search
Back to results

Evaluation of Lower Extremity Athletic Injuries and Response to Treatment Using SWE and MFI

Primary Purpose

Lower Extremity Musculoskeletal Injury

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Shear wave elastography and microvascular flow imaging.
Sponsored by
Oregon Health and Science University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Lower Extremity Musculoskeletal Injury focused on measuring Ultrasound, Shear wave elastography, Microvascular flow imaging

Eligibility Criteria

18 Years - 89 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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.

Sites / Locations

  • University of OregonRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Musculoskeletal injury

Arm Description

Shear wave elastography and microvascular flow imaging.

Outcomes

Primary Outcome Measures

kPa
Tissue stiffness measured by shear wave elastography
kPa
Tissue stiffness measured by shear wave elastography
kPa
Tissue stiffness measured by shear wave elastography
kPa
Tissue stiffness measured by shear wave elastography
kPa
Tissue stiffness measured by shear wave elastography
Presence of blood flow
Measured by microvascular flow imaging
Presence of blood flow
Measured by microvascular flow imaging
Presence of blood flow
Measured by microvascular flow imaging
Presence of blood flow
Measured by microvascular flow imaging
Presence of blood flow
Measured by microvascular flow imaging

Secondary Outcome Measures

Full Information

First Posted
October 20, 2022
Last Updated
October 16, 2023
Sponsor
Oregon Health and Science University
Collaborators
University of Oregon
search

1. Study Identification

Unique Protocol Identification Number
NCT05608824
Brief Title
Evaluation of Lower Extremity Athletic Injuries and Response to Treatment Using SWE and MFI
Official Title
Evaluation of Lower Extremity Athletic Injuries and Response to Treatment Using Shear Wave Elastography and Micro-vascular Flow Imaging
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 1, 2023 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Oregon Health and Science University
Collaborators
University of Oregon

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lower Extremity Musculoskeletal Injury
Keywords
Ultrasound, Shear wave elastography, Microvascular flow imaging

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Masking Description
All SWE and MFI images are evaluated for quality and analyzed by qualified study physicians that are blinded to the clinical data. The analysis includes but is not limited to reading images, identifying the regions of interest, and making measurements. Clinical data will then be reviewed to validate the clinical diagnosis.
Allocation
N/A
Enrollment
80 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Musculoskeletal injury
Arm Type
Experimental
Arm Description
Shear wave elastography and microvascular flow imaging.
Intervention Type
Device
Intervention Name(s)
Shear wave elastography and microvascular flow imaging.
Intervention Description
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.
Primary Outcome Measure Information:
Title
kPa
Description
Tissue stiffness measured by shear wave elastography
Time Frame
Within 48 hours
Title
kPa
Description
Tissue stiffness measured by shear wave elastography
Time Frame
5 days post injury (+/- 2 days)
Title
kPa
Description
Tissue stiffness measured by shear wave elastography
Time Frame
6 weeks post injury (+/- 1 week)
Title
kPa
Description
Tissue stiffness measured by shear wave elastography
Time Frame
12 weeks post injury (+/- 1 week)
Title
kPa
Description
Tissue stiffness measured by shear wave elastography
Time Frame
24 weeks post injury (+/- 1 week)
Title
Presence of blood flow
Description
Measured by microvascular flow imaging
Time Frame
Within 48 hours
Title
Presence of blood flow
Description
Measured by microvascular flow imaging
Time Frame
5 days post injury (+/- 2 days)
Title
Presence of blood flow
Description
Measured by microvascular flow imaging
Time Frame
6 weeks post injury (+/- 1 week)
Title
Presence of blood flow
Description
Measured by microvascular flow imaging
Time Frame
12 weeks post injury (+/- 1 week)
Title
Presence of blood flow
Description
Measured by microvascular flow imaging
Time Frame
24 weeks post injury (+/- 1 week)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
89 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
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.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Natalie Pettigrew, DPT
Phone
858-342-4191
Email
terwilln@ohsu.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Jody Oyama, DrPH
Phone
808-781-4609
Email
oyamajo@ohsu.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kenton Gregory, MD
Organizational Affiliation
Oregon Health and Science University
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Oregon
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97403
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zak Kindl, M.S.
Phone
541-346-4114
Email
zkindl@uoregon.edu
First Name & Middle Initial & Last Name & Degree
Mike Hahn, PhD

