evaluation of the distal femoral cartilage in patients with anterior cruciate ligament reconstruction. Eklem Hastalik Cerrahisi 27:2–8

    PubMed  Google Scholar 

  62. 62.

    Aubry S, Nueffer JP, Tanter M, Becce F, Vidal C, Michel F (2015) Viscoelasticity in Achilles tendonopathy: quantitative assessment by using real-time shear-wave elastography. Radiology 274:821–829

    PubMed  Google Scholar 

  63. 63.

    Balaban M, Idilman IS, Ipek A, Ikiz SS, Bektaser B, Gumus M (2016) Elastographic findings of Achilles tendons in asymptomatic professional male volleyball players. J Ultrasound Med 35:2623–2628

    PubMed  Google Scholar 

  64. 64.

    Baumer TG, Davis L, Dischler J et al (2017) Shear wave elastography of the supraspinatus muscle and tendon: Repeatability and preliminary findings. J Biomech 53:201–204

    PubMed  Google Scholar 

  65. 65.

    Botanlioglu H, Kantarci F, Kaynak G et al (2013) Shear wave elastography properties of vastus lateralis and vastus medialis obliquus muscles in normal subjects and female patients with patellofemoral pain syndrome. Skeletal Radiol 42:659–666

    PubMed  Google Scholar 

  66. 66.

    Buck AR, Verstraete N, Li Y, Schweizer A, Snedeker JG, Buck FM (2012) Detection of small tendon lesions by sonoelastographic visualization of strain profile differences: initial experiences. Skeletal Radiol 41:1073–1079

    PubMed  Google Scholar 

  67. 67.

    Chernak Slane L, Thelen DG (2014) The use of 2D ultrasound elastography for measuring tendon motion and strain. J Biomech 47:750–754

    PubMed  Google Scholar 

  68. 68.

    Chimenti RL, Flemister AS, Ketz J, Bucklin M, Buckley MR, Richards MS (2016) Ultrasound strain mapping of Achilles tendon compressive strain patterns during dorsiflexion. J Biomech 49:39–44

    PubMed  Google Scholar 

  69. 69.

    Dirrichs T, Quack V, Gatz M, Tingart M, Kuhl CK, Schrading S (2016) Shear wave elastography (SWE) for the evaluation of patients with tendinopathies. Acad Radiol 23:1204–1213

    PubMed  Google Scholar 

  70. 70.

    De Zordo T, Chhem R, Smekal V et al (2010) Real-time sonoelastography: findings in patients with symptomatic Achilles tendons and comparison to healthy volunteers. Ultraschall Med 31:394–400

    PubMed  Google Scholar 

  71. 71.

    De Zordo T, Fink C, Feuchtner GM, Smekal V, Reindl M, Klauser AS (2009) Real-time sonoelastography findings in healthy Achilles tendons. AJR Am J Roentgenol 193:W134–W138

    PubMed  Google Scholar 

  72. 72.

    De Zordo T, Lill SR, Fink C et al (2009) Real-time sonoelastography of lateral epicondylitis: comparison of findings between patients and healthy volunteers. AJR Am J Roentgenol 193:180–185

    PubMed  Google Scholar 

  73. 73.

    Drakonaki EE, Allen GM, Wilson DJ (2009) Real-time ultrasound elastography of the normal Achilles tendon: reproducibility and pattern description. Clin Radiol 64:1196–1202

    CAS  PubMed  Google Scholar 

  74. 74.

    Evranos B, Idilman I, Ipek A, Polat SB, Cakir B, Ersoy R (2015) Real-time sonoelastography and ultrasound evaluation of the Achilles tendon in patients with diabetes with or without foot ulcers: a cross sectional study. J Diabetes Complicat 29:1124–1129

    PubMed  Google Scholar 

  75. 75.

    Fu S, Cui L, He X, Sun Y (2016) Elastic characteristics of the normal Achilles tendon assessed by virtual touch imaging quantification shear wave elastography. J Ultrasound Med 35:1881–1887

    PubMed  Google Scholar 

  76. 76.

