The role of muscle ultrasonic examination in the assessment of sarcopenia

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Abstract

Sarcopenia (SP), being an age-associated health condition, is an important therapeutic problem predisposing to muscle weakness and fragility development. SP can be found not only among the elderly, but also in young population in individuals with various nosologies. At the international level, clinical and research interest to the study of this condition has sharply increased. In recent years, various methods of early diagnostics of SP have been analyzed, with ultrasound examination being considered as a promising and simple method for its assessment. The article presents a literature review on the capabilities and role of muscle ultrasound examination in the diagnostics of SP.

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About the authors

Irina F. Fairushina

Kazan State Medical University of the Ministry of Healthcare of Russia; Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan

Email: irina.fayruschina@kazangmu.ru
ORCID iD: 0000-0002-5975-4822
SPIN-code: 5074-4756

MD, PhD (Medicine), assistant professor of the Department of hospital therapy, ultrasound diagnostics physician

Russian Federation, Kazan; Kazan

Olga E. Akchurina

Kazan State Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: olya-akchurina@mail.ru
ORCID iD: 0009-0009-5739-7807
SPIN-code: 5036-4415

MD, resident of the Department of hospital therapy

Russian Federation, Kazan

Dilyara D. Mukhametova

Kazan State Medical University of the Ministry of Healthcare of Russia

Email: muhdilyara@gmail.com
ORCID iD: 0000-0003-2102-0142
SPIN-code: 7998-5365

MD, PhD (Medicine), ultrasound diagnostics physician, assistant at the Department of hospital therapy

