Analysis of the thenar muscles with ultrasound shear wave elastography: Reliability and preliminary findings.

Abstract

Ultrasound shear wave elastography (SWE) of the thenar muscles has the potential to provide a simple and noninvasive assessment of the severity of carpal tunnel syndrome (CTS), but its reliability is unknown. The purpose of this study was to assess the intra- and inter-rater reliability of SWE measurements of the elastic modulus of individual thenar muscles, to assess their suitability for clinical application. Fourteen healthy volunteers, seven male and seven female, participated in this study. The elastic modulus of the thenar muscles was measured with SWE, with two independent examiners to assess inter-rater reliability. The first examiner also performed a second measurement after an interval of least 1 day to assess intra-rater reliability. Reliability was evaluated using an intraclass correlation coefficient (ICC) and 95% confidence interval (CI). For the abductor pollicis brevis (APB) and opponens pollicis (OPP), the CI of ICC in intra-rater reliability was 0.47-0.85 and 0.56-0.88, respectively. The CI of ICC in inter-rater reliability was 0.27-0.78 for the APB and 0.22-0.76 for the OPP. The ICCs of intra- and/or inter-rater reliability of other thenar muscles were less than 0.5. In this study, SWE evaluations of thenar muscles were quite variable in terms of their reliability. A larger study will be needed to determine the source of this variability, improve reliability, and assess the value of SWE in the evaluation of the severity of CTS.