Shear wave elastography detects novel imaging biomarkers of aromatase inhibitor-induced joint pain: a pilot study.

Abstract

AIM:

To determine whether differences in joint and tendon stiffness as measured by ultrasound shear wave elastography are present in breast cancer patients with aromatase inhibitor-associated arthralgias compared to age-comparable healthy control women.

METHODS:

Postmenopausal women with stage I-III breast cancer who were taking adjuvant aromatase inhibitors and complained of joint pain were enrolled (n = 6). Postmenopausal women with no history of breast cancer, hormone treatment, or joint pain served as controls (n = 7). All subjects had bilateral hands and wrists evaluated by gray-scale and power Doppler ultrasound, and shear wave elastography ultrasound.

RESULTS:

Patients with AI-associated arthralgias had significantly stiffer tendons than controls in the 1st extensor compartment (long axis; p = 0.001), 4th extensor compartment (long axis; p = 0.014), 3rd metacarpophalangeal joint (p = 0.002), the pooled values of the extensor compartments, both long (p = 0.044) and short axes (p = 0.035), and the pooled values for the metacarpophalangeal joints (p = 0.002). On ultrasound, the patients (but not controls) presented with hyperemia and increased tenosynovial fluid in the flexor and extensor tendon sheaths, and the median nerves were symptomatic and bifid; however, these differences were not statistically significant.

CONCLUSIONS:

This is the first study to identify increased tendon stiffness as a putative physiological characteristic of aromatase inhibitor-associated arthralgias. Future studies should determine whether increased tendon stiffness is a risk factor for the development of aromatase inhibitor-associated arthralgias, or a result of aromatase inhibitor treatment.

• Authors: Jessica A Martinez, Mihra S Taljanovic, Russell S Witte, Andres A Nuncio Zuniga, Betsy C Wertheim, C Kent Kwoh, Brian A Goldstein, Denise J Roe, Pavani Chalasani
• Journal: Journal of ultrasonography (J Ultrason) Vol. 21 Issue 84 Pg. 1-6 ( 2021) ISSN: 2084-8404 [Print] Poland
• PMID: 33791110 (Publication Type: Journal Article)
• Copyright: © Polish Ultrasound Society.