Table 1 Are there quantitative imaging biomarkers associated with the presence of neck and shoulder MSDs?
From: Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders
MSD Classification and diagnosis | Author(s) | Major results (case-control comparison) | Conclusion |
|---|---|---|---|
Neck disorders and symptoms | |||
 Neck pain | Dibai Filho (2012) [37] | Skin temperature Skin temperature (L & R trapezius), difference btwn sides (thermal asymmetry), NS. | No |
 Neck pain | Elliott (2008) [46] | Fat index indicating fatty infiltration (relative fat) Fat index: cases < controls, p < 0.001 in all muscles. | Yes ↓ fat index in cases in all neck extensor muscles (see Additional file 7). |
 Neck pain | Falla (2004) [38] | Subcutaneous tissue thickness over SCM, AS SCM subcutaneous tissue thickness (L & R): NS cases vs. controls AS subcutaneous tissue thickness (L & R): NS cases vs. controls | No |
 Neck pain | Fernández-de-las-Peñas (2008) [47] | Multifidus CSA, muscle shape ratio CSA: ANOVA, group (p < 0.001) & cervical level (p < 0.001) effects. No interactions. Cases < controls at C3, C4, C5 (p < 0.001) & at C6 (p < 0.01). Muscle shape ratio: ANOVA, group (p < 0.001) & cervical level (p < 0.001) effects. Significant interactions btwn group & level (p = 0.01). Cases > controls at C3 (p < 0.001) & C6 (p < 0.01). | Yes ↓ multifidus CSA in cases at C3, C4, C5, C6 ↑ muscle shape ratio in cases at C3, C6 |
 Neck pain | Javanshir (2011) [48] | Lco CSA, anterior-posterior dimension (APD), lateral dimension (LD), and shape ratio (LD/APD) Lco CSA: cases < controls, p < 0.001. Lco APD: cases < controls, p < 0.01. Lco LD, shape ratio, NS cases vs. controls. | Yes ↓ Lco CSA in cases ↓ Lco APD in cases |
 Neck pain | Karimi (2016) [53] | Dorsal neck muscle thickness change w. 50% & 100% shoulder MVC in 6 directions Dorsal neck muscle thickness: During MVC: significant interaction of group x muscle, p = 0.008. NS, cases vs. controls group x direction; group x force. | Yes Dorsal neck muscle thickness group x muscle effect |
 Neck pain | Jesus-Moraleida (2011) [49] | Lco thickness, SCM thickness, change of thickness during test/thickness during rest = proportion of muscle recruitment Lco thickness increase throughout all CCFT phases: cases < controls (p < 0.001). SCM thickness increase throughout all CCFT phases: NS, cases vs. controls. Lco recruitment: cases < controls, phase 4 (p = 0.02), phase 5 (p = 0.004), NS other phases. SCM recruitment: NS, cases vs. controls. | Yes ↓ Lco thickness increase throughout all CCFT phases in cases ↓ Lco recruitment, phases 4 & 5 |
 Neck pain | Park (2013) [50] | Mean difference in the bilateral semispinalis capitis muscle thickness Mean difference in the bilateral semispinalis capitis thickness: cases > controls, p < 0.05. Within cases mean difference in the bilateral semispinalis capitis thickness: painful side < asymptomatic side, p < 0.05. | Yes ↑ mean difference in the bilateral semispinalis capitis thickness in cases ↓ mean difference in the bilateral semispinalis capitis thickness in painful side |
 Neck pain | Rahnama (2015) [52] | Multifidus muscle thickness change w. shoulder MVC in 6 directions Multifidus muscle thickness: baseline: NS, cases vs. controls; During MVC: significant interaction of group x force, controls > cases (p = 0.03). NS, cases vs. controls group x direction; 3- & 4-way interactions involving group. | Yes ↓ multifidus muscle thickness increase in cases during isometric MVC |
 Neck pain | Sheard (2012) [51] | Differences in water relaxation values (T2 relaxation) quantified from scans before and after exercise were calculated (T2 shift) as a measure of SA muscle activity T2 shift: significant effect for level (p = .03) and significant group × level interaction (p = .04) but no significant main effect for group (p = .59). Post hoc T2 shift: cases > controls at the T6 level (P = .02) only. | Yes ↑ T2 shift at T6 in cases |
