Savant Journals 2052-1480 *Corresponding Author: Ilker Ilhanlı, Asst. Prof., Department of Physical Medicine and Rehabilitation, School of Medicine, Giresun University, 28200, Giresun, Turkey, Tel: +90 454 310 16 90, Fax: +90 454 310 16 99, E-mail: ilkerilhanli@hotmail.com Savant Journal of Medicine and Medical Sciences Vol 1(3) pp. 030-034 August, 2015. http://www.savantjournals.org/sjmms Copyright © 2015 Savant Journals Original Research Paper Predictivity of Elastography for Supraspinatus Tears Ilker Ilhanli 1 *, Alptekin Tosun 2 , Necip Guder 3 and Murat Gul 4 1 MD., Department of Physical Medicine and Rehabilitation, School of Medicine, Giresun University, Giresun, Turkey. 2 MD., Department of Radiology, School of Medicine, Giresun University, Giresun, Turkey. 3 MD., Physical Medicine and Rehabilitation State Hospital, Giresun, Turkey 4 MS., Department of Statistics, Faculty of Science, Giresun University, Giresun, Turkey. Accepted 20 th July, 2015. Purpose: We tried to assess the predictive power of hardness in elastography for supraspinatus tears. Materials and Methods: Thirty patients who were admitted to our clinic with one-sided shoulder pain were included in our study. PatieŶts’ healthy shoulders were adŵitted as coŶtr ol. Both healthy and affected shoulders were evaluated with ultrasonography and elastography. All data, including age, gender, dominant hand, affected side, results of provocation tests, and degrees of range of motion were recorded. Supraspinatus lesions were classified by ultrasonography. Also, the thickness of supraspinatus was calculated. Through elastography, the hardness ratio of the tendon to the body of supraspinatus (RTB), the hardness ratio of the hardest tissue to the softest tissue of supraspinatus (RHS), and the hardness ratio of the biceps tendon to the supraspinatus (RBS) were calculated. Results: There was no significant difference between females and males except age. No correlation was found between the affected side and hand dominancy. Between affected and healthy shoulders, a significant difference was found for elasticity values. There was a positive, but insignificant correlation between age and partial tears. When we evaluated the correlations of partial tears, significant and negative correlation was found for the tendinosis, RTB, and RBS. In contrast to this finding, there was significant and positive correlation between both the partial tears and RHS. Conclusions: Hardness in the elastography seems to be predictive of partial tearing of the supraspinatus. Patients with increased hardness of supraspinatus might experience more partial tearing. Keywords: Elastography, Musculoskeletal, Supraspinatus, Tendon, Muscle. Abbreviations RTB: the hardness ratio of the tendon to the body of supraspinatus RHS: the hardness ratio of the hardest tissue to the softest tissue of supraspinatus RBS: the hardness ratio of the biceps tendon to the supraspinatus INTRODUCTION Elastography is an ultrasound-based imaging technique which was first used by Krouskop et al. in 1987 and has recently been applied to the evaluation of multiple organs and tissues such as the breasts, liver, prostate, thyroid, cervix, lymph nodes, and muscles (Krouskop et al, 1987). There are several types of sonoelastographic techniques, including the compression technique (Ophir et al, 1991), vibration sonoelastography (Lerner et al, 1988), real-time shear velocity (Hoyt et al, 2007), and acoustic radiation force generated by the ultrasound pulse (Bercoff et al, 2004). For this study, we used the compression technique, which is based on assessing the different behaviors of different tissues through the compression and evaluation of tissue hardness. Deformation occurs more in soft tissue than in hard tissue and can be seen in a colour spectrum (Fig.1): blue representing hard areas, red representing soft areas, and green representing areas with intermediate hardness. This objective information is obtained by the comparison of the hardness of the tissue before and after compression (Cho et al, 2008, Ginat et al, 2009). Through manual compression, this conventional technique calculates the estimated tissue hardness-elasticity ratio, but not in kilopascals (Frey, 2003, Itoh et al, 2006). Muscle