Russian Federation, Kazan

References

  1. Prell T, Grimm A, Axer H. Uncovering sarcopenia and frailty in older adults by using muscle ultrasound – A narrative review. Front Med (Lausanne). 2024;11:1333205. PMID: 38828232. PMCID: PMC11140070. https://doi.org/10.3389/fmed.2024.1333205
  2. Kirk B, Cawthon PM, Arai H, Avila-Funes JA, Barazzoni R, Bhasin S et al.; Global Leadership Initiative in Sarcopenia (GLIS) group. The conceptual definition of sarcopenia: Delphi consensus from the Global Leadership Initiative in Sarcopenia (GLIS). Age Ageing. 2024;53(3):afae052. PMID: 38520141. PMCID: PMC10960072. https://doi.org/10.1093/ageing/afae052
  3. Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet. 2019;393(10191):2636–46. PMID: 31171417. https://doi.org/10.1016/S0140-6736(19)31138-9
  4. Yuan S, Larsson SC. Epidemiology of sarcopenia: Prevalence, risk factors, and consequences. Metabolism. 2023;144:155533. PMID: 36907247. https://doi.org/10.1016/j.metabol.2023.155533
  5. Falcon LJ, Harris-Love MO. Sarcopenia and the New ICD-10-CM Code: Screening, staging, and diagnosis considerations. Fed Pract. 2017;34(7):24–32. PMID: 28867927. PMCID: PMC5576154.
  6. Nikodinovska VV, Ivanoski S. Sarcopenia, more than just muscle atrophy: Imaging methods for the assessment of muscle quantity and quality. Rofo. 2023;195(9):777–89. PMID: 37160148. https://doi.org/10.1055/a-2057-0205
  7. Торопцова Н.В., Феклистов А.Ю. Патология костно-мышечной системы: фокус на саркопению и остеосаркопению. Медицинский совет. 2019;(4):78–86. [Toroptsova NV, Feklistov AYu. Musculoskeletal system pathology: Focus on sarcopenia and osteosarcopenia. Meditsinskiy sovet = Medical Council. 2019;(4):78–86 (In Russ.)]. EDN: MHBEOO. https://doi.org/10.21518/2079-701X-2019-4-78-86
  8. Голоунина О.О., Фадеев В.В., Белая Ж.Е. Современные рекомендации по диагностике саркопении. Клиническая медицина. 2023;101(4–5):198–207. [Golounina OO, Fadeev VV, Belaya ZhE. Current recommendations for the diagnosis of sarcopenia. Clinical Medicine. 2023;101(4–5):198–207 (In Russ.)]. EDN: JFCIHL. https://doi.org/10.30629/0023-2149-2023-101-4-5-198-207
  9. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T et al.; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(4):601. PMID: 31081853. PMCID: PMC6593317. https://doi.org/10.1093/ageing/afz046
  10. Chen L-K, Woo J, Assantachai P, Auyeung T-W, Chou M-Y, Iijima K et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300–307.e2. PMID: 32033882. https://doi.org/10.1016/j.jamda.2019.12.012
  11. Beaudart C, Reginster JY, Slomian J, Buckinx F, Dardenne N, Quabron A et al. Estimation of sarcopenia prevalence using various assessment tools. Exp Gerontol. 2015;61:31–37. PMID: 25449859. https://doi.org/10.1016/j.exger.2014.11.014
  12. Nijholt W, Scafoglieri A, Jager-Wittenaar H, Hobbelen JSM, van der Schans CP et al. The reliability and validity of ultrasound to quantify muscles in older adults: A systematic review. J Cachexia Sarcopenia Muscle. 2017;8(5):702–12. PMID: 28703496. PMCID: PMC5659048. https://doi.org/10.1002/jcsm.12210
  13. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T et al.; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. PMID: 30312372. PMCID: PMC6322506. https://doi.org/10.1093/ageing/afy169
  14. Abe T, Thiebaud RS, Loenneke JP, Young KC. Prediction and validation of DXA-derived appendicular lean soft tissue mass by ultrasound in older adults. Age (Dordr). 2015;37(6):114. PMID: 26552906. PMCID: PMC5005856. https://doi.org/10.1007/s11357-015-9853-2
  15. Hida T, Ando K, Kobayashi K, Ito K, Tsushima M, Kobayakawa T et al. Ultrasound measurement of thigh muscle thickness for assessment of sarcopenia. Nagoya J Med Sci. 2018;80(4):519–27. PMID: 30587866. PMCID: PMC6295433. https://doi.org/10.18999/nagjms.80.4.519
  16. de Souza VA, Oliveira D, Cupolilo EN, Miranda CS, Colugnati FAB, Mansur HN et al. Rectus femoris muscle mass evaluation by ultrasound: Facilitating sarcopenia diagnosis in pre-dialysis chronic kidney disease stages. Clinics (Sao Paulo). 2018;73:e392. PMID: 30379225. PMCID: PMC6201140. https://doi.org/10.6061/clinics/2018/e392
  17. Sanada K, Kearns CF, Midorikawa T, Abe T. Prediction and validation of total and regional skeletal muscle mass by ultrasound in Japanese adults. Eur J Appl Physiol. 2006;96(1):24–31. PMID: 16235068. https://doi.org/10.1007/s00421-005-0061-0
