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  • Küçük Resim
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    Association of real-time sonoelastography findings with clinical parameters in lateral epicondylitis
    (Springer Heidelberg, 2016) Koçyiğit, Figen; Kuyucu, Ersin; Koçyiğit, Ali; Herek Tuncer, Duygu; Şavkın, Raziye; Aslan Baş, Ümmühan; Karabulut, Nevzat
    The objective of this study was to investigate the role of real-time sonoelastography (RTSE) in patients with lateral epicondylitis (LE) and whether it is associated with clinical parameters. Seventeen patients with unilateral LE were enrolled in the study. The healthy elbows of the participants constituted the control group. Using B-mode ultrasound, color Doppler ultrasound, and RTSE, we prospectively examined 34 common extensor tendon elbows of 17 patients. Both color scales and strain ratio were used for evaluating RTSE images. Two radiologists evaluated the RTSE images separately. Elbow pain was scored on a 100-mm visual analog scale (VAS). Symptom duration and the presence of nocturnal pain were questioned. Quick disabilities of arm shoulder and hand (DASH) Questionnaire was applied to assess the pain, function, and disability. Nottingham health profile (NHP) was used to determine and quantify perceived health problems. Both color scales and strain ratios of the affected tendon portions were significantly different from that of healthy tendons (p < 0.001). There was no significant association between NHP, VAS, Quick DASH scores, and color scales and strain ratio. Strain ratio of the medial portion of the affected tendon was significantly correlated with symptom duration (rho = -0.61 p = 0.010) and nocturnal pain (rho = 0.522 p = 0.031). Interobserver agreement was substantial for color scales (kappa = 0.74, p = 0.001) and strain ratio (ICC = 0.61, p = 0.031). RTSE may facilitate differentiation between healthy and affected elbows as a feasible and practical supplementary method with substantial interobserver agreement. RTSE was superior to B-mode ultrasound and color Doppler ultrasound in discriminating tendons with LE. Strain ratio of the medial portion of the tendon is associated moderately with nocturnal pain and symptom duration. No other associations were present between RTSE findings and clinical or functional parameters.
  • Küçük Resim
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    Sonoelastographic strain index in the early diagnosis of plantar fasciitis
    (Elsevier, 2015) Koçyi?it, Figen; Kuyucu, Ersin; Koçyiğit, Ali; Karabulut, Nevzat
    We read with great interest the recent study published inClinical Imaging that reported the utility of real-time elastography in plantar fasciitis and the comments on this article [1,2]. We would like to share our experience with sonoelastographic strain in early diagnosis of plantar fasciitis (PF). A 36-year-old female patient was admitted with left heel pain. She described a sharp, burning pain that exacerbated in the morning and after rest. She had no symptoms on the right heel. Physical examination revealed positive heel compression test on the left side. Left plantar fascia tenderness was detected on palpation. She had no foot deformities. Her calcaneal X-ray was in normal range without any signs of fascial thickening and calcaneal spur formation (Fig. 1a, b). B-mode ultrasonography (US) revealed normal findings for both right and left plantar fascia with a thickness of 0.8 mm and 2.2 mm, respectively (Fig. 2a, b). Given that her plantar fascia was normal according to B-mode US findings, stretching exercises and modification of daily living activities were recommended. On the follow-up visit 2 weeks later, she reported only 25% relief in her symptoms. Real-time sonoelastography (RTSE) was performed to detect early structural changes in the symptomatic plantar fascia with a high-resolution ultrasound device (Logiq E9; GE Healthcare, Milwaukee, WI, USA) equipped with an elastographycompatible 6–15-MHz matrix linear probe.