Evaluation of Lower Extremity Athletic Injuries and Response to Treatment Using SWE and MFI
Evaluation of Lower Extremity Athletic Injuries and Response to Treatment Using Shear Wave Elastography and Micro-vascular Flow Imaging
Primary Objective:
To explore changes in shear wave elastography (SWE) and microvascular flow imaging (MFI) measurements from time of injury through the recovery phase of lower extremity musculoskeletal injuries to determine if a correlation exists with functional impairment.
Secondary Objective:
To develop a deep learning AI system for automated region of interest (ROI) determination for measurement of average SWE and MFI.
Methodology:
Eligible subjects with lower extremity injuries will undergo SWE and MFI measurements and complete the Lower Extremity Functional Scale questionnaire at each study visit. Clinical data related to the evaluation of the injury acquired during standard medical care of the injury will be collected from the patients' medical record such as CT or MRI scans, X-rays, physical exams and tests as well as laboratory measurements. Subjects will undergo serial SWE and MFI imaging throughout their rehabilitation episode of care to assess changes over time, status in rehabilitation and comparison to the contralateral extremity.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Natalie Pettigrew, DPT
- Phone Number: 858-342-4191
- Email: terwilln@ohsu.edu
Study Contact Backup
- Name: Jody Oyama, DrPH
- Phone Number: 808-781-4609
- Email: oyamajo@ohsu.edu
Study Locations
-
-
Oregon
-
Eugene, Oregon, United States, 97403
- University of Oregon
-
Portland, Oregon, United States, 97239
- Oregon Health & Science University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Subjects age 18 - 89 years;
- Able to sign an informed consent document;
- Suspected MSK injury of the lower extremity (i.e. hamstring injuries and soft tissue injuries involving the ankle).
Exclusion Criteria:
- Prior fasciotomy of same limb;
- Hemodialysis grafts of involved extremity;
- Extremity wounds preventing ultrasound imaging.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Musculoskeletal injury
Shear wave elastography and microvascular flow imaging.
|
Subjects will undergo serial SWE and MFI imaging throughout their rehabilitation episode of care to assess changes over time, status in rehabilitation and comparison to the contralateral extremity.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
kPa
Time Frame: Within 48 hours
|
Tissue stiffness measured by shear wave elastography
|
Within 48 hours
|
|
kPa
Time Frame: 5 days post injury (+/- 2 days)
|
Tissue stiffness measured by shear wave elastography
|
5 days post injury (+/- 2 days)
|
|
kPa
Time Frame: 6 weeks post injury (+/- 1 week)
|
Tissue stiffness measured by shear wave elastography
|
6 weeks post injury (+/- 1 week)
|
|
kPa
Time Frame: 12 weeks post injury (+/- 1 week)
|
Tissue stiffness measured by shear wave elastography
|
12 weeks post injury (+/- 1 week)
|
|
kPa
Time Frame: 24 weeks post injury (+/- 1 week)
|
Tissue stiffness measured by shear wave elastography
|
24 weeks post injury (+/- 1 week)
|
|
Presence of blood flow
Time Frame: Within 48 hours
|
Measured by microvascular flow imaging
|
Within 48 hours
|
|
Presence of blood flow
Time Frame: 5 days post injury (+/- 2 days)
|
Measured by microvascular flow imaging
|
5 days post injury (+/- 2 days)
|
|
Presence of blood flow
Time Frame: 6 weeks post injury (+/- 1 week)
|
Measured by microvascular flow imaging
|
6 weeks post injury (+/- 1 week)
|
|
Presence of blood flow
Time Frame: 12 weeks post injury (+/- 1 week)
|
Measured by microvascular flow imaging
|
12 weeks post injury (+/- 1 week)
|
|
Presence of blood flow
Time Frame: 24 weeks post injury (+/- 1 week)
|
Measured by microvascular flow imaging
|
24 weeks post injury (+/- 1 week)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Kenton Gregory, MD, Oregon Health and Science University
Publications and helpful links
General Publications
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- Sarvazyan A, Hall TJ, Urban MW, Fatemi M, Aglyamov SR, Garra BS. AN OVERVIEW OF ELASTOGRAPHY - AN EMERGING BRANCH OF MEDICAL IMAGING. Curr Med Imaging Rev. 2011 Nov;7(4):255-282. doi: 10.2174/157340511798038684.
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- Kelly JF, Ritenour AE, McLaughlin DF, Bagg KA, Apodaca AN, Mallak CT, Pearse L, Lawnick MM, Champion HR, Wade CE, Holcomb JB. Injury severity and causes of death from Operation Iraqi Freedom and Operation Enduring Freedom: 2003-2004 versus 2006. J Trauma. 2008 Feb;64(2 Suppl):S21-6; discussion S26-7. doi: 10.1097/TA.0b013e318160b9fb.
- Mauser N, Gissel H, Henderson C, Hao J, Hak D, Mauffrey C. Acute lower-leg compartment syndrome. Orthopedics. 2013 Aug;36(8):619-24. doi: 10.3928/01477447-20130724-07.
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- Rush RM Jr, Beekley AC, Puttler EG, Kjorstad RJ. The mangled extremity. Curr Probl Surg. 2009 Nov;46(11):851-926. doi: 10.1067/j.cpsurg.2009.05.003. No abstract available.
