{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:02:38Z","timestamp":1783522958245,"version":"3.55.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5-6","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000005","name":"Department of Defense","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Peer Reviewed Orthopaedic Research Program"},{"name":"Clinical Translational Research","award":["#OR200188"],"award-info":[{"award-number":["#OR200188"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Measurement of muscle compartment pressure can be important in clinical scenarios such as diagnosing acute compartment syndrome; the gold standard is invasive and costly pressure-transducer measurement. Past studies have shown the promise of ultrasound (US) as a diagnostic adjunct by measuring the elastic modulus of the muscle while it is being compressed by a US probe (compression sonography). However, the reliability of compression sonography in multiple muscle locations has not been previously examined. This study aimed to test the reliability and validity of compression sonography in elastic modulus estimation (EME) in multiple muscle locations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A phantom model was used to map EME measurement to expected pressure measurement in physiologic and injury states. Ten healthy subjects were evaluated by two investigators using a standard ultrasound probe encased in a multi-sensor shell among the following extremity locations: forearm, arm, lower leg, and thigh. Each extremity location was scanned twice in both relaxed and flexed states of muscle contraction, the latter simulating elevated compartment pressure, for each investigator. Elastic modulus estimation was calculated using force, measured by a load cell, and tissue displacement generated by the US probe, measured by specifically designed software. Institutional institutional review board approval was obtained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using the phantom model, a mean EME above 170.0 kPa was equivalent to pressure states above 20 mmHg. In healthy human volunteers, flexed states reliably produced higher mean EME values (range: 103.0-200.0, SE [5.7-10.5]) than relaxed states (range: 49.8-123.0, SE [3.2-5.9]) for each extremity location across all ten subjects. The EME difference between flexed and relaxed states was statistically significant for each extremity location (P\u2009&amp;lt;\u2009.001). There was a proportional increase in the EME difference between states as tension increased in the forearm, which was statistically significant (P\u2009&amp;lt;\u2009.001, P\u2009&amp;lt;\u2009.001). Investigators had good agreement for both relaxed (ICC\u2009=\u20090.67, 95% CI [0.49-0.80]) and flexed states (ICC\u2009=\u20090.63, 95% CI [0.43-0.77]) across subjects and extremity locations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elastic modulus estimation using compression sonography was shown to have good inter- and intra-rater reliability in multiple muscle sites. The human volunteer model reliably produced higher EME values among flexed states versus relaxed, with the flexed states EME mapping to pressure states seen in acute compartment syndrome. This study demonstrates the potential utility of a low-cost ultrasound-based device to aid in detecting elevated muscle compartment pressures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf485","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T12:32:56Z","timestamp":1758112376000},"page":"e1001-e1005","source":"Crossref","is-referenced-by-count":1,"title":["Validation of Ultrasound-Based Muscle Elastic Modulus Estimation in a Healthy Human Volunteer Model"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7458-6775","authenticated-orcid":false,"given":"Zodina A","family":"Beiene","sequence":"first","affiliation":[{"name":"Orthopaedic Trauma Institute , San Francisco, CA 94110,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J M","family":"Rohde","sequence":"additional","affiliation":[{"name":"Orthopaedic Trauma Institute , San Francisco, CA 94110,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meir T","family":"Marmor","sequence":"additional","affiliation":[{"name":"Orthopaedic Trauma Institute , San Francisco, CA 94110,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"2026050517474913400_usaf485-B1","doi-asserted-by":"publisher","first-page":"S59","DOI":"10.1097\/TA.0000000000002284","article-title":"Noninvasive diagnostics for extremity compartment syndrome following traumatic injury: a state-of-the-art review","volume":"87","author":"Walters","year":"2019","journal-title":"J Trauma Acute Care Surg"},{"key":"2026050517474913400_usaf485-B2","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1177\/000313480707301201","article-title":"Diagnosis and mangement of extremity