    Guilhem G, Doguet V, Hauraix H et al (2016) Muscle force loss and soreness subsequent to maximal eccentric contractions depend on the amount of fascicle strain in vivo. Acta Physiol (Oxford) 217:152–163

    CAS  Google Scholar 

  77. 77.

    Hahn S, Lee YH, Lee SH, Suh JS (2017) Value of the strain ratio on ultrasonic elastography for differentiation of benign and malignant soft tissue tumors. J Ultrasound Med 36:121–127

    PubMed  Google Scholar 

  78. 78.

    Hou SW, Merkle AN, Babb JS, McCabe R, Gyftopoulos S, Adler RS (2017) Shear wave ultrasound elastographic evaluation of the rotator cuff tendon. J Ultrasound Med 36:95–106

    PubMed  Google Scholar 

  79. 79.

    Kantarci F, Ustabasioglu FE, Delil S et al (2014) Median nerve stiffness measurement by shear wave elastography: a potential sonographic method in the diagnosis of carpal tunnel syndrome. Eur Radiol 24:434–440

    PubMed  Google Scholar 

  80. 80.

    Klauser AS, Miyamoto H, Martinoli C et al (2015) Sonoelastographic findings of carpal tunnel injection. Ultraschall Med 36:618–622

    CAS  PubMed  Google Scholar 

  81. 81.

    Klauser AS, Miyamoto H, Tamegger M et al (2013) Achilles tendon assessed with sonoelastography: histologic agreement. Radiology 267:837–842

    PubMed  Google Scholar 

  82. 82.

    Klauser AS, Pamminger M, Halpern EJ et al (2017) Extensor tendinopathy of the elbow assessed with sonoelastography: histologic correlation. Eur Radiol 27:3460–3466

    PubMed  Google Scholar 

  83. 83.

    Klauser AS, Pamminger MJ, Halpern EJ et al (2017) Sonoelastography of the common flexor tendon of the elbow with histologic agreement: a cadaveric study. Radiology 283:486–491

    PubMed  Google Scholar 

  84. 84.

    Kocyigit F, Kuyucu E, Kocyigit A et al (2016) Association of real-time sonoelastography findings with clinical parameters in lateral epicondylitis. Rheumatol Int 36:91–100

    PubMed  Google Scholar 

  85. 85.

    Krepkin K, Bruno M, Raya JG, Adler RS, Gyftopoulos S (2017) Quantitative assessment of the supraspinatus tendon on MRI using T2/T2* mapping and shear-wave ultrasound elastography: a pilot study. Skeletal Radiol 46:191–199

    PubMed  Google Scholar 

  86. 86.

    Lee SS, Gaebler-Spira D, Zhang LQ, Rymer WZ, Steele KM (2016) Use of shear wave ultrasound elastography to quantify muscle properties in cerebral palsy. Clin Biomech (Bristol, Avon) 31:20–28

    Google Scholar 

  87. 87.

    Lee SU, Joo SY, Kim SK, Lee SH, Park SR, Jeong C (2016) Real-time sonoelastography in the diagnosis of rotator cuff tendinopathy. J Shoulder Elb Surg 25:723–729

    Google Scholar 

  88. 88.

    Lee SY, Park HJ, Kwag HJ et al (2014) Ultrasound elastography in the early diagnosis of plantar fasciitis. Clin Imaging 38:715–718

    PubMed  Google Scholar 

  89. 89.

    Liao YY, Lee WN, Lee MR et al (2015) Carpal tunnel syndrome: US strain imaging for diagnosis. Radiology 275:205–214

    PubMed  Google Scholar 

  90. 90.

    Lin YH, Chiou HJ, Wang HK, Lai YC, Chou YH, Chang CY (2015) Management of rotator cuff calcific tendinosis guided by ultrasound elastography. J Chin Med Assoc 78:603–609

    PubMed  Google Scholar 

  91. 91.

