• Shear wave elastography detects novel imaging biomarkers of aromatase inhibitor–induced joint pain: A pilot study

      Martinez, J.A.; Taljanovic, M.S.; Witte, R.S.; Nuncio, Zuniga, A.A.; Wertheim, B.C.; Kwoh, C.K.; Goldstein, B.A.; Roe, D.J.; Chalasani, P.; The University of Arizona Cancer Center; et al. (Polish Ultrasound Society, 2021)
      Aim: To determine whether differences in joint and tendon stiffness as measured by ultrasound shear wave elastography are present in breast cancer patients with aromatase inhib-itor-associated arthralgias compared to age-comparable healthy control women. Methods: Postmenopausal women with stage I–III breast cancer who were taking adjuvant aromatase inhibitors and complained of joint pain were enrolled (n = 6). Postmenopausal women with no history of breast cancer, hormone treatment, or joint pain served as controls (n = 7). All subjects had bilateral hands and wrists evaluated by gray-scale and power Doppler ultra-sound, and shear wave elastography ultrasound. Results: Patients with AI-associated arthral-gias had significantly stiffer tendons than controls in the 1st extensor compartment (long axis; p = 0.001), 4th extensor compartment (long axis; p = 0.014), 3rd metacarpophalangeal joint (p = 0.002), the pooled values of the extensor compartments, both long (p = 0.044) and short axes (p = 0.035), and the pooled values for the metacarpophalangeal joints (p = 0.002). On ultrasound, the patients (but not controls) presented with hyperemia and increased tenosyno-vial fluid in the flexor and extensor tendon sheaths, and the median nerves were symptomatic and bifid; however, these differences were not statistically significant. Conclusions: This is the first study to identify increased tendon stiffness as a putative physiological characteris-tic of aromatase inhibitor–associated arthralgias. Future studies should determine whether increased tendon stiffness is a risk factor for the development of aromatase inhibitor–associ-ated arthralgias, or a result of aromatase inhibitor treatment. © Polish Ultrasound Society.
    • Ultrasound shear wave elastography of the anterior talofibular and calcaneofibular ligaments in healthy subjects

      Gimber, L.H.; Latt, L.D.; Caruso, C.; Nuncio Zuniga, A.A.; Krupinski, E.A.; Klauser, A.S.; Taljanovic, M.S.; Department of Orthopaedic Surgery, The University of Arizona College of Medicine Banner, University Medical Center; Department of Medical Imaging, The University of Arizona College of Medicine Banner, University Medical Center; Department of Biomedical Engineering, The University of Arizona (Polish Ultrasound Society, 2021)
      Aim of study: Most sprained lateral ankle ligaments heal uneventfully, but in some cases the ligament’s elastic function is not restored, leading to chronic ankle instability. Ultrasound shear wave elastography can be used to quantify the elasticity of musculoskeletal soft tissues; it may serve as a test of ankle ligament function during healing to potentially help differentiate normal from ineffective healing. The purpose of this study was to determine baseline shear wave velocity values for the lateral ankle ligaments in healthy male subjects, and to assess inter-observer reliability. Material and methods: Forty-six ankles in 23 healthy male subjects aged 20–40 years underwent shear wave elastography of the lateral ankle ligaments performed by two musculoskeletal radiologists. Each ligament was evaluated three times with the ankle relaxed by both examiners, and under stress by a single examiner. Mean shear wave velocity values were compared for each ligament by each examiner. Inter-observer agreement was evaluated. Results: The mean shear wave velocity at rest for the anterior talofibular ligament was 2.09 ± 0.3 (range 1.41–3.17); and for the calcaneofibular ligament 1.99 ± 0.36 (range 1.29–2.88). Good inter-observer agreement was found for the anterior talofibular ligament and calcaneo-fibular ligament shear wave velocity measurements with the ankle in resting position. There was a significant difference in mean shear wave velocities between rest and stressed conditions for both anterior talofibular ligament (2.09 m/s vs 3.21 m/s; p <0.001) and calcaneofibular ligament (1.99 m/s vs 3.42 m/s; p <0.0001). Conclusion: Shear wave elastography shows promise as a reproducible method to quantify ankle ligament stiffness. This study reveals that shear waves velocities of the normal lateral ankle ligaments increased with applied stress compared to the resting state. © Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.