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  1. Leong SS, Wong JHD, Rozalli FI, Yahya F, Tee YC, Yamin LSM, et al.
    Skeletal Radiol, 2024 Mar;53(3):455-463.
    PMID: 37594519 DOI: 10.1007/s00256-023-04425-1
    OBJECTIVE: To establish the scanning protocol for 2-dimensional shear wave elastography (SWE) on normal entheses by investigating the possible confounding factors that may increase the variability of measured elasticity.

    MATERIAL AND METHODS: 30 normal quadriceps entheses were scanned using SWE to compare the stiffness and coefficient variation by changing the ultrasonic coupling gel thickness, knee position, region of interest size, and scanning plane.

    RESULTS: No significant difference in median shear wave velocity (SWV) was observed in different coupling gel thicknesses. The median SWV was higher in the knee flexion position than in the extended position (p  0.05). For interobserver reliability for the proposed protocol, the intraclass correlation coefficients was 0.763.

    CONCLUSION: In this study, we determined supine position with the knee extended; using 2.0 mm diameter region of interest and image acquisition at the longitudinal plane with thicker layer coupling gel seems most appropriate to reliably image healthy quadriceps entheses with SWE.

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