Elastography and Applications in the Musculoskeletal System in Veterinary Medicine: From Physical Basis to Image Formation

Wanessa Patrícia Rodrigues da Silva; Rafaela Rodrigues Ribeiro; Iago Martins Oliveira; Naida Cristina Borges

doi:10.1055/a-2577-1449

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol
DOI: 10.1055/a-2577-1449

Review Article

Elastography and Applications in the Musculoskeletal System in Veterinary Medicine: From Physical Basis to Image Formation

Wanessa Patrícia Rodrigues da Silva

¹Programa de Pós-Graduação em Ciência Animal, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Rodovia Goiânia – Nova Veneza, Goiânia, Goiás, Brasil

,

Rafaela Rodrigues Ribeiro

²Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás, Câmpus II, Av. Engler, s/n – Jardim Mariliza, Goiânia, Goiás, Brasil

,

Iago Martins Oliveira

¹Programa de Pós-Graduação em Ciência Animal, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Rodovia Goiânia – Nova Veneza, Goiânia, Goiás, Brasil

²Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás, Câmpus II, Av. Engler, s/n – Jardim Mariliza, Goiânia, Goiás, Brasil

,

Naida Cristina Borges

³Departamento de Medicina Veterinária, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Rodovia Goiânia – Nova Veneza, Goiânia, Goiás, Brasil

› Author Affiliations

Abstract

Musculoskeletal ultrasound is a versatile imaging technique, surpassing conventional radiographic examinations in detecting certain alterations in the musculoskeletal system and showing effectiveness comparable to magnetic resonance imaging in assessing articular and periarticular soft tissues. The objective of this review is to discuss the physical principles of ultrasound elastography and its applications in the musculoskeletal system of veterinary medicine. This bibliographic review compiles relevant studies exploring elastography's physical basis, its technological development, and its clinical applications in veterinary contexts. Elastography complements B-mode ultrasound by assessing tissue stiffness, offering unique diagnostic insights beyond acoustic impedance and flow properties. Studies have demonstrated the potential of elastography in evaluating tendon injuries, muscle disorders, and bone healing, with promising results in dogs, horses and experimental models like sheep. Techniques such as compression elastography and shear wave elastography provide qualitative and quantitative data, enhancing the assessment of pathological changes. Shear wave elastography enables precise measurements of tissue elasticity, aiding the diagnosis, monitoring of healing and evaluation of therapeutic interventions. Despite technical challenges, elastography is a valuable tool that can optimize musculoskeletal diagnostics and treatment planning. Its expanding use in veterinary medicine underscores its clinical relevance and potential for widespread adoption as a complementary imaging modality.

