Clin Pain.  2024 Dec;23(2):99-104. 10.35827/cp.2024.23.2.99.

Ultrasonography in Muscular Diseases

• Park J

• KMID: 2563777
• DOI: http://doi.org/10.35827/cp.2024.23.2.99

Abstract

Ultrasonography is a valuable diagnostic tool in muscle diseases, offering real-time, non-invasive, and cost-effective evaluation. Techniques such as gray-scale analysis and cross-sectional area measurements provide objective and quantifiable data, enabling the monitoring of disease progression and response to treatment. Pathological muscles often exhibit histological changes like fatty degeneration and fibrosis, leading to increased echogenicity and characteristic ultrasound findings. Inflammatory myopathies display increased muscle thickness and echogenicity during the acute phase due to edema, while chronic stages show atrophy and infiltration of fat and fibrous tissue. In inclusion body myositis, increased echogenicity is frequently observed in the flexor digitorum communis, vastus medialis, and medial gastrocnemius muscles, along with a diaphragm thickening fraction that correlates with muscle strength and disease duration. Muscular dystrophies, such as Duchenne muscular dystrophy, reveal homogeneous hyperechogenicity and pseudohypertrophy, whereas fascioscapulohumeral dystrophy demonstrates multifocal heterogeneous patterns. Myotonic dystrophy is associated with reduced muscle thickness and increased echogenicity, with novel ultrasound techniques quantifying delayed muscle relaxation. While ultrasound has limitations in differentiating specific diseases, its ability to reflect histopathological changes and monitor disease dynamics makes it indispensable. Advancements in imaging technology and standardization of protocols are expected to further enhance its diagnostic accuracy and clinical utility.

Keyword

Ultrasonography; Muscular diseases; Muscles; Diagnosis; Pathology