Research Article
Volume 11 Issue 10 - 2020
The Sciatic Nerve Elastography in the Clinical Pathway
Stajic Sava* and Misic Miroslav
Academy of Professional studies, High Medical School, Belgrade, Serbia
*Corresponding Author: Stajic Sava, Professor of Applied Radiology, Academy of Professional studies, High medical School, Belgrade, Serbia.
Received: May 27, 2020; Published: September 30, 2020




Abstract

Last few years there are more papers related to the usefulness of sciatic nerve elastography in clinical practice. Sonoelastographic evaluation was performed predominantly in patients with deep gluteal syndrome (DGS). In this review in the final processing, 14 studies were identified, three with strain ratio. 11 with shear wave elastography. The final processing was done by ROC analysis of patients results. The scientific data were from 2013th to 2019th. Looking at the reviewed studies, there were applied different techniques (quasi-static, ARFI and shear wave elastography), with various joint movements (“knee movement”, “limb movement”, “ankle motion”, “plantar or dorsal flexion”), the several position of the transducer at the “region of interest”, non-standardized measurement units and in patients were dissimiliar pathology. The ultrasound equipment upgraded with shear wave elastography option gave a new opportunity to this review technique. It is based on direct measurement of muscle stiffness. In the musculoskeletal field, the quasi-static method was not often applied, looking at a relative strain ration, and that the region of interest (ROI) was not clearly defined. However, some authors have presented the referent values of relative stiffness in knee extension, and in knee flexion. Some authors have noted the neurodynamic sciatic nerve changings in exercises of plantar flexion to dorsiflexion. The shear wave features were presented in different conditions and diseases, respectively in healthy patients and in patients with chronic low back leg pain. The shear wave sciatic nerve stiffness was also tested during human ankle motion in conclusion the follow of EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Updated by 2018 was required. In this review the resume of all obtained results lead us to conclude that sciatic nerve ultrasound elastography test is not well established and clinically standardized. However, in everyday practice this method can be applied. The nerve and surrounding muscles have to be assessed by color scale and B mode. Determining strain index may be useful, on particular equipment and within the same institution. The shear wave technique provides much more secure, direct results, comparable to those of other institutions and researchers. Most proven this method can use deep gluteal syndrome with a wide range of manifestations, unilateral lumbar disc hernia, in the assessment of sports injuries, to study musculoskeletal activity, in monitoring the course of rehabilitation and in monitoring postoperative recovery.

Keywords: Sciatic Nerve Elastography; Shear Wave; ARFI; Strain Elastography; Deep Gluteal Syndrome

References

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Citation: Stajic Sava and Misic Miroslav. “The Sciatic Nerve Elastography in the Clinical Pathway”. EC Orthopaedics 11.10 (2020): 45-50.

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