Shoulder disorders and symptoms | |||
 Degenerative rotator cuff lesion | Biberthaler (2003) [54] | Mean functional capillary density, mean capillary diameterMean functional capillary density: lesion < control tissue (p < 0.05). Mean capillary diameter: NS, lesion vs. control tissue (p > 0.05). | Yes ↓ mean functional capillary density in lesion tissue |
 Rotator cuff tear (full thickness) | Chang (2014) [56] | Biceps long tendon (BLT) width, thickness, flattening ratio (width/thickness), cross-sectional area, echogenicity ratio BLT width, echogenicity ratio: NS, cases vs. controls BLT thickness: cases > controls, p < 0.01. BLT flattening ratio: cases < controls, p < 0.01. BLT cross-sectional area: cases > controls, p < 0.01. | Yes ↑ BLT thickness in cases ↓ BLT flattening ratio in cases ↑ BLT cross-sectional area in cases |
 Rotator cuff tear | Choo (2014) [57] | Rotator cable thickness, width Rotator cable thickness: difference among 4 groups (see shoulder tendinosis - Choo), p < 0.001; post-hoc analysis – full-thickness tear > normal, p < 0.001. Rotator cable width: difference among 4 groups (see shoulder tendinosis - Choo), p < 0.001; post-hoc analysis – full-thickness tear > normal, p < 0.001; partial-thickness tear > normala. | Yes ↑ rotator cable thickness in full-thickness tears ↑ rotator cable width in full-thickness tears Perhaps ↑ rotator cable width in partial-thickness tears |
 Rotator cuff tear | Funakoshi (2010) [55] | Vascularity in 4 ROIs: articular & bursal sides of supraspinatus tendon, medial & lateral sides of bursa Non-injected side: cases (RCT) < controls, p < 0.0001, in articular & bursal side of the supraspinatus tendon. Injected side: cases (contralateral to RCT) < controls, p < 0.0001, in articular & bursal side of the supraspinatus tendon. Cases vs. controls, NS, in medial and lateral side of bursa. | Perhaps ↓ vascularity in articular & bursal sides of supraspinatus in non-injected (rotator cuff tear) side in cases, but may be attributed to age. ↓ vascularity in articular & bursal sides of supraspinatus in injected (rotator cuff intact) side in cases, but may be attributed to age. |
 Rotator cuff tear | Hirano (2006) [39] | Full vs. partial rotator cuff tear, rotator cuff tear length, amount of subacrominal-subdeltoid bursal fluid Proportion of full & partial tears, NS. Proportion in categorical size of tears, NS. amount of subacrominal-subdeltoid bursal fluid, NS . | No |
 Rotator cuff tear | Karthikeyan (2015) [58] | Total blood flow in 4 supraspinatus zones, in anteromedial zone, in posteromedial zone Total blood flow in 4 supraspinatus zones: cases (including shoulder impingement – see below) < controls, p = 0.001. Anteromedial supraspinatus zone: full-thickness tears < controls, p = 0.02; partial-thickness tears vs. controls, NS. Posteromedial supraspinatus zone: full-thickness tears < controls, p = 0.04; partial-thickness tears vs. controls, NS. | Yes ↓ supraspinatus blood flow in cases ↓ anteromedial supraspinatus blood flow in full-thickness tears ↓ posteromedial supraspinatus blood flow in full-thickness tears |
 Rotator cuff tear (full-thickness) | Keener (2015) [35] | Baseline rotator cuff tear width; Width enlargement (defined as ≥ 5 mm compared with that at baseline) percentage Baseline rotator cuff tear width: rotator cuff tear with anterior supraspinatus cable disruption > rotator cuff tear with anterior supraspinatus cable intact, p < 0.0001. Width enlargement percentage: NS, rotator cuff tear with anterior supraspinatus cable disruption vs. rotator cuff tear with anterior supraspinatus cable intact . | Yes ↑ baseline rotator cuff tear width with anterior supraspinatus cable disruption. |