Keywords

diagnosis - strain elastography - tissue stiffness - ultrasound

Full Text

References

References
1 Baillet A, Gaujoux-Viala C, Mouterde G. et al. Comparison of the efficacy of sonography, magnetic resonance imaging and conventional radiography for the detection of bone erosions in rheumatoid arthritis patients: a systematic review and meta-analysis. Rheumatology (Oxford) 2011; 50 (06) 1137-1147
2 Cook CR. Ultrasound imaging of the musculoskeletal system. Vet Clin North Am Small Anim Pract 2016; 46 (03) 355-371 , v
3 Winn N, Lalam R, Cassar-Pullicino V. Sonoelastography in the musculoskeletal system: Current role and future directions. World J Radiol 2016; 8 (11) 868-879
4 Rubaltelli L, Corradin S, Dorigo A. et al. Differential diagnosis of benign and malignant thyroid nodules at elastosonography. Ultraschall Med 2009; 30 (02) 175-179
5 Dietrich CF, Barr RG, Farrokh A, Dighe M, Hocke M, Jenssen C, Havre RF. Strain elastography-how to do it?. Ultrasound International Open 2017; 3 (04) 137-149
6 Ormachea J, Parker KJ. Elastography imaging: the 30 year perspective. Phys Med Biol 2020; 65 (24) 1-24
7 Breasted JH. The Edwin Smith Surgical Papyrus: published in facsimile and hieroglyphic transliteration with translation and commentary in two volumes. Chicago, United States: University of Chicago Press; 1930
8 Garra BS. Elastography: history, principles, and technique comparison. Abdom Imaging 2015; 40 (04) 680-697
9 Shiina T. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: part 1: basic principles and terminology. Ultrasound Med Biol 2017; 43: 191-192
10 Fung YC. Biomechanics: Mechanical Properties of Living Tissues (1981, 1st ed.). Springer Science and Business Media; 2013.
11 Hooke R. Lectures de Potentia Restitutiva, or of Spring: Explaining the Power of Springing Bodies (1678, No. 6). John Martyn; 2016.
12 Sarvazyan AP, Rudenko OV, Swanson SD, Fowlkes JB, Emelianov SY. Shear wave elasticity imaging: a new ultrasonic technology of medical diagnostics. Ultrasound Med Biol 1998; 24 (09) 1419-1435
13 Parker KJ, Doyley MM, Rubens DJ. Imaging the elastic properties of tissue: the 20 year perspective. Phys Med Biol 2011; 56 (01) R1-R29
14 Doyley MM. Model-based elastography: a survey of approaches to the inverse elasticity problem. Phys Med Biol 2012; 57 (03) R35-R73
15 Glaser KJ, Manduca A, Ehman RL. Review of MR elastography applications and recent developments. J Magn Reson Imaging 2012; 36 (04) 757-774
16 Wang S, Larin KV. Optical coherence elastography for tissue characterization: a review. J Biophotonics 2015; 8 (04) 279-302
17 Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 1991; 13 (02) 111-134
18 Garra BS, Cespedes EI, Ophir J. et al. Elastography of breast lesions: initial clinical results. Radiology 1997; 202 (01) 79-86
19 Cè M, D'Amico NC, Danesini GM. et al. Ultrasound elastography: basic principles and examples of clinical applications with artificial intelligence-a review. BioMedInformatics 2023; 3 (01) 17-43
20 Walter EG. Sobre o módulo de Young. Rev Soc Bras Hist Cienc 1991; (06) 45-58
21 Halliday D, Resnik R, Krane KS. Physics. 5th ed.. Hoboken, NJ: John Wiley; 2001
22 Ozturk A, Grajo JR, Dhyani M, Anthony BW, Samir AE. Principles of ultrasound elastography. Abdom Radiol (NY) 2018; 43 (04) 773-785
23 Sigrist RMS, Liau J, Kaffas AE, Chammas MC, Willmann JK. Ultrasound elastography: review of techniques and clinical applications. Theranostics 2017; 7 (05) 1303-1329
24 Wells PN, Liang HD. Medical ultrasound: imaging of soft tissue strain and elasticity. J R Soc Interface 2011; 8 (64) 1521-1549
25 Deffieux T, Montaldo G, Tanter M, Fink M. Shear wave spectroscopy for in vivo quantification of human soft tissues visco-elasticity. IEEE Trans Med Imaging 2009; 28 (03) 313-322
26 Zheng Y, Chen X, Yao A. et al. Shear Wave Propagation in Soft Tissue with Ultrasound Vibrometry. Electrical and Computer Engineering Faculty Publications; 2013;Vol. 1:pp. 1–24
