Abstract
Diagnostic musculoskeletal ultrasound is a non-invasive, low-cost, imaging modality that may be used to characterize normal and pathological muscle tissue. Sonography has been long proposed as a method of assessing muscle damage due to neuromuscular diseases such as muscular dystrophy (Reimers et al., 1996), and more recently, changes in body and tissue composition associated with muscle wasting disorders such as sarcopenia (Pillen and van Alfen, 2011). The use of quantitative ultrasound as an adjunct diagnostic procedure has different technical challenges than the traditional use of ultrasound in clinical medicine. Examiner-dependent technique and variation are critical considerations when assessing the presence of muscle atrophy via tissue dimension estimates using muscle thickness measures, or when quantifying pathological changes in muscle quality via estimates of echointensity using grayscale analysis. Understanding both the promise of quantitative ultrasound as an assessment tool for muscle disorders and the known threats to measurement validity may foster greater adoption of this imaging modality in the management of muscular dystrophy and sarcopenia.
Highlights
Diagnostic musculoskeletal ultrasound is a non-invasive, low-cost, imaging modality that may be used to characterize normal and pathological muscle tissue
In some instances, M-mode ultrasound may have advantages over electromyography for the assessment of muscle fasciculations, which is a clinical feature of some forms of muscular dystrophy and myopathy (Walker et al, 1990; Scheel et al, 1997; Pillen and van Alfen, 2011)
Ishida and Watanabe (2012) have cited the influence of compressive stress exerted by the examiner with the ultrasound transducer as a potential source of error in the assessment of abdominal muscle thickness
Summary
Diagnostic musculoskeletal ultrasound is a non-invasive, low-cost, imaging modality that may be used to characterize normal and pathological muscle tissue. Sonographic measures of echointensity for the purpose of tissue composition estimates, and digital caliper measures of tissue dimensions to assess muscle atrophy are both key elements of the ultrasound assessment of muscular dystrophy and sarcopenia (Pillen and van Alfen, 2011; Tieleman et al, 2012; Janssen et al, 2014). In some instances, M-mode ultrasound may have advantages over electromyography for the assessment of muscle fasciculations, which is a clinical feature of some forms of muscular dystrophy and myopathy (Walker et al, 1990; Scheel et al, 1997; Pillen and van Alfen, 2011).
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