Assessment of Muscular Stiffness in Children with Duchenne Muscular Dystrophy using Real-Time Elastography

Background:Imaging modalities, such as ultrasonography (USG), can be used to evaluate and monitor the musculoskeletal system during the clinical progression of Duchenne muscular dystrophy (DMD). Aim:This study aimed to measure passive muscle stiffness in children with Duchenne muscular dystrophy and to compare these measurements with those of healthy children. Methods:Patients with DMD were evaluated clinically (age, clinical functional score, timed Gover score), serum creatine kinase level, B-mode ultrasonography, and real-time tissue elastography imaging. Results:A total of 64 boys were included in this study. The medial and lateral gastrocnemius muscle strain ratio in patients with DMD was significantly bigger than that in the control group (medial; 1.66 +/- 1.23 vs 0.81 +/- 0.16, P < 0.001, lateral; 1.49 +/- 0.52 vs 0.85 +/- 0.16, P < 0.001). Conclusion:The strain ratios of the medial and lateral gastrocnemius muscles were greater in patients with Duchenne muscular dystrophy than in the controls, indicating that ultrasound elastography may be beneficial for diagnosis and follow-up.