Evaluation of Gender Differences in Shear-Wave Ultrasound Elastography of the Shoulder Joint in Kwazulu-Natal, South Africa

Abstract

Shear wave data for the rotator cuff and biceps tendons in asymptomatic individuals is limited in KwaZulu-Natal, South Africa.
This study aimed to investigate the gender differences in tendon elasticity of the rotator cuff and biceps tendons using shear wave
ultrasound elastography (SWUE). Rotator cuff and biceps tendons (sagittal and axial planes) of 260 patients (21-45 years), were
evaluated using SWUE. An independent samples t-test was used to investigate whether differences in the tendon elasticity
measurements for males and females exist. Gender based reference ranges for the mean elasticity of each tendon were found by
constructing a 95% confidence interval. Gender differences for tendon elasticity were observed for the sagittal plane of the biceps
tendon (proximal, middle and distal), the axial plane of the biceps tendon (middle) and the sagittal plane of the subscapularis
tendon (middle). The sagittal supraspinatus (distal) and axial supraspinatus (middle) revealed a significant gender difference in
tendon elasticity. A significant gender difference in tendon elastcicity was noted for the teres minor tendon (axial and sagittal).
Only the axial (proximal) region of the Infraspinatus tendon showed a significant gender difference in elasticity. Notably, males
had higher mean elasticity values than the females in all the tendons that demonstrated significant elasticity differences. A noninvasive gender estimate of the elasticity of the rotator cuff and biceps tendons (kPa), is provided which may complement BMode ultrasound in the screening of rotator cuff and biceps tendon pathology.