title: Validation of grayscale-based quantitative ultrasound in manual wheelchair users: relationship to established clinical measures of shoulder pathology.
abstract: OBJECTIVE
  The primary aim of this study is to establish the validity of grayscale-based quantitative ultrasound (QUS) measures of the biceps and supraspinatus tendons.
  
  
  METHODS
  Nine QUS measures of the biceps and supraspinatus tendons were computed from ultrasound images collected from 67 manual wheelchair users. Shoulder pathology was measured using questionnaires, physical examination maneuvers, and a clinical ultrasound grading scale.
  
  
  RESULTS
  Increased age, duration of wheelchair use, and body mass correlated with a darker and more homogenous tendon appearance. Subjects with pain during physical examination tests for biceps tenderness and acromioclavicular joint tenderness exhibited significantly different supraspinatus QUS values. Even when controlling for tendon depth, QUS measures of the biceps tendon differed significantly between subjects with healthy tendons, mild tendinosis, and severe tendinosis. Clinical grading of supraspinatus tendon health was correlated with QUS measures of the supraspinatus tendon.
  
  
  CONCLUSIONS
  QUS is valid method to quantify tendinopathy and may allow for early detection of tendinosis. Manual wheelchair users are at a high risk for developing shoulder tendon pathology and may benefit from QUS-based research that focuses on identifying interventions designed to reduce this risk.
authors.affiliation: Human Engineering Research Laboratories, Department of Veterans Affairs, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15206, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Collinger
authors.forename: Bradley
authors.initials: B
authors.lastname: Fullerton
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Impink
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Koontz
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
mesh_terms: D000328:Adult; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D020069:Shoulder Pain / Q000000981:diagnostic imaging*; D052256:Tendinopathy / Q000000981:diagnostic imaging*; D013710:Tendons / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014910:Wheelchairs
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