Look and listen: muscle pathology exposed from different perspectives

The Clinical Neuromuscular Imaging Group, based in the departments of Neurology and Radiology, focuses on bringing new, effective and patient-friendly tools to the care and research of patients with muscle and nerve disorders. Within this group, clinicians and researchers from the Clinical Neurophysiology function laboratory led by professor Nens van Alfen, are worldwide leaders of the development of muscle ultrasound as one such tool.

In their recent publication in Muscle & Nerve, Juerd Wijntjes, clinical neurophysiologist and PhD candidate, and colleagues report the comparison of muscle ultrasound and needle electromyography results in almost 1000 muscle pairs from 218 patients with a known neuromuscular disease. As new tools (muscle ultrasound) are often compared to established ones (needle EMG), the main question was whether these tools provide the same or similar information about muscle disease, or supplement each other by highlighting different aspects of pathology.

The study found that ultrasound and needle EMG pick up different aspects of muscle pathology. This means they cannot be used as one on one substitutes, but complement each other in a diagnostic or follow up setting. The use of each tool needs to be tailored to the specific clinical problem or research question at hand. As a specific scenario the study found that muscle ultrasound is less-well suited to detect mild neurogenic conditions, while previous work has showed excellent capability for detecting myopathic disease. Both techniques performed well in excluding abnormalities.

The results of this study mean another step forward to precision tooling in the workup of neuromuscular disorders. Next steps from our group are further honing the use of muscle ultrasound using Rasch-informed analysis and decision making and deep learning applications to automate muscle segmentation and basic texture analysis.

Read the publication here:

Wijntjes J, Gerritsen J, Doorduin J, van Alfen N. Comparison of muscle ultrasound and needle electromyography findings in neuromuscular disorders. Muscle Nerve. 2023 Oct 25. doi: 10.1002/mus.27989. Epub ahead of print. PMID: 37877239.