• J Shoulder Elbow Surg · Jun 2020

    Changes in medial elbow elasticity and joint space gapping during maximal gripping: reliability and validity in evaluation of the medial elbow joint using ultrasound elastography.

    • Hiroshi Hattori, Kiyokazu Akasaka, Takahiro Otsudo, Toby Hall, Katsuya Amemiya, Yoshihisa Mori, Katsunobu Sakaguchi, and Yomei Tachibana.
    • Department of Physical Therapy, Saitama Medical University Graduate School of Medicine, Saitama, Japan; Department of Rehabilitation, Kawagoe Clinic, Saitama Medical University, Saitama, Japan.
    • J Shoulder Elbow Surg. 2020 Jun 1; 29 (6): e245-e251.

    BackgroundMedial elbow injuries are common in baseball pitchers. This study investigated the reliability of medial elbow elastography measurement and the characteristics of the medial elbow stabilizers.MethodsMedial elbow joint space gapping and the strain ratios of the ulnar collateral ligament (UCL) and the forearm flexor-pronator muscle (FPM) were measured at rest and during gripping in 29 healthy college students. The intraclass correlation coefficients of elastography were calculated. The data were compared between tissues and between rest and gripping.ResultsThe intraclass correlation coefficients (ICC1,3) of the elastography measurements were 0.91 and 0.83 for the UCL and 0.80 and 0.85 for the FPM for each examiner. Medial elbow joint space gapping during gripping (3.1 ± 0.6 mm) was significantly less than that at rest (3.8 ± 0.8 mm, P < .001). The strain ratios for both the UCL and FPM during gripping were significantly greater than those at rest (17.64 ± 10.97 during gripping vs. 3.94 ± 1.92 at rest for UCL, P < .001; 1.72 ± 0.99 during gripping vs. 0.35 ± 1.92 at rest for FPM, P < .001). The strain ratio for the UCL was significantly greater than that for the FPM both at rest (P < .001) and during gripping (P < .001).ConclusionsElastography measurements of the UCL and FPM have almost perfect reliability. Gripping reduces medial elbow joint space gapping compared with rest. For both tissues, gripping reduces their elasticity compared with rest. The elasticity of the UCL is less than that of the FPM both at rest and during gripping.Copyright © 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

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