    Liu J, Zhan W, Zhou M, Zhang X (2015) Ultrasound elastography of the supraspinatus tendon guided by US-MRI virtual navigation. Technol Health Care 23:S263–S268

    PubMed  Google Scholar 

  92. 92.

    Magarelli N, Carducci C, Bucalo C et al (2014) Sonoelastography for qualitative and quantitative evaluation of superficial soft tissue lesions: a feasibility study. Eur Radiol 24:566–573

    PubMed  Google Scholar 

  93. 93.

    Martin MJ, Cartwright MS (2017) A pilot study of strain elastography in the diagnosis of carpal tunnel syndrome. J Clin Neurophysiol 34:114–118

    PubMed  PubMed Central  Google Scholar 

  94. 94.

    Masala S, Manenti G, Antonicoli M et al (2014) Real time evaluation of monolateral clubfoot with sonoelastography. Radiol Med 119:601–606

    PubMed  Google Scholar 

  95. 95.

    Miyamoto H, Halpern EJ, Kastlunger M et al (2014) Carpal tunnel syndrome: diagnosis by means of median nerve elasticity—improved diagnostic accuracy of US with sonoelastography. Radiology 270:481–486

    PubMed  Google Scholar 

  96. 96.

    Miyamoto H, Miura T, Isayama H, Masuzaki R, Koike K, Ohe T (2011) Stiffness of the first annular pulley in normal and trigger fingers. J Hand Surg Am 36:1486–1491

    PubMed  Google Scholar 

  97. 97.

    Muraki T, Ishikawa H, Morise S et al (2015) Ultrasound elastography-based assessment of the elasticity of the supraspinatus muscle and tendon during muscle contraction. J Shoulder Elb Surg 24:120–126

    Google Scholar 

  98. 98.

    Ooi CC, Richards PJ, Maffulli N et al (2016) A soft patellar tendon on ultrasound elastography is associated with pain and functional deficit in volleyball players. J Sci Med Sport 19:373–378

    PubMed  Google Scholar 

  99. 99.

    Ooi CC, Schneider ME, Malliaras P, Chadwick M, Connell DA (2015) Diagnostic performance of axial-strain sonoelastography in confirming clinically diagnosed Achilles tendinopathy: comparison with B-mode ultrasound and color Doppler imaging. Ultrasound Med Biol 41:15–25

    PubMed  Google Scholar 

  100. 100.

    Ooi CC, Schneider ME, Malliaras P, Counsel P, Connell DA (2015) Prevalence of morphological and mechanical stiffness alterations of mid Achilles tendons in asymptomatic marathon runners before and after a competition. Skeletal Radiol 44:1119–1127

    CAS  PubMed  Google Scholar 

  101. 101.

    Ozcan AN, Tan S, Tangal NG et al (2016) Real-time sonoelastography of the patellar and quadriceps tendons: pattern description in professional athletes and healthy volunteers. Med Ultrason 18:299–304

    PubMed  Google Scholar 

  102. 102.

    Park G, Kwon D, Park J (2014) Diagnostic confidence of sonoelastography as adjunct to greyscale ultrasonography in lateral elbow tendinopathy. Chin Med J 127:3110–3115

    PubMed  Google Scholar 

  103. 103.

    Pass B, Jafari M, Rowbotham E, Hensor EM, Gupta H, Robinson P (2017) Do quantitative and qualitative shear wave elastography have a role in evaluating musculoskeletal soft tissue masses? Eur Radiol 27:723–731

    CAS  PubMed  Google Scholar 

  104. 104.

    Pass B, Johnson M, Hensor EM, Gupta H, Robinson P (2016) Sonoelastography of Musculoskeletal Soft Tissue Masses: A Pilot Study of Quantitative Evaluation. J Ultrasound Med 35:2209–2216

    PubMed  Google Scholar 

  105. 105.

    Pedersen M, Fredberg U, Langberg H (2012) Sonoelastography as a diagnostic tool in the assessment of musculoskeletal alterations: a systematic review. Ultraschall Med 33:441–446

    CAS  PubMed  Google Scholar 

  106. 106.