compartment syndromes: an orthopaedic perspective","volume":"73","author":"Konstantakos","year":"2007","journal-title":"Am Surg"},{"key":"2026050517474913400_usaf485-B3","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1016\/j.apmr.2014.07.007","article-title":"Ultrasound elastrography: the new frontier in direct measurement of muscle stiffness","volume":"95","author":"Brandenburg","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"key":"2026050517474913400_usaf485-B4","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.injury.2019.11.027","article-title":"Non-invasive measurement of muscle compartment elasticity in lower limbs to determine acute compartment syndrome: clinical results with pressure related ultrasound","volume":"51","author":"Sellei","year":"2020","journal-title":"Injury"},{"key":"2026050517474913400_usaf485-B5","doi-asserted-by":"publisher","first-page":"2166","DOI":"10.1016\/j.injury.2021.02.054","article-title":"A dual-sensor ultrasound based method for detecting elevated muscle compartment pressures: a prospective clinical pilot study","volume":"52","author":"Marmor","year":"2021","journal-title":"Injury"},{"key":"2026050517474913400_usaf485-B6","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1080\/00913847.2024.2340421","article-title":"Ultrasound guided compressibility of the lower leg anterior tibial muscle compartment: a feasibility study","volume":"52","author":"van Heeswijk","year":"2024","journal-title":"Phys Sportsmed"},{"key":"2026050517474913400_usaf485-B7","doi-asserted-by":"publisher","first-page":"265","DOI":"10.26603\/001c.128284","article-title":"Reliability of ultrasound based compressibility of the lower leg anterior tibial muscle compartment in healthy volunteers","volume":"20","author":"van Heeswijk","year":"2025","journal-title":"Int J Sports Phys Ther"},{"key":"2026050517474913400_usaf485-B8","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1089\/ten.TEB.2010.0520","article-title":"Indentation versus tensile measurements of young\u2019s modulus for soft biological tissues","volume":"17","author":"McKee","year":"2011","journal-title":"Tissue Eng Part B Rev"},{"key":"2026050517474913400_usaf485-B9","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-011-1264-2_8","volume-title":"Materials Metrology and Standards for Structural Performance","author":"Dean","year":"1995"},{"key":"2026050517474913400_usaf485-B10","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s13037-014-0051-4","article-title":"Compartment elasticity measured by pressure-related ultrasound to determine patients \u201cat risk\u201d for compartment syndrome: an experimental in vitro study","volume":"9","author":"Sellei","year":"2015","journal-title":"Patient Saf Surg"},{"key":"2026050517474913400_usaf485-B11","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1016\/j.injury.2020.10.069","article-title":"Non-invasive and reliable assessment of compartment elasticity by pressure related ultrasound: an in-vitro study","volume":"52","author":"Sellei","year":"2021","journal-title":"Injury"},{"key":"2026050517474913400_usaf485-B12","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1016\/j.injury.2019.01.015","article-title":"Use of standard musculoskeletal ultrasound to determine the need for fasciotomy in an elevated muscle compartment pressure cadaver leg model","volume":"50","author":"Marmor","year":"2019","journal-title":"Injury"},{"key":"2026050517474913400_usaf485-B13","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1186\/s40001-023-01232-1","article-title":"Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures","volume":"28","author":"Sellei","year":"2023","journal-title":"Eur J Med Res"},{"key":"2026050517474913400_usaf485-B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.colsurfa.2011.12.014","author":"Sellei","year":"2012","journal-title":"Non-Invasive Diagnostics in Acute Compartment Syndrome"},{"key":"2026050517474913400_usaf485-B15","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1097\/TA.0b013e3182aaa63e","article-title":"Do one-time intracompartmental pressure measurements have a high false-positive rate in diagnosing compartment syndrome?","volume":"76","author":"Whitney","year":"2014","journal-title":"J Trauma Acute Care Surg"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/5-6\/e1001\/64710994\/usaf485.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/5-6\/e1001\/64710994\/usaf485.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T22:17:27Z","timestamp":1778019447000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/191\/5-6\/e1001\/8286841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":15,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2025,10,13]]},"published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf485","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2025,10,13]]}}}