27 Hall TJ, Zhu Y, Spalding CS. In vivo real-time freehand palpation imaging. Ultrasound Med Biol 2003; 29 (03) 427-435
28 Dobruch-Sobczak K. The differentiation of the character of solid lesions in the breast in the compression sonoelastography. Part I: The diagnostic value of the ultrasound B-mode imaging in the differentiation diagnostics of solid, focal lesions in the breast in relation to the pathomorphological verification. J Ultrason 2012; 12 (51) 402-419
29 Asteria C, Giovanardi A, Pizzocaro A. et al. US-elastography in the differential diagnosis of benign and malignant thyroid nodules. Thyroid 2008; 18 (05) 523-531
30 Healthcare GE. 2D Shear Wave Elastography: LOGIQ E9/E10/E10s. GE Healthcare; 2020. Accessed April 15, 2025 at: https://www.gehealthcare.com
31 William D, Callister JR. Materials Science and Engineering: An Introduction. 4th ed.. NewYork: John Wiley & Sons, Inc.; 1997: 532-533
32 Chen S, Fatemi M, Greenleaf JF. Quantifying elasticity and viscosity from measurement of shear wave speed dispersion. J Acoust Soc Am 2004; 115 (06) 2781-2785
33 Nightingale KR, Palmeri ML, Nightingale RW, Trahey GE. On the feasibility of remote palpation using acoustic radiation force. J Acoust Soc Am 2001; 110 (01) 625-634
34 Parmar BJ, Yang X, Chaudhry A. et al. Ultrasound elastography assessment of bone/soft tissue interface. Phys Med Biol 2016; 61 (01) 131-150
35 Rossignoli PP, Feliciano MAR, Minto BW. et al. B mode ultrasonography and elastography in the evaluation of the pectineus muscle indogs with hip dysplasia. Turk J Vet Anim Sci 2020; 44 (05) 1142-1149
36 Carneiro RK, da Cruz ICK, Gasser B. et al. B-mode ultrasonography and ARFI elastography of articular and peri-articular structures of the hip joint in non-dysplastic and dysplastic dogs as confirmed by radiographic examination. BMC Vet Res 2023; 19 (01) 181-192
37 Piccionello AP, Serrani D, Busoni V. et al. Sonoelastographic features of the patellar ligament in clinically normal dogs. Vet Comp Orthop Traumatol 2018; 31 (04) 279-284
38 Del Signore F, De Dominicis S, Mastromatteo G. et al. Sonoelastography of normal canine common calcaneal tendon: preliminary results. Vet Comp Orthop Traumatol 2021; 34 (03) 200-205
39 Diogo LMI, Andrade CR, Faria LG. et al. Acoustic radiation force impulse (ARFI) elastography of the stifle joint of healthy beagles. Arq Bras Med Vet Zootec 2020; 72: 1646-1652
40 Di Francesco P, Petrizzi L, Guerri G, Del Signore F, Vignoli M. Ultrasound elastography for evaluation of tendons and joint capsules in healthy dogs and horses: a preliminary study. J Med Ultrasound 2012; 20: 79-86
41 Kayser F, Bori E, Fourny S. et al. Ex vivo study correlating the stiffness of the ovine patellar tendon to age and weight. Int Biomech 2022; 9 (01) 1-9
42 Kayser F, Hontoir F, Clegg P, Kirschvink N, Dugdale A, Vandeweerd JM. Ultrasound anatomy of the normal stifle in the sheep. Anat Histol Embryol 2019; 48 (01) 87-96
43 Leitão JR, Minto BW, Tavares ABL. et al. Using elastography (Acoustic radiation force impulse) to correlate the effects of age, weight, sex, and Norberg angle on the pectineus muscle of dysplastic dogs. Cienc Rural 2025; 55 (05) 1-6
44 Cruz ICKD, Carneiro RK, Maronezi MC. et al. Acoustic radiation force impulse elastography to aid diagnosis of two canine malignant peripheral nerve sheath tumors. Cienc Rural 2024; 55 (01) 1-5
45 Embriano K, Holland M, Corriveau KM, Hofmeister E, McCarthy J. Shear-wave elastography of canine patellar tendons in healthy dogs and the influence of stifle joint angle. Vet Radiol Ultrasound 2025; 66 (01) e13447
46 Secchi V, Masala G, Corda A. et al. Strain elastography of injured equine superficial digital flexor tendons: A reliability study of manual measurements. Animals (Basel) 2021; 11 (03) 795
47 Bernardi NS, da Cruz ICK, Maronezi MC. et al. Applicability of ARFI elastography in detecting elasticity changes of the equine superficial digital flexor tendon with induced injury. Vet Radiol Ultrasound 2022; 63 (06) 790-797