The Role of Shear Wave Elastography in Quantifying Tendon Stiffness in Upper Extremities of Sonographers: Reducing Work-Related Musculoskeletal Disorders

Abstract

Objective:

Quantitative techniques to understand the contributing factors for repetitive stress injury among sonographers are limited. This study aims to quantify tendons stiffness in the upper extremities of upper sonographers during real-time imaging using shear wave elastography (SWE).

Methods:

The subjects comprised seven healthy sonographers performing renal imaging on eight healthy volunteers with varied body mass index (BMI) in different positions. Stiffness measurements were taken on the right supraspinatus (SSP), abductor pollicis longus (APL), and common extensor tendon (CET) as the sonographers were performing their ultrasound.

Results:

Sonographers with more work experience recorded higher stiffness in all three tendon groups compared to those with lesser experience (p < .05). The mean differences of stiffness in the SSP (0.26 m/s ± 0.10, p = .024) and CET (0.31 m/s ± 0.11, p = .013) were higher when scanning the sonographers in decubitus position. Significant differences were found in all three upper extremity tendons across four BMI categories of volunteers, with post-hoc test showing all tendons experiencing significantly higher stiffness when scanning overweight and obese volunteers compared with those of normal weight. General linear model–multivariate analysis indicated that BMI was the strongest predictor of stiffness (SSP [47.4%], APL [40.6%], and CET [39.5%] [p < .001]), followed by volunteers’ position (SSP [11.6%] and CET [11.0%] [p < .001]).

Conclusion:

Shear wave elastography can quantify real-time changes in tendon stiffness in ultrasound scanning. Participants’ positioning and BMI have a greater impact on tendon strain, particularly on the SSP.