The study, led by Dr. Timm Dirrichs of the University of Aachen, included 35 patients with 47 symptomatic tendons. All patients underwent a multimodality ultrasound protocol that included B-mode ultrasound, power Doppler, and shear-wave elastography on three occasions: before therapy, after four weeks of therapy, and after six months of therapy. An orthopedic surgeon ranked patients' clinical symptoms at each visit.
Overall clinical scores showed symptom relief in 46.8% of patients after four weeks (22 of 47 tendons) and in 68% of patients after six months (32 of 47 tendons). Of the three ultrasound modalities, shear-wave elastography had the highest correlation with patients' overall clinical scores: An increase in tendon stiffness was identified by the modality in 18 patients after four weeks (81.8%, or 18 of 22 tendons) and in 28 patients after six months (90.6%, or 28 of 32 tendons).
Because shear-wave elastography correlates better with clinical symptoms and more effectively tracks tendon healing, it is more useful than B-mode and power Doppler ultrasound for this application, the group concluded.
