Ultrasound and Shear Wave Elastography of Lower-Limb Muscles and Aponeurotic Structures in Human Cadavers-A Scoping...

Background: Human cadaveric models provide a controlled experimental setting to investigate the anatomical basis and mechanical behaviour underlying musculoskeletal ultrasound findings. In recent years, both B-mode ultrasound and shear wave elastography have been applied in cadaveric studies to explore muscle architecture, aponeurotic structures, and passive mechanical properties under standardized conditions. Objective: The aim of this scoping review was to map and synthesize cadaveric studies using ultrasound and shear wave elastography to investigate lower-limb muscles and their aponeurotic structures, with emphasis on methodological applications, anatomical insights, and limitations relevant to clinical interpretation. Material and Methods: A scoping review was conducted according to PRISMA-ScR principles. Studies were included if ultrasound imaging (B-mode and/or shear wave elastography) was applied directly to human cadaveric lower-limb muscles or aponeurotic structures. Data were extracted and synthesized descriptively by anatomical region and ultrasound technique. Results: A total of 11 studies met the inclusion criteria and were included in the final qualitative synthesis, all of which applied ultrasound imaging, with or without shear wave elastography, directly to human cadaveric muscle tissue Among these, seven studies specifically investigated lower-limb skeletal muscles and their aponeurotic structures using ultrasound-based techniques to describe muscle architecture, internal connective tissue anatomy, or passive mechanical behaviour. These studies focused on the quadriceps femoris, hamstrings, adductor longus, and the gastrocnemius-soleus complex. The remaining four studies were considered relevant and therefore included in the scoping review because, although they did not focus on a specific lower-limb muscle group, they addressed key methodological factors influencing ultrasound and elastography-derived measurements in cadaveric muscle tissue. These investigations examined the effects of tissue layering, specimen-related characteristics, and measurement conditions, thereby providing essential methodological context for the interpretation of ultrasound-based outcomes across different anatomical regions. Conclusions: Cadaveric ultrasound studies provide essential anatomical context for interpreting musculoskeletal ultrasound, while cadaveric shear wave elastography supports controlled exploration of passive muscle mechanics. At the same time, these studies highlight important methodological sensitivities that should be acknowledged before translating elastography findings to clinical decision-making.