{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:48:45Z","timestamp":1790092125673,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008270","name":"Lantheus Medical Imaging","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008270","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006775","name":"GE Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006775","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK118964"],"award-info":[{"award-number":["R01DK118964"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005625","name":"RSNA Research and Education Foundation","doi-asserted-by":"publisher","award":["RR1957"],"award-info":[{"award-number":["RR1957"]}],"id":[{"id":"10.13039\/100005625","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005625","name":"RSNA Research and Education Foundation","doi-asserted-by":"publisher","award":["NIH R01 DK118964"],"award-info":[{"award-number":["NIH R01 DK118964"]}],"id":[{"id":"10.13039\/100005625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Chronic exertional compartment syndrome (CECS) is an underdiagnosed condition that affects young athletes. CECS is caused by increased compartmental pressure in the fascial spaces during exercise. CECS is diagnosed by direct pressure readings (in mmHg), which is a painful and invasive test. Noninvasive shear\u2010wave elastography (SWE) and subharmonic\u2010aided pressure estimation (SHAPE) using contrast\u2010enhanced ultrasound were compared to compartment pressure testing for the diagnosis of CECS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ten healthy volunteers and five CECS patients enrolled in this prospective, IRB\u2010approved pilot study. Subjects were scanned pre\u2010 and post\u2010exercise using a modified LOGIQ E10 scanner (GE HealthCare). For SWE, muscle stiffness was expressed as median shear velocity over 12 measurements. Following intravenous infusion of Definity (3\u2009mL in 50\u2009mL of saline; Lantheus Medical Imaging) SHAPE power was optimized, and three 5\u2010second clips were acquired. SWE and SHAPE pre\u2010to\u2010post differences were calculated offline and compared to CECS pressure testing (the reference).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the healthy volunteers, pre\u2010 versus post\u2010exercise SWE showed a median velocity of 1.16\u2009\u00b1\u20090.17 versus 1.28\u2009\u00b1\u20090.22\u2009m\/s (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01). In the CECS patients, the difference was 1.11\u2009\u00b1\u20090.11 versus 1.41\u2009\u00b1\u20090.19\u2009m\/s (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.06). However, there were no SWE differences between healthy volunteers and CECS patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.14). For pre\u2010 and post\u2010exercise SHAPE, both healthy volunteers and CECS patients demonstrated significant differences (\u221262.9\u2009\u00b1\u20092.09 vs \u201358.7\u2009\u00b1\u20092.74\u2009dB and \u221259.0\u2009\u00b1\u20092.96 vs \u221250.8\u2009\u00b1\u20092.22\u2009dB, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.002). Healthy volunteers were statistically significantly different from CECS patients (4.2\u2009\u00b1\u20092.56 vs 8.1\u2009\u00b1\u20092.12\u2009dB;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01). The SHAPE gradient correlated with compartment pressure testing (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.95;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These preliminary results indicate that SHAPE may become a noninvasive alternative for diagnosing CECS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.70030","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T05:58:12Z","timestamp":1755064692000},"page":"95-103","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Noninvasive Diagnosis of Chronic Exertional Compartment Syndrome With Shear Wave Elastography and Subharmonic\u2010Aided Pressure Estimation"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5896-3841","authenticated-orcid":false,"given":"Corinne E.","family":"Wessner","sequence":"first","affiliation":[{"name":"Department of Radiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corbin","family":"Pomeranz","sequence":"additional","affiliation":[{"name":"Department of Radiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Blackman","sequence":"additional","affiliation":[{"name":"Department of Radiology Thomas Jefferson University  Philadelphia Pennsylvania USA"},{"name":"Sidney Kimmel Medical College Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K.","family":"Hoy","sequence":"additional","affiliation":[{"name":"Department of Radiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Bradigan","sequence":"additional","affiliation":[{"name":"Department of Radiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A.","family":"Stache","sequence":"additional","affiliation":[{"name":"Non\u2010Operative Sports Medicine Department Rothman Orthopaedic Institute  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Harwood","sequence":"additional","affiliation":[{"name":"Non\u2010Operative Sports Medicine Department Rothman Orthopaedic Institute  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levon","family":"Nazarian","sequence":"additional","affiliation":[{"name":"Department of Radiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2215-1371","authenticated-orcid":false,"given":"Flemming","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Department of Radiology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/OAJSM.S168368"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-010-9065-4"},{"key":"e_1_2_9_4_1","volume-title":"Campbell's Operative Orthopaedics","author":"Azar 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