Feasibility Trial to Evaluate Tendon Stiffness Obtained from Shear Wave Elastography Imaging as a Biomarker of Aromatase Inhibitor-Induced Arthralgias

Jessica A. Martinez, Mihra Taljanovic, Andres A.Nuncio Zuniga, Betsy C. Wertheim, Denise Roe, Sima Ehsani, Sao Jiralerspong, Jennifer Segar, Pavani Chalasani

Research output: Contribution to journalArticlepeer-review

Abstract

Aromatase inhibitor-induced arthralgia (AIA) comprises significant, activity-limiting mus-culoskeletal symptoms, including joint pain, myalgia, and joint stiffness. We conducted a prospective feasibility study in postmenopausal women diagnosed with early-stage (0–3) hormone receptor positive (HR+) breast cancer who were candidates for treatment with adjuvant AI therapy (n = 16). Tendons of the hands and wrists and the median nerve were imaged using gray-scale and power Doppler ultrasound (US) and US SWE. Arthralgia symptoms were evaluated using the Breast Cancer Prevention Trial (BCPT) Symptom Checklist musculoskeletal subscale (MS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and stiffness subscales. At baseline, there were significant differences in the SW velocities of tendons between dominant and nondominant hands. Increased velocity in 2 of 6 tendons and the median nerve was associated with greater pain at baseline, whereas slower velocity of the extensor digitorum tendon (suggesting decreased stiffness) was associated with a higher WOMAC stiffness score. Increased SW velocity (suggestive of increased stiffness) at baseline in the abductor pollicis longus tendon was associated with a worsening of all three pain and stiffness measures by 6 months. Future studies should evaluate SWE scores related to AIA outcomes in a larger sample size.

Original languageEnglish (US)
Article number1067
JournalJournal of Clinical Medicine
Volume11
Issue number4
DOIs
StatePublished - Feb 1 2022

Keywords

  • Aromatase inhibitors
  • Aromatase inhibitor–induced arthralgia (AIA)
  • Arthralgia
  • Breast cancer
  • Joint pain
  • Shear wave elastography
  • Stiffness
  • Ultrasound

ASJC Scopus subject areas

  • Medicine(all)

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