    Peltz CD, Haladik JA, Divine G, Siegal D, van Holsbeeck M, Bey MJ (2013) ShearWave elastography: repeatability for measurement of tendon stiffness. Skeletal Radiol 42:1151–1156

    CAS  PubMed  Google Scholar 

  107. 107.

    Petrescu PH, Izvernariu DA, Iancu C et al (2016) Evaluation of normal and pathological Achilles tendon by real-time shear wave elastography. Romanian J Morphol Embryol 57:785–790

    Google Scholar 

  108. 108.

    Pochini Ade C, Ferretti M, Kawakami EF et al (2015) Analysis of pectoralis major tendon in weightlifting athletes using ultrasonography and elastography. Einstein (Sao Paulo) 13:541–546

    Google Scholar 

  109. 109.

    Rosskopf AB, Ehrmann C, Buck FM, Gerber C, Flück M, Pfirrmann CW (2016) Quantitative shear-wave US elastography of the supraspinatus muscle: reliability of the method and relation to tendon integrity and muscle quality. Radiology 278:465–474

    PubMed  Google Scholar 

  110. 110.

    Ruan Z, Zhao B, Qi H et al (2015) Elasticity of healthy Achilles tendon decreases with the increase of age as determined by acoustic radiation force impulse imaging. Int J Clin Exp Med 8:1043–1050

    PubMed  PubMed Central  Google Scholar 

  111. 111.

    Sconfienza LM, Silvestri E, Bartolini B, Garlaschi G, Cimmino MA (2010) Sonoelastography may help in the differential diagnosis between rheumatoid nodules and tophi. Clin Exp Rheumatol 28:144–145

    CAS  PubMed  Google Scholar 

  112. 112.

    Sconfienza LM, Silvestri E, Cimmino MA (2010) Sonoelastography in the evaluation of painful Achilles tendon in amateur athletes. Clin Exp Rheumatol 28:373–378

    PubMed  Google Scholar 

  113. 113.

    Sconfienza LM, Silvestri E, Orlandi D et al (2013) Real-time sonoelastography of the plantar fascia: comparison between patients with plantar fasciitis and healthy control subjects. Radiology 267:195–200

    PubMed  Google Scholar 

  114. 114.

    Siu WL, Chan CH, Lam CH, Lee CM, Ying M (2016) Sonographic evaluation of the effect of long-term exercise on Achilles tendon stiffness using shear wave elastography. J Sci Med Sport 19:883–887

    PubMed  Google Scholar 

  115. 115.

    Slane LC, Martin J, DeWall R, Thelen D, Lee K (2017) Quantitative ultrasound mapping of regional variations in shear wave speeds of the aging Achilles tendon. Eur Radiol 27:474–482

    PubMed  Google Scholar 

  116. 116.

    Takenaga T, Sugimoto K, Goto H et al (2015) Posterior shoulder capsules are thicker and stiffer in the throwing shoulders of healthy college baseball players: a quantitative assessment using shear-wave ultrasound elastography. Am J Sports Med 43:2935–2942

    PubMed  Google Scholar 

  117. 117.

    Tan S, Kudaş S, Özcan AS et al (2012) Real-time sonoelastography of the Achilles tendon: pattern description in healthy subjects and patients with surgically repaired complete ruptures. Skeletal Radiol 41:1067–1072

    PubMed  Google Scholar 

  118. 118.

    Teber MA, Oğur T, Bozkurt A et al (2015) Real-time sonoelastography of the quadriceps tendon in patients undergoing chronic hemodialysis. J Ultrasound Med 34:671–677

    PubMed  Google Scholar 

  119. 119.

    Tudisco C, Bisicchia S, Stefanini M, Antonicoli M, Masala S, Simonetti G (2015) Tendon quality in small unilateral supraspinatus tendon tears. Real-time sonoelastography correlates with clinical findings. Knee Surg Sports Traumatol Arthrosc 23:393–398

    PubMed  Google Scholar 

  120. 120.