  18. Yang Q, Zhang C, Zhang Z, Su B. Muscle ultrasound to diagnose sarcopenia in chronic kidney disease: A systematic review and bayesian bivariate meta-analysis. BMC Nephrol. 2024;25(1):12. PMID: 38178026. PMCID: PMC10768384. https://doi.org/10.1186/s12882-023-03445-2
  19. Ang SW, Liew J, Dharmaratnam VM, Yik VYJ, Kok S, Aftab S et al. Diagnostic performance of various radiological modalities in the detection of sarcopenia within Asian populations: A systematic review. Ann Coloproctol. 2025;41(1):27–39. PMID: 40044110. PMCID: PMC11894942. https://doi.org/10.3393/ac.2024.00080.0011
  20. Stringer HJ, Wilson D. The role of ultrasound as a diagnostic tool for sarcopenia. J Frailty Aging. 2018;7(4):258–61. PMID: 30298175. PMCID: PMC6208738. https://doi.org/10.14283/jfa.2018.24
  21. Wijntjes J, van Alfen N. Muscle ultrasound: Present state and future opportunities. Muscle Nerve. 2021;63(4):455–66. PMID: 33051891. PMCID: PMC8048972. https://doi.org/10.1002/mus.27081
  22. Perkisas S, Baudry S, Bauer J, Beckwee D, De Cock A-M, Hobbelen H et al. Application of ultrasound for muscle assessment in sarcopenia: Towards standardized measurements. Eur Geriatr Med. 2018;9(6):739–57. PMID: 34674473. https://doi.org/10.1007/s41999-018-0104-9
  23. Perkisas S, Bastijns S, Baudry S, Bauer J, Beaudart C, Beckwee D et al. Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update. Eur Geriatr Med. 2021;12(1):45–59. PMID: 33387359. https://doi.org/10.1007/s41999-020-00433-9
  24. Kruse NT, Hughes WE, Casey DP. Mechanistic insights into the modulatory role of the mechanoreflex on central hemodynamics using passive leg movement in humans. J Appl Physiol (1985). 2018;125(2):545–52. PMID: 29771607. PMCID: PMC6139517. https://doi.org/10.1152/japplphysiol.01085.2017
  25. Alonso-Fernandez D, Gutierrez-Sanchez A, Garcia-Remeseiro T, Garganta R. Effects of the Nordic hamstring exercise on the architecture of the semitendinosus. Isokinetics and Exercise Science. 2018;26(2):81–88. https://doi.org/10.3233/IES-172196
  26. Lavalle S, Scapaticci R, Masiello E, Messina C, Aliprandi A, Salerno VM et al. Advancements in sarcopenia diagnosis: From imaging techniques to non-radiation assessments. Front Med Technol. 2024;6:1467155. PMID: 39445171. PMCID: PMC11496100. https://doi.org/10.3389/fmedt.2024.1467155
  27. Heckmatt JZ, Leeman S, Dubowitz V. Ultrasound imaging in the diagnosis of muscle disease. J Pediatr. 1982;101(5):656–60. PMID: 7131136. https://doi.org/10.1016/s0022-3476(82)80286-2
  28. Pearson WG Jr, Langmore SE, Zumwalt AC. Evaluating the structural properties of suprahyoid muscles and their potential for moving the hyoid. Dysphagia. 2011;26(4):345–51. PMID: 21069388. PMCID: PMC3154991. https://doi.org/10.1007/s00455-010-9315-z
  29. Billot M, Calvani R, Urtamo A, Sánchez-Sanchez JL, Ciccolari-Micaldi C, Chang M et al. Preserving mobility in older adults with physical frailty and sarcopenia: Opportunities, challenges, and recommendations for physical activity interventions. Clin Interv Aging. 2020;15:1675–90. PMID: 32982201. PMCID: PMC7508031. https://doi.org/10.2147/CIA.S253535
  30. Chen Y-L, Liu P-T, Chiang HK, Lee S-H, Lo Y-L, Yang Y-C, Chiou H-J. Ultrasound measurement of rectus femoris muscle parameters for discriminating sarcopenia in community-dwelling adults. J Ultrasound Med. 2022;41(9):2269–77. PMID: 34873739. https://doi.org/10.1002/jum.15913
  31. Matsuzawa R, Yamamoto S, Suzuki Y, Imamura K, Harada M, Matsunaga A et al. The clinical applicability of ultrasound technique for diagnosis of sarcopenia in hemodialysis patients. Clin Nutr. 2021;40(3):1161–67. PMID: 32798065. https://doi.org/10.1016/j.clnu.2020.07.025
  32. Yoshida T, Kumon Y, Takamatsu N, Nozaki T, Inoue M, Nodera H et al. Ultrasound assessment of sarcopenia in patients with rheumatoid arthritis. Mod Rheumatol. 2022;32(4):728–35. PMID: 34897497. https://doi.org/10.1093/mr/roab049
  33. Isaka M, Sugimoto K, Yasunobe Y, Akasaka H, Fujimoto T, Kurinami H et al. The usefulness of an alternative diagnostic method for sarcopenia using thickness and echo intensity of lower leg muscles in older males. J Am Med Dir Assoc. 2019;20(9):1185.e1–1185.e8. PMID: 30902675. https://doi.org/10.1016/j.jamda.2019.01.152
  34. Jimenez EL, Alvarez MN, Colino RM, Lopez MC, Jiménez CG, Rodríguez PP et al. Muscle mass loss measured with portable ultrasound in hospitalized older adults: The ECOSARC study. J Nutr Health Aging. 2024;28(1):100010. PMID: 38267149. https://doi.org/10.1016/j.jnha.2023.100010