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
20370999
Citation
Belmont PJ, Schoenfeld AJ, Goodman G. Epidemiology of combat wounds in Operation Iraqi Freedom and Operation Enduring Freedom: orthopaedic burden of disease. J Surg Orthop Adv. 2010 Spring;19(1):2-7.
Results Reference
background
PubMed Identifier
18376168
Citation
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.
Results Reference
background
PubMed Identifier
23937740
Citation
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.
Results Reference
background
PubMed Identifier
18376159
Citation
Ritenour AE, Dorlac WC, Fang R, Woods T, Jenkins DH, Flaherty SF, Wade CE, Holcomb JB. Complications after fasciotomy revision and delayed compartment release in combat patients. J Trauma. 2008 Feb;64(2 Suppl):S153-61; discussion S161-2. doi: 10.1097/TA.0b013e3181607750.
Results Reference
background
PubMed Identifier
20485126
Citation
Ritenour AE, Blackbourne LH, Kelly JF, McLaughlin DF, Pearse LA, Holcomb JB, Wade CE. Incidence of primary blast injury in US military overseas contingency operations: a retrospective study. Ann Surg. 2010 Jun;251(6):1140-4. doi: 10.1097/SLA.0b013e3181e01270.
Results Reference
background
PubMed Identifier
19804853
Citation
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.
Results Reference
background
PubMed Identifier
25543232
Citation
Shadgan B, Pereira G, Menon M, Jafari S, Darlene Reid W, O'Brien PJ. Risk factors for acute compartment syndrome of the leg associated with tibial diaphyseal fractures in adults. J Orthop Traumatol. 2015 Sep;16(3):185-92. doi: 10.1007/s10195-014-0330-y. Epub 2014 Dec 28.
Results Reference
background
PubMed Identifier
21321506
Citation
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.
Results Reference
background
PubMed Identifier
31468110
Citation
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.
Results Reference
background
PubMed Identifier
25792582
Citation
Brandenburg JE, Eby SF, Song P, Zhao H, Landry BW, Kingsley-Berg S, Bamlet WR, Chen S, Sieck GC, An KN. Feasibility and reliability of quantifying passive muscle stiffness in young children by using shear wave ultrasound elastography. J Ultrasound Med. 2015 Apr;34(4):663-70. doi: 10.7863/ultra.34.4.663.
Results Reference
background
PubMed Identifier
22370174
Citation
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.
Results Reference
background
PubMed Identifier
11508987
Citation
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.
Results Reference
background
PubMed Identifier
9361149
Citation
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.
Results Reference
background
PubMed Identifier
18238506
Citation
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.
Results Reference
background
PubMed Identifier
10385964
Citation
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.
Results Reference
background
PubMed Identifier
15139541
Citation
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. Erratum In: IEEE Trans Ultrason Ferroelectr Freq Control. 2020 Jul;67(7):1492-1494.
Results Reference
background
PubMed Identifier
2194336
Citation
Parker KJ, Huang SR, Musulin RA, Lerner RM. Tissue response to mechanical vibrations for "sonoelasticity imaging". Ultrasound Med Biol. 1990;16(3):241-6. doi: 10.1016/0301-5629(90)90003-u.
Results Reference
background
PubMed Identifier
7569924
Citation
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.
Results Reference
background
PubMed Identifier
22308105
Citation
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.
Results Reference
background
PubMed Identifier
25064780
Citation
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.
Results Reference
background
PubMed Identifier
29224123
Citation
Creze M, Nordez A, Soubeyrand M, Rocher L, Maitre X, Bellin MF. Shear wave sonoelastography of skeletal muscle: basic principles, biomechanical concepts, clinical applications, and future perspectives. Skeletal Radiol. 2018 Apr;47(4):457-471. doi: 10.1007/s00256-017-2843-y. Epub 2017 Dec 9.
Results Reference
background
PubMed Identifier
28273102
Citation
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.
Results Reference
background
PubMed Identifier
30563763
Citation
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.
Results Reference
background
PubMed Identifier
29756164
Citation
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.
Results Reference
background
PubMed Identifier
13950177
Citation
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.
Results Reference
background
PubMed Identifier
4938749
Citation
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.
Results Reference
background
PubMed Identifier
14814827
Citation
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.
Results Reference
background
PubMed Identifier
31161755
Citation
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.
Results Reference
background
PubMed Identifier
30074839
Citation
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.
Results Reference
background
PubMed Identifier
20349819
Citation
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.
Results Reference
background
PubMed Identifier
10201543
Citation
Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999 Apr;79(4):371-83.
Results Reference
background

Learn more about this trial

Evaluation of Lower Extremity Athletic Injuries and Response to Treatment Using SWE and MFI

We'll reach out to this number within 24 hrs