 Rotator cuff tear | Mall (2010) [33] | Rotator cuff tear length, tear width, tear area, rate of substantial tear progression (transformation of a partial-thickness tear into a full-thickness tear or a size increase of > 5 mm in either the width or the length of a full thickness tear compared with that at the time of enrollment) Time of enrollment: full-thickness tear width: symptomatic > asymptomatic, p = 0.02; tear length, tear area, NS. Change between visit 1 & visit 2 (see paper for definitions): Shoulder remained asymptomatic: NS, tear length, width, area. Shoulder became symptomatic: tear length: visit 2 > visit 1, p = 0.008. tear width: visit 2 > visit 1, p = 0.01 tear area: visit 2 > visit 1, p = 0.006. Rate of substantial tear progression: symptomatic > asymptomatic, p < 0.01 | Yes ↑ full-thickness tear width at enrollment in those who later became symptomatic in asymptomatic shoulder. ↑ tear length, width, & area at visit 2 vs. at visit 1 in those who became symptomatic in asymptomatic shoulder. ↑ rate substantial tear progression in in those who became symptomatic in asymptomatic shoulder. |
 Rotator cuff tear | Moosmayer (2013) [36] | Rotator cuff tear size in anteroposterior plane, in mediolateral plane, tear size increase in anteroposterior plane, in mediolateral plane. Rotator cuff tear size in anteroposterior plane: baseline: NS, symptomatic vs. asymptomatic; 3-year follow-up: symptomatic > asymptomatic, p = 0.02 Rotator cuff tear size in mediolateral plane: baseline: NS, symptomatic vs. asymptomatic; 3-year follow-up: NS, symptomatic vs. asymptomatic. Tear size increase in anteroposterior plane: NS, symptomatic vs. asymptomatic. Tear size increase in mediolateral plane: NS, symptomatic vs. asymptomatic. | Yes ↑ rotator cuff tear size in anteroposterior plane at follow-up in tears that became symptomatic |
 Rotator cuff tear (partial & full) or rotator cuff disease | Keener (2015) [34] | Rotator cuff tear enlargement (see paper for definition) Tear enlargement in 49%; median time to enlargement = 2.8 yrs. tear enlargement: assoc. w. final tear type, p < 0.05: full vs. control, HR = 4.17; partial vs. control, HR = 2.73; full vs. partial, HR = 1.53 (all p < 0.05, no CI given). New shoulder pain in 46%; median time to pain = 2.6 yrs. shoulder pain assoc. w. final tear type, p < 0.05. Assoc. w. tear enlargement, HR = 1.66, p < 0.05. 63% became painful before or at tear enlargement; 22% became painful later. | Yes ↑ risk tear enlargement in full-tears vs. controls, in partial tears vs controls, in full-tears vs. partial tears. ↑ risk new shoulder pain w. tear enlargement. |
 Rotator cuff tear | Terabayashi (2014) [59] | Difference in blood flow peak systolic velocity (PSV), resistance index (RI) between sides Difference between sides in PSV in BA: NS, in any group. Difference between sides in PSV in AHCA: affected > unaffected side in rotator cuff tear with night pain, p < 0.001. NS, other groups. Difference between sides in RI in BA: NS, in any group. Difference between sides in RI in AHCA: affected < unaffected side in rotator cuff tear with night pain, p < 0.01. | Yes ↑ PSV in AHCA in affected vs unaffected side in rotator cuff tear with night pain. ↓ RI in AHCA in affected vs unaffected side in rotator cuff tear with night pain. |
 Supraspinatus tendinopathy | Arend (2014) [63] | Maximal supraspinatus tendon thickness (MSTT) MSTT: cases > controls, p < 0.05 | Yes ↑ MSTT in cases |
 Rotator cuff tendinitis | Cay (2012) [60] | Subacromial distance, humeral head diameter, Glenoid APD, glenoid articular surface diameter Sagittal subacromial distance: cases < controls, p < 0.001 humeral head diameter, glenoid APD, axial glenoid/humerus, and axial glenoid minus humerus, NS in cases vs controls. coronal diameter of humerus: cases < controls, p = 0.02. coronal glenoid/humerus, coronal glenoid minus humerus: NS in cases vs controls. | Yes ↓ sagittal subacromial distance in cases ↓ coronal diameter of humerus in cases |
