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Quantitative assessment of change in upper extremity muscle stiffness following fluid injection using shear wave elastography

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Abstract

Objective

To quantitatively assess changes in muscle stiffness following intramuscular saline injection using shear wave elastography (SWE).

Materials and methods

Thirty muscles (lateral deltoid (LD), biceps brachii (BB), brachialis, pronator teres (PT), flexor carpi radialis (FCR), flexor carpi ulnaris (FCU)) from fresh-frozen cadaveric specimens were injected with saline under ultrasound guidance. Pre- and post-injection muscle thickness (MT) (mm) and SWE (kPa) measurements were recorded.

Results

All muscles demonstrated a decrease in the mean SWE value post-injection, with the largest differences ± standard error noted in the LD (14.76 ± 3.55 kPa, p = 0.021) and brachialis muscles (12.02 ± 2.51 kPa, p = 0.013). Muscle thickness increased following injection, although the degree of changes poorly correlated with the change in SWE.

Conclusion

In summary, following intramuscular injection of saline injection, a decrease in upper extremity muscle stiffness is detected using SWE. It is important to note that if performing a longitudinal assessment of muscle stiffness after intramuscular injection, saline will likely contribute to a decrease in muscle stiffness in the immediate post-injection time period.

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References

  1. Multani I, Manji J, Hastings-Ison T, et al. Botulinum toxin in the management of children with cerebral palsy. Paediatr Drugs. 2019;21(4):261–81.

    Article  Google Scholar 

  2. Eby SF, Song P, Chen S, et al. Validation of shear wave elastography in skeletal muscle. J Biomech. 2013;46(14):2381–7.

    Article  Google Scholar 

  3. Brandenburg JE, Eby SF, Song P, et al. Ultrasound elastography: the new frontier in direct measurement of muscle stiffness. Arch Phys Med Rehabil. 2014;95(11):2207–19.

    Article  Google Scholar 

  4. Brandenburg JE, Eby SF, Song P, et al. Feasibility and reliability of quantifying passive muscle stiffness in young children by using shear wave ultrasound elastography. J Ultrasound Med. 2015;34(4):663–70.

    Article  Google Scholar 

  5. Brandenburg JE, Eby SF, Song P, et al. Quantifying passive muscle stiffness in children with and without cerebral palsy using ultrasound shear wave elastography. Dev Med Child Neurol. 2016;58(12):1288–94.

    Article  Google Scholar 

  6. Alfuraih AM, O’Connor P, Tan AL, et al. An investigation into the variability between different shear wave elastography systems in muscle. Med Ultrason. 2017;19(4):392–400.

    Article  Google Scholar 

  7. Wu CH, Ho YC, Hsiao MY, et al. Evaluation of post-stroke spastic muscle stiffness using shear wave ultrasound elastography. Ultrasound Med Biol. 2017;43(6):1105–11.

    Article  Google Scholar 

  8. Koman LA, Smith BP, Williams R, et al. Upper extremity spasticity in children with cerebral palsy: a randomized, double-blind, placebo-controlled study of the short-term outcomes of treatment with botulinum a toxin. J Hand Surg Am. 2013;38(3):435–46 e1.

    Article  Google Scholar 

  9. Brandenburg JE, Eby SF, Song P, et al. Quantifying effect of onabotulinum toxin a on passive muscle stiffness in children with cerebral palsy using ultrasound shear wave elastography. Am J Phys Med Rehabil. 2018;97(7):500–6.

    Article  Google Scholar 

  10. Ceyhan Bilgici M, Bekci T, Ulus Y, et al. Quantitative assessment of muscle stiffness with acoustic radiation force impulse elastography after botulinum toxin a injection in children with cerebral palsy. J Med Ultrason (2001). 2018;45(1):137–41.

    Article  Google Scholar 

  11. Kwon DR, Park GY, Kwon JG. The change of intrinsic stiffness in gastrocnemius after intensive rehabilitation with botulinum toxin a injection in spastic diplegic cerebral palsy. Ann Rehabil Med. 2012;36(3):400–3.

    Article  Google Scholar 

  12. Graham HK. Botulinum toxin a in cerebral palsy: functional outcomes. J Pediatr. 2000;137(3):300–3.

    Article  CAS  Google Scholar 

  13. Carruthers A, Carruthers J. Botulinum toxin type a: history and current cosmetic use in the upper face. Semin Cutan Med Surg. 2001;20(2):71–84.

