Tobias De Zordo MD, Presenter: Nothing to Disclose

Stephanie Lill, Abstract Co-Author: Nothing to Disclose

Gudrun Feuchtner MD, Abstract Co-Author: Nothing to Disclose

Peter Franz Walter Soegner MD, Abstract Co-Author: Nothing to Disclose

Werner R. Jaschke MD, PhD, Abstract Co-Author: Nothing to Disclose

Andrea Klauser MD, Abstract Co-Author: Nothing to Disclose

To evaluate Sonoelastography (SEL)  in the assessment of common extensor tendon origins in healthy volunteers and patients complaining of lateral epicondylitis and compare these findings to clinical examination, and Ultrasound (US) findings. Correlation to Power Doppler Ultrasound (PDUS) and pain score, using a visual analog scale (VAS), was performed.

The study was approved by the institutional review board, and informed consent was obtained. In a prospective analysis 38 elbows of 32 consecutive patients (10 men, 22 women; mean age, 52.63 years; range, 38-70 years) complaining of lateral epicondylitis and 44 asymptomatic elbows of 28 healthy volunteers (11 men, 17 women; mean age, 43.64 years; range, 24 - 89 years) were assessed by clinical examination, US, PDUS and SEL. Common extensor tendon abnormalities detectable by US were defined as hypo- or hyperechoic intratendinous lesions, whereas pathological alterations detectable by SEL were defined as intratendinous tissue softening. Presence of intratendinous hyperemia by using PDUS was correlated and additionally pain was recorded by using a VAS score. Clinical examination was used as standard of reference.

Using SEL a sensitivity of 100%, a specificity of 89%, an accuracy of 94%, a positive predictive value of 88% and a negative predictive value of 100%was found, whereas US showed a sensitivity of 95%, a specificity of 89%, an accuracy of 91%, a positive predictive value of 88% and a negative predictive value of 95%. SEL showed good correlation to US findings (R > .900). No correlation between US and PDUS or SEL and PDUS could be detected, but PDUS showed a strong correlation with VAS score.  

SEL showed good sensitivity and sensitivity in the detection of lateral epicondylitis, whereas SEL was slightly more sensitive than US in detecting lateral epicondylitis. SEL could represent a diagnostic adjunct to US and PDUS for a detailed diagnostic approach in patients presenting with lateral epicondylitis.

Detection of tissue softening in lateral epicondylitis by using SEL can be considered as a diagnostic adjunct besides US and PDUS.

De Zordo, T, Lill, S, Feuchtner, G, Soegner, P, Jaschke, W, Klauser, A, Value of Real-time Sonoelastography in Lateral Epicondylitis: Comparison with Clinical Examination, Ultrasound, and Power Doppler Ultrasound.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6016840.html