  35. Koruyucu AN, Aşantogrol F. Determination of masseter and temporal muscle thickness by ultrasound and muscle hardness by shear wave elastography in healthy adults as reference values. Dentomaxillofac Radiol. 2024;53(2):137–52. PMID: 38211311. https://doi.org/10.1093/dmfr/twad013
  36. Gonzalez-Fernandez M, Perez-Nogueras J, Serrano-Oliver A, Torres-Anoro E, Sanz-Arque A, Arbones-Mainar JM, Sanz-Paris A. Masseter muscle thickness measured by ultrasound as a possible link with sarcopenia, malnutrition and dependence in nursing homes. Diagnostics (Basel). 2021;11(9):1587. PMID: 34573928. PMCID: PMC8469670. https://doi.org/10.3390/diagnostics11091587
  37. Janovic A, Miličić B, Antic S, Bracanovic Đ, Markovic-Vasiljkovic B. Feasibility of using cross-sectional area of masticatory muscles to predict sarcopenia in healthy aging subjects. Sci Rep. 2024;14(1):2079. PMID: 38267441. PMCID: PMC10808244. https://doi.org/10.1038/s41598-024-51589-4
  38. Staempfli JS, Kistler-Fischbacher M, Gewiess J, Bastian JD, Eggimann AK. The validity of muscle ultrasound in the diagnostic workup of sarcopenia among older adults: A scoping review. Clin Interv Aging. 2024;19:993–1003. PMID: 38831963. PMCID: PMC11146336. https://doi.org/10.2147/CIA.S463917
  39. Abe T, Loenneke JP, Thiebaud RS, Ogawa M, Mitsukawa N. Age-related site-specific muscle loss in the thigh and zigzag walking performance in older men and women. Acta Physiol Hung. 2014;101(4):488–95. PMID: 25201711. https://doi.org/10.1556/APhysiol.101.2014.006
  40. Kara M, Kaymak B, Frontera W, Ata AM, Ricci V, Ekiz T et al. Diagnosing sarcopenia: Functional perspectives and a new algorithm from the ISarcoPRM. J Rehabil Med. 2021;53(6):jrm00209. PMID: 34121127. PMCID: PMC8814891. https://doi.org/10.2340/16501977-2851
  41. Kara M, Kaymak B, Ata AM, Ozkal O, Kara O, Baki A et al. STAR-sonographic thigh adjustment ratio: A golden formula for the diagnosis of sarcopenia. Am J Phys Med Rehabil. 2020;99(10):902–8. PMID: 32941253. https://doi.org/10.1097/PHM.0000000000001439
  42. Narici M, McPhee J, Conte M, Franchi MV, Mitchell K, Tagliaferri S et al. Age-related alterations in muscle architecture are a signature of sarcopenia: The ultrasound sarcopenia index. J Cachexia Sarcopenia Muscle. 2021;12(4):973–82. PMID: 34060717. PMCID: PMC8350200. https://doi.org/10.1002/jcsm.12720
  43. Mulinacci G, Pirola L, Gandola D, Ippolito D, Viganò C, Laffusa A et al. Ultrasound muscle assessment for sarcopenia detection in inflammatory bowel disease: A prospective study. United European Gastroenterol J. 2024;12(5):562–73. PMID: 38549182. PMCID: PMC11176911. https://doi.org/10.1002/ueg2.12566
  44. Rustani K, Kundisova L, Capecchi PL, Nante N, Bicchi M. Ultrasound measurement of rectus femoris muscle thickness as a quick screening test for sarcopenia assessment. Arch Gerontol Geriatr. 2019;83:151–54. PMID: 31029040. https://doi.org/10.1016/j.archger.2019.03.021
  45. Ozturk Y, Koca M, Burkuk S, Unsal P, Dikmeer A, Oytun MG et al. The role of muscle ultrasound to predict sarcopenia. Nutrition. 2022;101:111692. PMID: 35660496. https://doi.org/10.1016/j.nut.2022.111692
  46. Vitale JA, Messina C, Albano D, Fascio E, Galbusera F, Corbetta S et al. Appendicular muscle mass, thigh intermuscular fat infiltration, and risk of fall in postmenopausal osteoporotic elder women. Gerontology. 2021;67(4):415–24. PMID: 33677443. https://doi.org/10.1159/000513597
  47. Zhao R, Li X, Jiang Y, Su N, Li J, Kang L et al. Evaluation of appendicular muscle mass in sarcopenia in older adults using ultrasonography: A systematic review and meta-analysis. Gerontology. 2022;68(10):1174–98. PMID: 35878591. PMCID: PMC9677864. https://doi.org/10.1159/000525758
  48. Zuo X, Li X, Tang K, Zhao R, Wu M, Wang Y, Li T. Sarcopenia and cardiovascular diseases: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2023;14(3):1183–98. PMID: 37002802. PMCID: PMC10235887. https://doi.org/10.1002/jcsm.13221
  49. Han X, Zhang GS, Li QR, Zhang Z. Current approach to the diagnosis of sarcopenia in cardiovascular diseases. Front Nutr. 2024;11:1422663. PMID: 39619285. PMCID: PMC11604458. https://doi.org/10.3389/fnut.2024.1422663
