Interobserver variability and stiffness measurements of normal common extensor tendon in healthy volunteers using shear wave elastography.

Sendur H. N., Cindil E., Cerit M. N., Demir N. B., Sendur A. B., Özhan Oktar S.

Skeletal radiology, vol.48, no.1, pp.137-141, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 48 Issue: 1
  • Publication Date: 2019
  • Doi Number: 10.1007/s00256-018-3021-6
  • Journal Name: Skeletal radiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.137-141
  • Keywords: Common extensor tendon, Shear wave elastography, Interobserver variability, REAL-TIME SONOELASTOGRAPHY, ULTRASOUND ELASTOGRAPHY, EPICONDYLITIS, ELBOW
  • Gazi University Affiliated: Yes


ObjectivesThe purposes of our study are to determine the quantitative elasticity values of normal common extensor tendon (CET) and to assess the interobserver variability of stiffness measurements using shear wave elastography (SWE).Materials and methodsA total of 60 CETs of 30 (15 female, 15 male, mean age 30.2years) healthy volunteers without any symptoms of lateral epicondylitis were examined by two radiologists. Age, sex, height, weight, body mass index (BMI), and dominant hand of all participants were noted. The first observer performed B-mode and SWE imaging, and the second observer performed only SWE imaging. Tendon thickness and stiffness values in kPa were measured.ResultsThe mean thickness of CETs was 3.570.36mm. The mean stiffness values of CETs for two observers were 45.28 +/- 9.82kPa and 45.80 +/- 9.72kPa respectively. Tendon thickness had a weak correlation with weight (r=0.281, p=0.03), and moderate correlation with stiffness values (r=0.429, p<0.001). The mean interobserver difference of CET stiffness measurements was -0.5% of the mean CET stiffness values. Range of measurement error, defined as 95% limits of agreement, was +/- 23.5%. There was no significant difference between absolute values of interobserver measurements (p=0.741).CShear wave elastography is a reproducible imaging technique for the evaluation of CET elasticity and the standard stiffness values of normal CET can be used as reference data to differentiate normal from pathological tissues.