Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders

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Abstract

Background

This study systematically summarizes quantitative imaging biomarker research in non-traumatic neck and shoulder musculoskeletal disorders (MSDs). There were two research questions: 1) Are there quantitative imaging biomarkers associated with the presence of neck and shoulder MSDs?, 2) Are there quantitative imaging biomarkers associated with the severity of neck and shoulder MSDs?

Methods

PubMed and SCOPUS were used for the literature search. One hundred and twenty-five studies met primary inclusion criteria. Data were extracted from 49 sufficient quality studies.

Results

Most of the 125 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. Only half controlled for potential confounders via exclusion or in the analysis. Approximately one-third reported response rates. In sufficient quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied. The literature synthesis suggested that neck muscle size may be decreased in neck pain, and trapezius myalgia and neck/shoulder pain may be associated with reduced vascularity in the trapezius and reduced trapezius oxygen saturation at rest and in response to upper extremity tasks. Reduced vascularity in the supraspinatus tendon may also be a feature in rotator cuff tears. Five of eight studies showed an association between a quantitative imaging marker and MSD severity.

Conclusions

Although research on quantitative imaging biomarkers is still in a nascent stage, some MSD biomarkers were identified. There are limitations in the articles examined, including possible selection bias and inattention to potentially confounding factors. Recommendations for future studies are provided.

Electronic supplementary material

The online version of this article (doi:10.1186/s12891-017-1694-y) contains supplementary material, which is available to authorized users.

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Most cited references 143

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A standardized method for the assessment of shoulder function.

R R Richards, K. An, L U Bigliani … (1994)

The American Shoulder and Elbow Surgeons have adopted a standardized form for assessment of the shoulder. The form has a patient self-evaluation section and a physician assessment section. The patient self-evaluation section of the form contains visual analog scales for pain and instability and an activities of daily living questionnaire. The activities of daily living questionnaire is marked on a four-point ordinal scale that can be converted to a cumulative activities of daily living index. The patient can complete the self-evaluation portion of the questionnaire in the absence of a physician. The physician assessment section includes an area to collect demographic information and assesses range of motion, specific physical signs, strength, and stability. A shoulder score can be derived from the visual analogue scale score for pain (50%) and the cumulative activities of daily living score (50%). It is hoped that adoption of this instrument to measure shoulder function will facilitate communication between investigators, stimulate multicenter studies, and encourage validity testing of this and other available instruments to measure shoulder function and outcome. Copyright © 1994 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

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The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity.

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Articles describing motor function in five chronic musculoskeletal pain conditions (temporomandibular disorders, muscle tension headache, fibromyalgia, chronic lower back pain, and postexercise muscle soreness) were reviewed. It was concluded that the data do not support the commonly held view that the pain of these conditions is maintained by some form of tonic muscular hyperactivity. Instead, it seems clear that in these conditions the activity of agonist muscles is often reduced by pain, even when this does not arise from the muscle itself. On the other hand, pain causes small increases in the level of activity of the antagonist. As a consequence of these changes, force production and the range and velocity of movement of the affected body part are often reduced. To explain how such changes in the behaviour come about, we propose a neurophysiological model based on the phasic modulation of excitatory and inhibitory interneurons supplied by high-threshold sensory afferents. We suggest that the "dysfunction" that is characteristic of several types of chronic musculoskeletal pain is a normal protective adaptation and is not a cause of pain.

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Quantitative imaging biomarkers: a review of statistical methods for technical performance assessment.

David L Raunig, Lisa McShane, Gene Pennello … (2015)

Technological developments and greater rigor in the quantitative measurement of biological features in medical images have given rise to an increased interest in using quantitative imaging biomarkers to measure changes in these features. Critical to the performance of a quantitative imaging biomarker in preclinical or clinical settings are three primary metrology areas of interest: measurement linearity and bias, repeatability, and the ability to consistently reproduce equivalent results when conditions change, as would be expected in any clinical trial. Unfortunately, performance studies to date differ greatly in designs, analysis method, and metrics used to assess a quantitative imaging biomarker for clinical use. It is therefore difficult or not possible to integrate results from different studies or to use reported results to design studies. The Radiological Society of North America and the Quantitative Imaging Biomarker Alliance with technical, radiological, and statistical experts developed a set of technical performance analysis methods, metrics, and study designs that provide terminology, metrics, and methods consistent with widely accepted metrological standards. This document provides a consistent framework for the conduct and evaluation of quantitative imaging biomarker performance studies so that results from multiple studies can be compared, contrasted, or combined.

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Author and article information

Contributors

Judith E. Gold: JudithEGold@gmail.com

David M. Hallman: David.Hallman@hig.se

Fredrik Hellström: Fredrik.Hellstrom@hig.se

Martin Björklund: Martin.Bjorklund@hig.se

Albert G. Crenshaw: Albert.Crenshaw@hig.se

Svend Erik Mathiassen: Svenderik.Mathiassen@hig.se

Mary F. Barbe: mBarbe@temple.edu

Sayed Ali: Sayed.Ali@tuhs.temple.edu

Journal

Journal ID (nlm-ta): BMC Musculoskelet Disord

Journal ID (iso-abbrev): BMC Musculoskelet Disord

Title: BMC Musculoskeletal Disorders

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2474

Publication date (Electronic): 12 September 2017

Publication date PMC-release: 12 September 2017

Publication date Collection: 2017

Volume: 18

Electronic Location Identifier: 395

Affiliations

[1 ]ISNI 0000 0001 1017 0589, GRID grid.69292.36, Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, , University of Gävle, ; Gävle, Sweden

[2 ]ISNI 0000 0001 1034 3451, GRID grid.12650.30, Department of Community Medicine and Rehabilitation, Physiotherapy, , Umeå University, ; Umeå, Sweden

[3 ]ISNI 0000 0001 2248 3398, GRID grid.264727.2, Department of Anatomy and Cell Biology, , Temple University Medical School, ; Philadelphia, PA USA

[4 ]ISNI 0000 0001 2248 3398, GRID grid.264727.2, Department of Radiology, , Temple University Medical School, ; Philadelphia, PA USA

[5 ]Gold Standard Research Consulting, 830 Montgomery Ave, Bryn Mawr, PA USA

Article

Publisher ID: 1694

DOI: 10.1186/s12891-017-1694-y

PMC ID: 5596923

PubMed ID: 28899384

SO-VID: b078666d-5167-4073-8c50-2f9f8a4f608f

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 12 January 2017

Date accepted : 24 July 2017

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100006636, Forskningsrådet om Hälsa, Arbetsliv och Välfärd;

Award ID: 2009–1761

Funded by: FundRef http://dx.doi.org/10.13039/100000069, National Institute of Arthritis and Musculoskeletal and Skin Diseases;

Award ID: AR056019

Award Recipient : Mary F. Barbe

Custom metadata

ScienceOpen disciplines: Orthopedics

Keywords: mri,msd,near-infrared spectroscopy,pain,ultrasound

Data availability:

ScienceOpen disciplines: Orthopedics

Keywords: mri, msd, near-infrared spectroscopy, pain, ultrasound

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Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders

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Abstract

Background

Methods

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Conclusions

Electronic supplementary material

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Orthopedics

Most cited references 143

A standardized method for the assessment of shoulder function.

The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity.

Quantitative imaging biomarkers: a review of statistical methods for technical performance assessment.

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Cited by 7

Most referenced authors 1,535