Rheumatic Diseases and Myopathies in SWE

Background

The traditional process of performing ultra-sound has proven ineffective in dealing with most contemporary diseases (Ahuja 2014). Most of the machines were designed to only deal with diseases that were common at the time of the invention of those machines. Therefore, they cannot sufficiently deal with diseases that are more problematic today than they were in the past. Worse still, the ultra-sound machines have exhibited several demerits that render them obsolete. Some of the demerits are the production of noise, poor resolution, and optimization, and slow acquisition abilities. As a result, they leave medical experts with results that cannot help them make proper conclusions about the diagnosis of their patients. This dilemma meant that scientists had to look for other ways of handling such problems without much trouble.

These demerits led to the development of shear wave elastography. This new technology applies ultra-sound in checking the elasticity of various parts of the body. It approximates the stiffness of various tissues and gives good and reliable results in good time. Usually, shear waves develop in the tissues when ordinary US waves emitted by a transducer meet with the tissues. The waves move perpendicularly to the axial displacement produced by the US pulse. They then attenuate close to 10, 000 faster than the ordinary US. The speed of the shear waves can be recorded and applied in the evaluation of tissue stiffness. This is, usually, done by calculating the elastic Young’s modulus. This process produces qualitative electrograms that are color-coded and shear maps.

Lately, there has been an increase in the number of patients complaining about skeletal muscle pains (Colligan 2010). There were very few such cases in the past ten years. Such situations usually occur due to myopathies that impair the structure or functioning of the muscles (Kagen 2012). The manifestations of myopathies may include muscle weakness, inability to tolerate exercises, fatigue, muscle cramps, myalgias, contractures, myoglobinuria, and myotonia.

Rheumatic diseases, on the other hand, affect both the joints and muscles (Charlish 2012). Some of them develop due to the effects of wear and tear while others result from problems in the immune system. Most of the time, the patients cannot stand, walk or sit due to inflammation and destruction the disease has on the joints.

The rationale for the Study

Rheumatism and myopathies have been very common diseases. However, many of the recent methods of identifying and diagnosing these problems have not been good enough. Many of them have demerits that make them ineffective and disturbing to the patients. The demerits include noise, inaccuracy in their results, and taking too long to process the results. The SWE technology will help diagnose these diseases in a manner that is free of these disadvantages. It will help medical experts in identifying stiffness in muscles and impairment in joints.

Study Aims and Objectives

The main aim of this study is to study the relationship between discrete myopathies and rheumatic diseases in shear wave elastography. These two types of diseases have caused many problems to many people in the recent past. However, the methods that medical experts have used in handling them in the past have not been effective enough (Wortmann 2011). Therefore, SWE will help identify these problems with ease and treat them in good time. It will also help overcome the problems that come with the use of old ultra-sound techniques such as noise, the lack of accuracy, and low acquisition rates among other disadvantages.

Study Endpoints

The shear wave electrography technology will be used in determining the relationship between discrete myopathies and rheumatic diseases through:

  • Imaging the joints of individuals proven to be suffering from myopathies to check whether they also suffer from rheumatism or not
  • The stiffness of the muscles of individuals suffering rheumatic disorders will be checked to check whether they also suffer from myopathies or not

Shear waves will be produced when ordinary ultra-sound waves encounter the tissues of the parts being examined. The elastic Young’s modulus will then be used in the processing of the results. These calculations are strongly based on the velocity of the shear waves, which varies depending on the stiffness of the muscles. The results of the use of this technology also entail color-coded elastograms. The elastogram records red, yellow, green, or blue colors depending on the level of the stiffness of the muscles or tendons (Dimachkie 2014). These colors help the experts establish the exact action to take in every circumstance.

Variables

Levels of stiffness in the muscles and joints of the participants with both rheumatic disorders and myopathies will be checked using shear waves (Klippel 2014). The objective will be to confirm or refute the hypothesis that there is a relationship between rheumatic disorders and myopathies (Madhok, Capell & Luthra 2013). The colors of the elastograms will help in this process (Müller-Wohlfahrt 2013).