- Kragh JF Jr, Wade CE, Baer DG, Jones JA, Walters TJ, Hsu JR, Wenke JC, Blackbourne LH, Holcomb JB. Fasciotomy rates in operations enduring freedom and iraqi freedom: association with injury severity and tourniquet use. J Orthop Trauma. 2011 Mar;25(3):134-9. doi: 10.1097/BOT.0b013e3181e52333.
- McMillan TE, Gardner WT, Schmidt AH, Johnstone AJ. Diagnosing acute compartment syndrome-where have we got to? Int Orthop. 2019 Nov;43(11):2429-2435. doi: 10.1007/s00264-019-04386-y. Epub 2019 Aug 29.
- Lacourpaille L, Hug F, Bouillard K, Hogrel JY, Nordez A. Supersonic shear imaging provides a reliable measurement of resting muscle shear elastic modulus. Physiol Meas. 2012 Mar;33(3):N19-28. doi: 10.1088/0967-3334/33/3/N19. Epub 2012 Feb 28.
- Nightingale KR, Palmeri ML, Nightingale RW, Trahey GE. On the feasibility of remote palpation using acoustic radiation force. J Acoust Soc Am. 2001 Jul;110(1):625-34. doi: 10.1121/1.1378344.
- Ganesan S, Man CS, Lai-Fook SJ. Generation and detection of lung stress waves from the chest surface. Respir Physiol. 1997 Oct;110(1):19-32. doi: 10.1016/s0034-5687(97)00065-0.
- Catheline S, Thomas JL, Wu F, Fink MA. Diffraction field of a low frequency vibrator in soft tissues using transient elastography. IEEE Trans Ultrason Ferroelectr Freq Control. 1999;46(4):1013-9. doi: 10.1109/58.775668.
- 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 Nov;24(9):1419-35. doi: 10.1016/s0301-5629(98)00110-0.
- Muthupillai R, Lomas DJ, Rossman PJ, Greenleaf JF, Manduca A, Ehman RL. Magnetic resonance elastography by direct visualization of propagating acoustic strain waves. Science. 1995 Sep 29;269(5232):1854-7. doi: 10.1126/science.7569924.
- Brandenburg JE, Eby SF, Song P, Zhao H, Brault JS, Chen S, An KN. Ultrasound elastography: the new frontier in direct measurement of muscle stiffness. Arch Phys Med Rehabil. 2014 Nov;95(11):2207-19. doi: 10.1016/j.apmr.2014.07.007. Epub 2014 Jul 24.
- Hildebrandt W, Schwarzbach H, Pardun A, Hannemann L, Bogs B, Konig AM, Mahnken AH, Hildebrandt O, Koehler U, Kinscherf R. Age-related differences in skeletal muscle microvascular response to exercise as detected by contrast-enhanced ultrasound (CEUS). PLoS One. 2017 Mar 8;12(3):e0172771. doi: 10.1371/journal.pone.0172771. eCollection 2017.
- Sadeghi S, Johnson M, Bader DA, Cortes DH. The shear modulus of lower-leg muscles correlates to intramuscular pressure. J Biomech. 2019 Jan 23;83:190-196. doi: 10.1016/j.jbiomech.2018.11.045. Epub 2018 Dec 10.
- Gliemann L, Mortensen SP, Hellsten Y. Methods for the determination of skeletal muscle blood flow: development, strengths and limitations. Eur J Appl Physiol. 2018 Jun;118(6):1081-1094. doi: 10.1007/s00421-018-3880-5. Epub 2018 May 14.
- GREENFIELD AD, WHITNEY RJ, MOWBRAY JF. Methods for the investigation of peripheral blood flow. Br Med Bull. 1963 May;19:101-9. doi: 10.1093/oxfordjournals.bmb.a070026. No abstract available.
- Jorfeldt L, Wahren J. [Leg blood supply during exercise: methodological studies with a dye dilution technic]. Nord Med. 1971 Aug 26;86(34):1009. No abstract available. Swedish.
- WILD JJ, NEAL D. Use of high-frequency ultrasonic waves for detecting changes of texture in living tissues. Lancet. 1951 Mar 24;1(6656):655-7. doi: 10.1016/s0140-6736(51)92403-8. No abstract available.
- Nguyen T, Davidson BP. Contrast Enhanced Ultrasound Perfusion Imaging in Skeletal Muscle. J Cardiovasc Imaging. 2019 Jul;27(3):163-177. doi: 10.4250/jcvi.2019.27.e31. Epub 2019 May 20.
- Dunford EC, Au JS, Devries MC, Phillips SM, MacDonald MJ. Cardiovascular aging and the microcirculation of skeletal muscle: using contrast-enhanced ultrasound. Am J Physiol Heart Circ Physiol. 2018 Nov 1;315(5):H1194-H1199. doi: 10.1152/ajpheart.00737.2017. Epub 2018 Aug 3.
- Sboros V, Tang MX. The assessment of microvascular flow and tissue perfusion using ultrasound imaging. Proc Inst Mech Eng H. 2010;224(2):273-90. doi: 10.1243/09544119JEIM621.
- Bercoff J, Tanter M, Fink M. Supersonic shear imaging: a new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control. 2004 Apr;51(4):396-409. doi: 10.1109/tuffc.2004.1295425.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 00000608
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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