title: Real-time sonoelastography in the diagnosis of rotator cuff tendinopathy.
abstract: BACKGROUND
  Real-time sonoelastography can be used to assess tissue elasticity. The present study evaluated the relationship between tendon stiffness on sonoelastography and the magnetic resonance imaging (MRI) tendinosis grade in patients with rotator cuff tendinopathy.
  
  
  METHODS
  The study included 39 patients with chronic pain and no history of trauma or rotator cuff tear. The supraspinatus tendons were graded according to MRI findings (grade 0, normal; grade 1, mild tendinosis; grade 2, moderate tendinosis; grade 3, marked tendinosis), and the subcutaneous fat-to-tendon (Fat/T) and gel pad-to-tendon (Pad/T) strain ratios were assessed. We used the trend test to analyze the relationship of the MRI grade with the Fat/T strain ratio and the Pad/T strain ratio.
  
  
  RESULTS
  Of the 39 patients, 9 had grade 0, 17 had grade 1, 12 had grade 2, and 1 had grade 3 tendinosis. The mean real-time elastography Fat/T and Pad/T strain ratios were 2.92 ± 2.13 and 20.77 ± 21.78 in patients with grade 0 tendinosis, 4.08 ± 4.09 and 21.78 ± 17.16 in patients with grade 1 tendinosis, 13.48 ± 10.19 and 83.00 ± 48.26 in patients with grade 2 tendinosis, and 12.3 ± 0.00 and 16.58 ± 0.00 in patients with grade 3 tendinosis, respectively. The Fat/T and Pad/T strain ratios were positively associated with the MRI grade (P <.001).
  
  
  CONCLUSIONS
  The MRI tendinosis grade is associated with stiffness assessed using sonoelastography in patients with rotator cuff tendinopathy. Therefore, sonoelastography might be a useful diagnostic tool for supraspinatus tendinopathy.
  
  
  METHODS
  Level III; Diagnostic Study.
authors.affiliation: Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sang-Uk
authors.initials: SU
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Joo
authors.affiliation: Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sun Ki
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sung-Ryeoll
authors.initials: SR
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. Electronic address: changhoonj@naver.com.
authors.forename: Changhoon
authors.initials: C
authors.lastname: Jeong
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000209:etiology; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012720:Severity of Illness Index; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D052256:Tendinopathy / Q000150:complications / Q000000981:diagnostic imaging*
keywords: diagnosis; grade; magnetic resonance imaging; rotator cuff; sonoelastography; supraspinatus tendon; tendinopathy