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Testing the Reliability of a Procedure Using Shear-Wave Elastography for Measuring Longus Colli Muscle Stiffness.

Juan Izquierdo-García1,2,3, Juan Antonio Valera-Calero3,4, Marcos José Navarro-Santana3,4

  • 1Department of Physical Medicine and Rehabilitation, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.

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|January 10, 2026
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Summary

Shear-wave elastography (SWE) provides reliable measurements of longus colli (LC) muscle stiffness in patients with mechanical neck pain. A standardized protocol ensures reproducibility, with averaging acquisitions improving accuracy in multi-examiner scenarios.

Keywords:
longus collineck painreproducibilityshear-wave elastographyultrasound imaging

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Area of Science:

  • Musculoskeletal Ultrasound
  • Biomechanics
  • Medical Imaging

Background:

  • Reproducible assessment of deep cervical muscle mechanics is crucial for clinical applications.
  • The reliability of shear-wave elastography (SWE) for the longus colli (LC) muscle has not been previously established.
  • Mechanical neck pain necessitates reliable methods for evaluating muscle function.

Purpose of the Study:

  • To determine the intra- and inter-examiner reliability of LC stiffness measurements using SWE.
  • To establish the reproducibility of SWE for assessing LC muscle mechanical properties.
  • To validate a standardized SWE protocol for patients with mechanical neck pain.

Main Methods:

  • A longitudinal reliability study involving adults with chronic neck pain (≥6 months).
  • Two examiners with varying experience performed bilateral LC imaging using standardized SWE presets.
  • Measurements of shear-wave speed and Young's modulus were obtained, with reliability assessed using intraclass correlation coefficients (ICCs).

Main Results:

  • Good to excellent inter-examiner agreement was observed for single (ICC3,2 > 0.818) and averaged (ICC3,2 > 0.866) LC stiffness measurements.
  • Intra-examiner repeatability was good to excellent (ICC3,1 > 0.891) for a novice examiner and excellent (ICC3,1 > 0.973) for an experienced examiner.
  • No significant differences in stiffness were found based on sex or side of measurement (p > 0.05).

Conclusions:

  • A standardized SWE workflow enables reproducible measurement of LC stiffness in individuals with mechanical neck pain.
  • For longitudinal studies, maintaining a single operator is recommended.
  • In multi-examiner settings, averaging at least two acquisitions per side enhances the sensitivity to detect true changes in LC stiffness.