  50. Ерохина А.С., Голованова Е.Д., Милосердов М.А. Роль ультразвуковой оценки мышечной массы в диагностике саркопении у пациентов с сердечно-сосудистыми заболеваниями. Кардиоваскулярная терапия и профилактика. 2021;20(3):57–64. [Erokhina AS, Golovanova ED, Miloserdov MA. The role of ultrasound assessment of muscle mass in the diagnosis of sarcopenia in patients with cardiovascular diseases. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2021;20(3):57–64 (In Russ.)]. EDN: AMDDYC. https://doi.org/10.15829/1728-8800-2021-2699
  51. Barone M, Viggiani MT, Anelli MG, Fanizzi R, Lorusso O, Lopalco G et al. Sarcopenia in patients with rheumatic diseases: Prevalence and associated risk factors. J Clin Med. 2018;7(12):504. PMID: 30513782. PMCID: PMC6306844. https://doi.org/10.3390/jcm7120504
  52. McKee A, Morley JE, Matsumoto AM, Vinik A. Sarcopenia: An endocrine disorder? Endocr Pract. 2017;23(9):1140–49. PMID: 28704095. https://doi.org/10.4158/EP171795.RA
  53. Kuan LL, Dennison AR, Garcea G. Prevalence and impact of sarcopenia in chronic pancreatitis: A review of the literature. World J Surg. 2021;45(2):590–97. PMID: 33165641. PMCID: PMC7773619. https://doi.org/10.1007/s00268-020-05828-0
  54. Ryan E, McNicholas D, Creavin B, Kelly ME, Walsh T, Beddy D. Sarcopenia and inflammatory bowel disease: A systematic review. Inflamm Bowel Dis. 2019;25(1):67–73. PMID: 29889230. https://doi.org/10.1093/ibd/izy212
  55. Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol. 2014;2(10):819–29. PMID: 24731660. PMCID: PMC4156923. https://doi.org/10.1016/S2213-8587(14)70034-8
  56. Campani F, Li Cavoli TV, Arena U, Marra F, Lynch EN, Campani C. Quick and easy assessment of sarcopenia in cirrhosis: Can ultrasound be the solution? World J Gastroenterol. 2024;30(17):2287–93. PMID: 38813055. PMCID: PMC11130576. https://doi.org/10.3748/wjg.v30.i17.2287
  57. Deng M, Yan L, Tong R, Zhao J, Li Y, Yin Y et al. Ultrasound assessment of the rectus femoris in patients with chronic obstructive pulmonary disease predicts sarcopenia. Int J Chron Obstruct Pulmon Dis. 2022;17:2801–10. PMID: 36348815. PMCID: PMC9637333. https://doi.org/10.2147/COPD.S386278
  58. Chianca V, Albano D, Messina C, Gitto S, Ruffo G, Guarino S et al. Sarcopenia: Imaging assessment and clinical application. Abdom Radiol (NY). 2022;47(9):3205–16. PMID: 34687326. PMCID: PMC8536908. https://doi.org/10.1007/s00261-021-03294-3
  59. Wilkinson TJ, Gould DW, Nixon DGD, Watson EL, Smith AC. Quality over quantity? Association of skeletal muscle myosteatosis and myofibrosis on physical function in chronic kidney disease. Nephrol Dial Transplant. 2019;34(8):1344–53. PMID: 29939315. https://doi.org/10.1093/ndt/gfy139
  60. Sabatino A, Kooman J, Avesani CM, Gregorini M, Bianchi S, Regolisti G, Fiaccadori E. Sarcopenia diagnosed by ultrasound-assessed quadriceps muscle thickness and handgrip strength predicts mortality in patients on hemodialysis. J Nephrol. 2024;37(4):993–1003. PMID: 38263531. https://doi.org/10.1007/s40620-023-01867-7
  61. Beaudart C, Zaaria M, Pasleau F, Reginster J-Y, Bruyère O. Health outcomes of sarcopenia: A systematic review and meta-analysis. PLoS One. 2017;12(1):e0169548. PMID: 28095426. PMCID: PMC5240970. https://doi.org/10.1371/journal.pone.0169548
  62. Beaudart C, Demonceau C, Reginster J-Y , Locquet M, Cesari M, Jentoft AJC, Bruyère O. Sarcopenia and health-related quality of life: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2023;14(3):1228–43. PMID: 37139947. PMCID: PMC10235892. https://doi.org/10.1002/jcsm.13243

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2. Fig. 1. A. Features of ultrasound reflection. b. In the gray scale mode, two different images are formed at different positions of the sensor. c. Visualization of skin (blue), subcutaneous fat (yellow), muscles (red) and bone contour during ultrasound examination of the rectus femoris (transverse scan). G. Sonogram of the gastrocnemius muscle of a healthy person during longitudinal and transverse scanning (echograms from the authors' personal archive, illustration by the authors)

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3. Fig. 2. The technique of fixing the sensor during ultrasound examination of the MSCS (image from the personal archive of the authors

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4. Fig. 3. An echogram performed during transverse scanning of the anterior surface of the thigh with a linear sensor, a healthy person and a patient with sarcopenia (from the authors' personal archive)

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