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Purpose To evaluate the clinical efficacy of real-time sonoelastography (RTS) for the follow-up of congenital muscular torticollis, based on measurements of muscle elasticity. Materials and Methods Thirty-four infants (23 male, 11 female) with congenital sternocleidomastoid (SCM) muscle torticollis underwent ultrasonography and elastography between November 2012 and December 2014. We evaluated the thickness, morphology (mass-like, fusiform, or overall thickened shape), and echogenicity of the SCM muscle on grayscale images and color patterns (homogeneous blue, mixed green < 50% and ≥ 50%, and green to red) on elastography. Strain ratios were measured using Q-lab software. A clinician classified the degree of neck rotation and side flexion deficits using a 5-point grade system based on angles of neck rotation and side flexion. Correlations between the ultrasonography and clinical findings were evaluated by statistical analysis. Results Twenty-two infants had right and 12 had left SCM torticollis, respectively. Linear regression analysis showed that involved/contralateral SCM thickness differences, morphology, elasticity color scores, and strain ratios of the affected SCM muscles were significantly correlated with neck rotation and side flexion deficit scores (p < 0.05). The elasticity color score of the affected SCM muscle was the most significant factor. Conclusion RTS might provide a reliable means for evaluating and monitoring congenital muscular torticollis.

Purpose: Using magnetic resonance imaging (MRI) as the standard of reference, the purpose of this study was to evaluate the accuracy of sonoelastography (SE) for assessment of fatty degeneration of suprasupinatus (SSP). Materials and Methods: A retrospective analysis was conducted in 131 shoulders of 126 consecutive patients who underwent shoulder MRI, and SE. Oblique sagittal images of SSP were obtained using SE; the SE images were evaluated by two orthopedic surgeons using a 256 degree color map image. Results: When the supraspinatus fatty degenerations were based on MRI findings, the sensitivity of SE was 89.47%, specificity 92.85%, and accuracy 91.60%. The interobserver reliability of the SE findings was ‘almost perfect agreement' with a weighted kappa coefficient of 0.81. By comparison of MRI with the SE findings, the grades of MRI and SE showed positive correlation (r=0.85, p≤0.001). In addition, the occupation ratio and blue region area ratio also showed positive correlation (r=0.69, p≤0.001). Conclusion: SE is valuable in quantitative assessment of the severity of fatty atrophy of the supraspinatus and has excellent accuracy, excellent correlation with MRI and conventional ultrasonography, and excellent interobserver reliability. [ABSTRACT FROM AUTHOR]