 Rotator cuff tendinosis | Choo (2014) [57] | Rotator cable thickness, width Rotator cable thickness: difference among 4 groups (see rotator cuff tear - Choo), p < 0.001; post-hoc analysis – NS, tendinosis vs controls. Rotator cable width: difference among 4 groups (see rotator cuff tear - Choo), p < 0.001; post-hoc analysis – tendinosis > normal, p < 0.05a. | Perhaps ↑ rotator cable width in tendinosis |
 Rotator cuff tendinitis | Rechardt (2010) [61] | Carotid artery intima-media thickness Carotid artery imtima-media thickness: NS, in males and females. | No |
 Shoulder tendinopathy | Joensen (2009) [62] | Supraspinatus tendon thickness Tendon thickness: symptomatic side > asymptomatic side, p < 0.01. | Yes ↑ tendon thickness in symptomatic side |
 Frozen shoulder (Adhesive capsulitis) | Li (2011) [64] | CHL thickness CHL thickness: cases > controls, p < 0.001. | Yes ↑ CHL thickness in cases |
 Frozen shoulder (Adhesive capsulitis) | Michelin (2013) [67] | Joint capsule thickness Joint capsule thickness: cases > controls, p < 0.0001 | Yes ↑ joint capsule thickness in cases |
 Frozen shoulder (Adhesive capsulitis) | Song (2011) [65] | Joint capsule thickness in the axillary recess, enhancing portion of the axillary recess thickness, rotator interval thickness Axillary recess: Joint capsule thickness: cases > controls, p < 0.001. Axillary recess enhancing portion thickness: cases > controls, p < 0.001. Rotator interval Enhancing portion thickness cases > controls, p < 0.001. | Yes ↑ axillary recess joint capsule thickness in cases ↑ Axillary recess enhancing portion thickness in cases ↑ Rotator interval Enhancing portion thickness in cases |
 Frozen shoulder (Adhesive capsulitis | Zhao (2012) [66] | CHL thickness, articular capsule thickness CHL thickness: cases > controls, p < 0.001 . articular capsule thickness: cases > controls, p < 0.05. | Yes ↑ CHL thickness in cases ↑ articular capsule thickness in cases |
 Shoulder impingement syndrome | Daghir (2011) [71] | Subacromial-subdeltoid bursal thickness Greatest thickness in any view: NS cases vs. controls. Thickness in shortaxis supraspinatus view: cases > controls, p = 0.0009. Thickness in long-axis supraspinatus view: NS cases vs. controls.Thickness in long-axis subscapularis view: NS cases vs. controls. | Yes ↑ subacromial-subdeltoid bursal thickness in cases on shortaxis supraspinatus view |
 Shoulder impingement syndrome | Hébert (2003) [68] | AHD Cases vs. contralateral control: Flexion: main effect of group, p < 0.01, and no interaction with position. Post hoc comparisons: cases < controls at 70, 90, 110 & 130 degrees, p < 0.01. Abduction: main effect of group, p < 0.01, no interaction with position. Post hoc comparisons: cases < controls at 80, 90, p < 0.05 and 110 degrees, p < 0.01. Cases vs. contralateral control vs. asymptomatic controls: Flexion - main effect of group, p < 0.0001, (position effect, p < 0.0001) interaction with position, p = 0.01. Post hoc comparisons: cases < asymptomatic controls at 90 & 110 degrees, p < 0.01. NS contralateral control vs asymptomatic controls, all positions. Abduction - main effect of group, p = 0.052. Post hoc comparisons: cases < asymptomatic controls at 90 & 110 degrees, p < 0.01. NS contralateral control vs asymptomatic controls, all positions. | Yes ↓ AHD in cases at 70, 90, 110, 130 degrees flexion vs. contralateral control ↓ AHD in cases at 80, 90, 110 degrees abduction vs. contralateral control ↓ AHD in cases at 90, 110 degrees flexion vs. asymptomatic controls ↓ AHD in cases at in 90, 110 degrees abduction vs. asymptomatic controls |