    Turan A, Teber MA, Yakut ZI, Unlu HA, Hekimoglu B (2015) Sonoelastographıc assessment of the age-related changes of the Achilles tendon. Med Ultrason 17:58–61

    PubMed  Google Scholar 

  121. 121.

    Turan A, Tufan A, Mercan R et al (2013) Real-time sonoelastography of Achilles tendon in patients with ankylosing spondylitis. Skeletal Radiol 42:1113–1118

    PubMed  Google Scholar 

  122. 122.

    Turo D, Otto P, Hossain M et al (2015) Novel use of ultrasound elastography to quantify muscle tissue changes after dry needling of myofascial trigger points in patients with chronic myofascial pain. J Ultrasound Med 34:2149–2161

    PubMed  PubMed Central  Google Scholar 

  123. 123.

    Wu CH, Chang KV, Mio S, Chen WS, Wang TG (2015) Sonoelastography of the plantar fascia. Radiology 259:502–507

    Google Scholar 

  124. 124.

    Wu CH, Chen WS, Wang TG (2016) Elasticity of the coracohumeral ligament in patients with adhesive capsulitis of the shoulder. Radiology 278:458–464

    PubMed  Google Scholar 

  125. 125.

    Yamamoto Y, Yamaguchi S, Sasho T et al (2016) Quantitative ultrasound elastography with an acoustic coupler for Achilles tendon elasticity: measurement repeatability and normative values. J Ultrasound Med 35:159–166

    PubMed  Google Scholar 

  126. 126.

    Yanagisawa O, Niitsu M, Kurihara T, Fukubayashi T (2011) Evaluation of human muscle hardness after dynamic exercise with ultrasound real-time tissue elastography: a feasibility study. Clin Radiol 66:815–819

    CAS  PubMed  Google Scholar 

  127. 127.

    Yoshida K, Itoigawa Y, Maruyama Y et al (2017) Application of shear wave elastography for the gastrocnemius medial head to tennis leg. Clin Anat 30:114–119

    PubMed  Google Scholar 

  128. 128.

    Yoshitake Y, Takai Y, Kanehisa H, Shinohara M (2014) Muscle shear modulus measured with ultrasound shear-wave elastography across a wide range of contraction intensity. Muscle Nerve 50:103–113

    PubMed  Google Scholar 

  129. 129.

    Zhang LN, Wan WB, Wang YX et al (2016) Evaluation of elastic stiffness in healing Achilles tendon after surgical repair of a tendon rupture using in vivo ultrasound shear wave elastography. Med Sci Monit 22:1186–1191

    PubMed  PubMed Central  Google Scholar 

  130. 130.

    Orlandi D, Gitto S, Perugin Bernardi S et al (2017) Advanced power Doppler technique increases synovial vascularity detection in patients with rheumatoid arthritis. Ultrasound Med Biol 43:1880–1887

    PubMed  Google Scholar 

  131. 131.

    Viviano SL, Chandler LK, Keith JD (2017) Ultrahigh frequency ultrasound imaging of the hand: a new diagnostic tool for hand surgery. Hand (N Y) 1:1558944717731856

    Google Scholar 

  132. 132.

    Cosgrove D, Piscaglia F, Bamber J et al (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications. Ultraschall Med 34(3):238–253

    CAS  PubMed  Google Scholar 

  133. 133.

    Möller I, Janta I, Backhaus M et al (2017) The 2017 EULAR standardised procedures for ultrasound imaging in rheumatology. Ann Rheum Dis 76:1974–1197

    PubMed  Google Scholar 

  134. 134.

    Brouwers MC, Kho ME, Browman GP et al (2010) AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ 182:E839–E842

    PubMed  PubMed Central  Google Scholar 

Download references

Funding

The authors state that this work has not received any funding.

