Case Study on Compression Elastography vs Shear Wave Elastography in Tendon Injury Assessment

Vasuki A

Abstract: Elastography has emerged as a revolutionary advancement in ultrasound imaging, enabling non-invasive evaluation of tissue stiffness - a critical parameter in detecting pathological changes. It is broadly categorized into two main techniques: Compression Elastography (CE) and Shear Wave Elastography (SWE). CE functions by assessing tissue deformation in response to manual or physiological compression, offering qualitative or semi-quantitative insight. In contrast, SWE quantitatively measures the velocity of shear waves induced by focused acoustic radiation, providing objective and reproducible data on tissue elasticity. Both modalities have demonstrated significant clinical value in musculoskeletal imaging, particularly in the assessment of tendon injuries, where stiffness alterations often precede morphological changes. CE, while more accessible and cost-effective, is operator-dependent and subject to variability. SWE, although technologically advanced and more accurate, demands specialized equipment and technical expertise. This article explores the fundamental principles of CE and SWE, compares their diagnostic performance, and discusses their practical applications, advantages, and limitations in the evaluation of tendon pathologies. Understanding these modalities aids in selecting the appropriate technique for clinical scenarios and contributes to enhanced, elasticity-based diagnostic approaches in tendon injury management.

Keywords: Ultrasound Elastography, Tendon Biomechanics, Achilles Tendon Pathology, Shear Wave Velocity, Strain Imaging, Quantitative Stiffness Evaluation, Real-time Tissue Characterization, Chronic Tendinopathy Diagnostics