 Shoulder impingement syndrome | Karthikeyan (2015) [58] | Total blood flow in 4 supraspinatus zones, in anteromedial zone, in posteromedial zone Total blood flow in 4 supraspinatus zones: cases (including rotator cuff tears – see above) < controls, p = 0.001. Anteromedial supraspinatus zone: shoulder impingement < controls, p = 0.01. Posteromedial supraspinatus zone: shoulder impingement < controls, p = 0.03. | Yes ↓ supraspinatus blood flow in cases ↓ anteromedial supraspinatus blood flow in cases ↓ posteromedial supraspinatus blood flow in cases |
 Shoulder impingement syndrome | Leong (2012) [69] | AHD, supraspinatus tendon thickness AHD: NS group effect, p = 0.08 Supraspinatus tendon thickness: group effect, p = 0.002, post-hoc analysis: control volleyball players > controls, p < 0.001; cases > controls: p = 0.02; NS, control volleyball players vs. cases. | Yes ↑ supraspinatus tendon thickness in cases vs non-volleyball player controls |
 Shoulder impingement syndrome | Park (2007) [70] | Difference in mean skin temperature btwn sh sides in 5 ROIs Difference in mean skin temperature btwn sh sides anteromedial ROI: cases > controls, p = 0.004. anterolateral: cases > controls, p = 0.001. posteromedial: cases > controls, p = 0.013. posterolateral: cases > controls, p = 0.030. lateral: cases > controls, p = 0.039. | Yes ↑ difference in mean skin temperature btwn sides in all 5 ROIs in cases |
 Shoulder pain w. rotator cuff disease (multiple diagnoses) | Kalra (2010) [40] | AHD No group effects at rest (p = 0.43) or 45 degrees abduction (p = 0.84). No interaction between group and posture. | No |
 Shoulder pain | O’Sullivan (2012) [41] | Trapezius muscle thickness % change in thickness during contraction vs. rest: NS btwn cases & controls in any of the 4 trapezius regions, at 90 degrees or 120 degrees abduction. Muscle thickness difference between sides at rest or during contractions in cases: NS in any of the 4 trapezius regions, at 0, 90, or 120 degrees abduction. | No |
 Shoulder pain | Rechardt (2010) [61] | Carotid artery intima-media thickness Carotid imtima-media thickness, NS in males and females. For each standard deviation increase in carotid IMT, risk of unilateral or bilateral sh pain, OR = 1.4 (95% CI 1.0–1.9) for males 60 + . | Perhaps ↑ carotid artery intima-media thickness increases odds of shoulder pain in males 60+ |
 Shoulder pain (internal impingement pain) | Tuite (2007) [72] | Labral length, thick-capsule labrum length, posterior recess angle Labral length: cases > controls, p = 0.001. Thick-capsule labrum length: cases > controls, p < 0.001. Posterior recess angle: cases > controls, p = 0.002. MR arthrogram: greater (dichotomized) glenohumeral internal rotation deficit (GIRD): labral length, thick-capsule labrum length, posterior recess angle, NS. | Yes ↑ labral length in cases ↑ thick capsule labral length in cases ↑ posterior recess angle in cases |
Neck/shoulder disorders and symptoms | |||
 Neck/shoulder pain | Hallman (2011) [80] | Muscle blood flow (MBF) During HGT: MBF cases < controls (p = 0.02 - ipsi; p = 0.04 - contra). After HGT: MBF cases < controls (p = 0.001 - ipsi; p = 0.003 - contra). During CPT: increase in MBF cases < controls (p = 0.04 - ipsi); NS, contra. After CPT: increase in MBF cases < controls (p < 0.05 - ipsi); NS, contra. | Yes ↓ MBF in cases during & after HGT in ipsi- and contralateral sides. ↓ increase in MBF during and after CPT in ipsilateral side. |
 Neck/shoulder pain | Nilsen (2007) [42] | Finger blood flow Finger blood flow: baseline, NS. Response to stressful task: group x time (baseline, 0–10 min, 50–60 min) interaction, p = 0.02. Post-hoc comparison: controls vs. cases: p = 0.35. | No |