Author information

Affiliations

  1. Unità Operativa di Radiologia Diagnostica ed Interventistica, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy

    Luca Maria Sconfienza & Carmelo Messina

  2. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milano, Italy

    Luca Maria Sconfienza & Carmelo Messina

  3. Department of Radiology, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy

    Domenico Albano

  4. Department of Radiology, St Lukes Radiology Oxford Ltd, Oxford, UK

    Georgina Allen & David Wilson

  5. Diagnostic and Interventional Radiology, “Rizzoli” Orthopaedic Institute, Bologna, Italy

    Alberto Bazzocchi

  6. Department of Health Sciences (DISSAL), University of Genoa, Via Pastore 1, 16132, Genova, Italy

    Bianca Bignotti, Carlo Martinoli, Federica Rossi & Alberto Stefano Tagliafico

  7. Department of Advanced Biomedical Sciences, Università degli studi Federico II, via Pansini 5, 80131, Napoli, Italy

    Vito Chianca

  8. Hospital General Universitario de Valencia, Ave. Tres Cruces 2, 46014, Valencia, Spain

    Fernando Facal de Castro, Rebeca Mirón Mombiela & Jelena Vucetic

  9. Independent MSK radiology practice, Heraklion, Crete, Greece

    Elena E. Drakonaki

  10. Department of Radiology, University Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain

    Elena Gallardo

  11. Radiology and S.P.O.R.T.S. Department, Antwerp University and Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Antwerp, Belgium

    Jan Gielen

  12. Department of Radiology, Medical University Innsbruck, Section Rheumatology and Sports Imaging, Innsbruck, Austria

    Andrea Sabine Klauser

  13. Ospedale Policlinico San Martino, Genova, Italy

    Carlo Martinoli & Alberto Stefano Tagliafico

  14. Division of Interventional Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milano, Italy

    Giovanni Mauri

  15. Oxford Musculoskeletal Radiology, Oxford, UK

    Eugene McNally

  16. Department of Physiology, Universidad de Valencia/INCLIVA, Avenida Blasco Ibañez 15, 46010, Valencia, Spain

    Rebeca Mirón Mombiela & Jelena Vucetic

  17. S.C. Diagnostica per Immagini e Ecografia Interventistica, Ospedale Evangelico Internazionale, Corso Solferino 1A, 16122, Genova, Italy

    Davide Orlandi

  18. Department of Radiology, Private Institution of Ultrasonography, Athens, Greece

    Athena Plagou

  19. Department of Radiology, W. Dega Orthopaedic and Rehabilitation University Hospital of Karol Marcinkowski University of Medical Sciences, Poznan, Poland

    Magdalena Posadzy

  20. Hospital Universitario Marqués de Valdecilla, Santander, Spain

    Rosa de la Puente

  21. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    Monique Reijnierse

  22. Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania

    Saulius Rutkauskas

  23. Ljubljana University Medical Centre, Clinical Institute of Radiology, Ljubljana, Slovenia

    Ziga Snoj

Authors
  1. Luca Maria Sconfienza
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Domenico Albano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Georgina Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alberto Bazzocchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bianca Bignotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vito Chianca
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fernando Facal de Castro
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Elena E. Drakonaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Elena Gallardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jan Gielen
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Andrea Sabine Klauser
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Carlo Martinoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Giovanni Mauri
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Eugene McNally
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Carmelo Messina
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Rebeca Mirón Mombiela
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Davide Orlandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Athena Plagou
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Magdalena Posadzy
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Rosa de la Puente
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Monique Reijnierse
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Federica Rossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Saulius Rutkauskas
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Ziga Snoj
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Jelena Vucetic
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. David Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Alberto Stefano Tagliafico
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luca Maria Sconfienza.

Ethics declarations

Guarantors

The scientific guarantor of this publication is Luca Maria Sconfienza.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because this study does not involve patients directly.

Ethical approval

Institutional Review Board approval was not required because this study does not involve patients directly.

Methodology

• Literature systematic review

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sconfienza, L.M., Albano, D., Allen, G. et al. Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus. Eur Radiol 28, 5338–5351 (2018). https://doi.org/10.1007/s00330-018-5474-3

Download citation

Keywords

  • Ultrasonography
  • Musculoskeletal system
  • Elasticity imaging techniques
  • Guideline
  • Delphi technique