Panoramic Ultrasound Examination of Posterior Neck Extensors in Healthy Subjects: Intra-Examiner Reliability Study

César Fernández-de-las-Peñas,Juan Antonio Valera-Calero,Gracia María Gallego-Sendarrubias,José Luis Arias-Buría,Ricardo Ortega-Santiago,Joshua A. Cleland

doi:10.3390/diagnostics10100740

César Fernández-de-las-Peñas, Juan Antonio Valera-Calero + Show 4 more

Open Access

https://doi.org/10.3390/diagnostics10100740

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Abstract

Previous studies analyzing morphometry of posterior cervical muscles with ultrasound (US) imaging have mainly used Brightness mode (B-mode). Our aim was to investigate the intra-examiner reliability of panoramic US imaging for assessing posterior-lateral cervical muscle layers. Panoramic US images of the neck at C4/C5 level were acquired in 25 asymptomatic subjects (40% women; mean age: 24 years) by an experienced assessor. The cross-sectional area (CSA) of the upper trapezius, splenius, semispinalis, multifidi, rotators, and levator scapulae was measured from panoramic US scans on two separate days. Intra-class correlation coefficients (ICC3,1), standard error of measurement (SEM), minimal detectable change (MDC) and mean, absolute and percent errors were calculated. In general, intra-examiner reliability was excellent with ICC3,1 ranging from 0.978 (trapezius) to 0.993 (semispinalis). The SEM ranged from 0.02 (multifidus) to 0.07 (semispinalis/levator), whereas the MDC ranged from 0.05 (cervical multifidus) to 0.19 (levator/semispinalis). Absolute error was lower than 0.11 cm2 (levator/semispinalis). No differences between males and females were found. This study found that intra-examiner/rater reliability of panoramic US imaging was excellent for assessing the CSA of the posterior-lateral neck extensor muscles in asymptomatic subjects. The current findings suggest that panoramic US may be a reliable technique for examining the size of the cervical extensor muscles in both males and females.

Highlights

Ultrasound imaging (US) is an easy, safe, low-cost method for evaluating the musculoskeletal system
Evidence supports the reduction of the cross-sectional area (CSA) in the cervical multifidi in individuals with neck pain, the systematic review by DePauw et al [4] concluded that more studies are needed as results from previous studies are inconsistent
From a total of 43 subjects responding to the announcement, 18 were excluded due to a previous history of whiplash (n = 7) and history of chronic neck pain symptoms (n = 11)

Summary

Introduction

Ultrasound imaging (US) is an easy, safe, low-cost method for evaluating the musculoskeletal system. Brightness mode (B-mode) is generally used for assessing muscular echogenicity as indicator of muscle quality [1] and morphology measurements, e.g., thickness, depth, width, shape, or the cross-sectional area (CSA) [2]. Some studies have used B-mode to examine posterior neck muscle morphology in patients with neck pain [3]. Diagnostics 2020, 10, 740 neck pain induces changes in the posterior neck muscles, which could contribute to the chronification of pain symptoms. Evidence supports the reduction of the CSA in the cervical multifidi in individuals with neck pain, the systematic review by DePauw et al [4] concluded that more studies are needed as results from previous studies are inconsistent. Measuring the CSA of the posterior neck muscles is limited with B-mode.

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