 Neck/shoulder pain | Shiro (2012) [81] | ΔOHb, ΔHHb, ΔTHb from baseline ΔO2Hb: cases < controls during Relax 3 (p < 0.01) & recovery (p < 0.05). ΔHHb: NS, cases vs. controls. ΔTHb: cases < controls during Relax 2 & Relax 3 in R trapezius (p < 0.05); cases < controls: each Relax & recovery in L trapezius (all p < 0.05, except Relax 2 & Relax 3, p < 0.001). | Yes ↓ ΔO2Hb in cases during Relax 3 & recovery. ↓ ΔTHb in cases during Relax 2 & Relax 3 in R trapezius; during each Relax & recovery in L trapezius |
 Neck/shoulder pain | Strøm (2009) [43] | Muscle blood flow At start of work task: cases vs controls, NS difference in blood flow increase in either active or contralateral trapezius. Blood flow during 15 min of recovery in active & contralateral trapezius: cases > controls (p = 0.05). | No |
 Neck/shoulder pain | Takiguchi (2010) [79] | Minimal & maximal standardized uptake values (SUV) of [18F]fluorodeoxyglucose (18F–FDG) Trapezius: mean SUVmax, mean SUVmin: cases < controls, p < 0.0001. Presence/absence of neck/shoulder pain and mean SUVmax (R2 = 0.16, p < 0.0001), and for SUVmin(R2 = 0.26, p < 0.0001), after adjusting for age, gender, smoking status, and diabetes. Gluteus maximus: mean SUVmax, mean SUVmin: NS, cases vs. controls mean. Presence/absence of neck/shoulder pain and mean SUVmax or SUVmin, NS. | Yes |
 Cervicobrachial pain syndrome | Larsson (1998) [114] | Muscle blood flow Unilateral pain patients: muscle blood flow: painful < asymptomatic side, p = 0.01; painful < control, p = 0.0009. | Yes ↓ blood flow in painful side in unilateral cases ↓ blood flow in cases |
 Trapezius myalgia | Acero (1999) [74] | Relative blood volume ANOVA - main effect for group, case < control, during 61–120 s of cold pressor stimulation, p = 0.04. All other time points group NS. | Yes ↓ relative blood volume in cases during 61–120 s of cold pressor stimulation. |
 Trapezius myalgia | Andersen (2010) [44] | ΔOHb, ΔHHb, ΔTHb from baseline ANOVA - main effect of time for all 3ΔxHb (p < 0.0001), group x time interaction for OHb (p < 0.05). Group effect NS for HHb & THb. Group effect p-value for OHb not stated. OHb after exercise increase from baseline: cases < controls, p = 0.05. | No |
 Trapezius myalgia | Cagnie (2012) [75] | Oxygen saturation, muscle blood flow Oxygen saturation: MANOVA - main effects of time, muscle part, and interaction muscle part x group (p = 0.049). Post hoc cases < controls in L & R middle trapezius at all time points p = 0.03, except 40 min for R middle trapezius (NS). Blood flow: MANOVA - main effects of time, muscle part, and no interaction muscle part x group. No group effect. | Yes ↓ oxygen saturation in L & R trapezius at all but 1 time point. |
 Trapezius myalgia | Flodgren (2010) [76] | Muscle oxygenation Muscle oxygenation percentage decreased during work (P = 0.02), and returned to baseline during recovery. | Perhaps No control subjects were included in this study. Authors conclude normal response in these cases when comparing them to a previous similar study with normal subjects (see Flodgren (2005)). |
 Trapezius myalgia | Peolsson (2008) [45] | Strain rate, strain rate RMS - before provocation, after provocation, difference after - before NS cases vs. controls: strain rate, strain rate RMS - before provocation, after provocation, difference after - before. After factor analysis with strain rate and strain variables (not velocity variables), followed by clustering, distribution of cases and controls differed, p = 0.05. Examination of factors indicated that post-provocation -- most cases have lower levels of strain rate & strain after pain provocation compared with most controls. | No |
 Trapezius myalgia | Sjøgaard (2010) [77] | ΔOHb, ΔHHb, ΔTHb from baseline Cases: OHb 35 min after start of peg board task < baseline, p < 0.05. Controls: OHb not different from baseline. Other OHb, HHb, and THb similar results for cases and controls. | Yes ↓ OHb (vs. baseline) 35 min after start of peg board task in cases, but no change in controls. |