    Article  CAS  Google Scholar 

  14. Susmita A, Kolli NN, Meka S, et al. An evaluation of use of botulinum toxin type a in the management of dynamic forehead wrinkles - a clinical study. J Clin Diagn Res. 2016;10(10):ZC127–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Alfuraih AM, O’Connor P, Tan AL, et al. Muscle shear wave elastography in idiopathic inflammatory myopathies: a case-control study with MRI correlation. Skelet Radiol. 2019.

  16. Pichiecchio A, Alessandrino F, Bortolotto C, et al. Muscle ultrasound elastography and MRI in preschool children with Duchenne muscular dystrophy. Neuromuscul Disord. 2018;28(6):476–83.

    Article  Google Scholar 

  17. Mercuri E, Pichiecchio A, Allsop J, et al. Muscle MRI in inherited neuromuscular disorders: past, present, and future. J Magn Reson Imaging. 2007;25(2):433–40.

    Article  Google Scholar 

  18. Creze M, Nordez A, Soubeyrand M, et al. Shear wave sonoelastography of skeletal muscle: basic principles, biomechanical concepts, clinical applications, and future perspectives. Skelet Radiol. 2018;47(4):457–71.

    Article  Google Scholar 

  19. Hotfiel T, Kellermann M, Swoboda B, et al. Application of acoustic radiation force impulse elastography in imaging of delayed onset muscle soreness: a comparative analysis with 3T MRI. J Sport Rehabil. 2018;27(4):348–56.

    Article  Google Scholar 

  20. Agten CA, Buck FM, Dyer L, et al. Delayed-onset muscle soreness: temporal assessment with quantitative MRI and shear-wave ultrasound elastography. AJR Am J Roentgenol. 2017;208(2):402–12.

    Article  Google Scholar 

  21. Sadeghi S, Newman C, Cortes DH. Change in skeletal muscle stiffness after running competition is dependent on both running distance and recovery time: a pilot study. PeerJ. 2018;6:e4469.

    Article  Google Scholar 

  22. Kwon DR, Park GY, Lee SU, et al. Spastic cerebral palsy in children: dynamic sonoelastographic findings of medial gastrocnemius. Radiology. 2012;263(3):794–801.

    Article  Google Scholar 

  23. Lee SS, Gaebler-Spira D, Zhang LQ, et al. Use of shear wave ultrasound elastography to quantify muscle properties in cerebral palsy. Clin Biomech (Bristol, Avon). 2016;31:20–8.

    Article  Google Scholar 

  24. Barrett RS, Lichtwark GA. Gross muscle morphology and structure in spastic cerebral palsy: a systematic review. Dev Med Child Neurol. 2010;52(9):794–804.

    Article  Google Scholar 

  25. Lieber RL, Runesson E, Einarsson F, et al. Inferior mechanical properties of spastic muscle bundles due to hypertrophic but compromised extracellular matrix material. Muscle Nerve. 2003;28(4):464–71.

    Article  Google Scholar 

  26. Booth CM, Cortina-Borja MJ, Theologis TN. Collagen accumulation in muscles of children with cerebral palsy and correlation with severity of spasticity. Dev Med Child Neurol. 2001;43(5):314–20.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th Street, 3rd Floor, New York, NY, 10021, USA

    O. Kenechi Nwawka, Nicholas Gutierrez, Bin Lin, Lydia M. Ko & Theodore T. Miller

  2. Department of Radiology, Weill Cornell Medical College of Cornell University, New York, NY, USA

    O. Kenechi Nwawka & Theodore T. Miller

Authors
  1. O. Kenechi Nwawka
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  2. Nicholas Gutierrez
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  3. Bin Lin
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  4. Lydia M. Ko
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  5. Theodore T. Miller
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Correspondence to O. Kenechi Nwawka.

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This study was approved by the Institutional Review Board of our hospital, with a waiver of informed consent for this cadaveric study.

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The authors declare that they have no conflict of interest.

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Nwawka, O.K., Gutierrez, N., Lin, B. et al. Quantitative assessment of change in upper extremity muscle stiffness following fluid injection using shear wave elastography. Skeletal Radiol 50, 1455–1460 (2021). https://doi.org/10.1007/s00256-020-03648-w

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  • DOI: https://doi.org/10.1007/s00256-020-03648-w

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