Assessing Low Skeletal Mass in Patients Undergoing Hip Surgery: The Role of Sonoelastography

PURPOSE: To analyze the utility of sonoelastography—a radiation-free procedure to characterize muscle properties—as an instrument to qualitatively and quantitatively assess the rectus femoris muscle. MATERIALS AND METHODS: Fifty-one consecutive patients who underwent a pelvic computed tomography (CT) exam were enrolled prospectively. The final analysis was conducted using data from 39 patients after 12 were removed due to exclusion criteria (muscle strength could not be measured due to poor cognition [n=11]; too young [n=1]). The potential correlation between average Hounsfield unit (HFU) at the rectus femoris muscle (measured by CT) and muscle quality grade (determined by sonoelastography) was assessed along with a retrospective analysis of the relationship between hand grip strength, knee extensor power, history of intensive care unit stay, length of hospital day and sonoelastographic grade. RESULTS: There was a significant correlation between sonoelastographic grade and the average HFU (P<0.001). Furthermore, hand grip strength (P<0.001) and knee extensor power (P<0.001) decreased significantly as the sonoelastographic grade increased. The likelihood of an intensive care unit stay and prevalence of low skeletal mass increased significantly with an increase in sonoelastography grade (P=0.037, P<0.001, respectively). The sensitivity, specificity, and accuracy of sonoelastographic images for predicting low skeletal mass were 77.3%, 100%, and 87.5%, respectively. CONCLUSION: Sonoelastography advantages, including the lack of radiation and greater accessibility, may make it a valuable alternative to qualitatively and quantitatively identify sarcopenia and low skeletal mass.