Study Design

T en people suffering from rheumatic disorders and ten others suffering from myopathies will be taken to serve as specimens in this study. The participants will be taken through check-ups using shear waves (Shaver, T & Anderson 2012). Those suffering from rheumatic disorders will have their muscles checked for myopathies using shear waves while those suffering from myopathies will have their joints checked for rheumatic disorders (Lehman 2013). The number of participants confirmed to be suffering from both diseases will be used in concluding: whether the two diseases are related or not. Specifically, if more than four people are confirmed to be suffering from both disorders, then the conclusion will be that the two disorders are related. On the contrary, if only less than five of the participants will be confirmed as having both diseases, then it will be concluded that the two diseases are not related. This, therefore, means that none of the participants should be negative to either of the two diseases. However, the participants will be free to leave the study whenever they want to or when they feel their rights are not being respected.

Rationale for Study

This research will confirm or refute the argument that there is a relationship between rheumatic disorders and myopathies. As witnessed by the work done by SWE, it is apparent that the study will also demonstrate the advantages of using SWE over ordinary ultra-sound. It will help demonstrate the ability of SWE to overcome the undoing of ultra-sound as people are used to it (Scoutt 2015). The advantages of using SWE outweigh the disadvantages. It is, therefore, a study worth carrying out.

Selection and Withdrawal of the Participants

The participants will be selected from people suffering from diseases and those suffering from muscle injuries and other myopathy disorders. A total of 10 participants from each category: the category of those suffering from rheumatic diseases and that of those suffering from myopathies will be selected. This number is good for the sake of making conclusions about whether a relationship exists between rheumatic diseases and myopathies or not. More than half the total number against or in support of the hypothesis will refute or reinforce the argument.

Participants will be dropped in case they change their minds and decide not to participate in the study. They will not necessarily have to give reasons for their withdrawal. Participants will also have the right to withdraw at any given time in the course of the study without having to explain to anybody why they should not participate in the study.

Methods of Assessment

The selection of participants will involve asking them questions about their status: whether they suffer from rheumatic diseases or myopathies. They will then be checked using shear waves with the view of assessing their muscles and joints. Colors indicated on the apparatus will show that they either have the diseases or not. In case more than half the participants in each of the two disease categories record positive results for each of the diseases, then the hypothesis will be confirmed. On the other hand, if less than 10 or none of the participants produces positive results; the conclusion will be that the two diseases are not related. This assessment will determine the nature of the conclusion to be made at the end of the study.

Results

The colors expected on the electogram are yellow, green, blue, or red (Kayen 2014). These colors show the degree of the problem a particular patient suffers from at a given time. Conclusions will be made depending on whether half or more than half the total number of participants record positive or negative results. The conclusions will also be positive or negative.

Discussion

The use of shear waves is a better method of diagnosing rheumatic diseases and myopathies (Ferraioli 2014). It eliminates the weaknesses of the traditional method of diagnosing these diseases (Campilho & Kamel 2013). The main weaknesses of past methods of ultrasound include the production of noise in the process of working, low acquisition rates, and the lack of precision. This study aims at establishing whether the two diseases are related or not. It bases its objectives on the existing suspicion of the possibility of a relationship between them owing to their occurrence in similar situations. Much unconfirmed evidence has been witnessed among the people who suffer from the two diseases. Precisely, individuals that suffer from one of them have also suffered from the other. Therefore, the participants confirmed to be suffering from rheumatic diseases are tested for myopathies, and those suffering from myopathies are tested for rheumatic diseases to check whether the suspected causal relationship between them exists or not. If more than half the total number of participants record positive results, then it means many of those suffering from one disease also suffer from the other. However, if more than half the total number of the participants record negative results, then the suspected causal relationship between the two diseases does not exist. This is the surest test to prove the existence or absence of a causal relationship between the diseases.

References

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