Young's moduli of subcutaneous tissues and muscles under different loads at the gluteal region calculated using ultrasonography.
Kaoru Isogai, Shogo Okamoto, Takayuki Asaba and 4 others
PMID 36507079WHAT IT FOUND
Gluteal subcutaneous tissue is much softer than muscle at light pressure.
Palpate gently to assess fat and firmly to assess muscle. Tissue hardness varies widely between people, so compare the patient’s side to side rather than relying on a general sense of normal.
Key findings
01Subcutaneous tissue is significantly softer than muscle under light loads, allowing for distinct evaluation of each layer if the correct pressure is applied.
02There is high individual variation in tissue hardness, with no significant correlations between subcutaneous and muscle hardness or within tissues at different loads.
03Clinicians should use low compressive stress to evaluate subcutaneous tissue and high compressive stress to evaluate muscle tissue in the gluteal region.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was small and consisted only of young, healthy males, so results may not apply to women, older adults, or patients with pathology. Tissue boundaries were identified by visual inspection of ultrasound images without third-party confirmation, which may affect accuracy. The compression was applied slowly (1.67 mm/s), which may not match the speed of manual palpation. Ultrasound gel was used, which adds weight and pressure, potentially affecting low-load measurements. The study only examined the gluteal region, so it is unclear if these specific hardness values apply to other body parts.
Declared interests
The authors declare no conflicts of interest. The work was supported by JSPS KAKENHI grants.
The easy way to misread this
Do not assume that a 'normal' palpation finding in the gluteal region applies to other body parts or that hardness in one tissue layer predicts hardness in another. The lack of correlation between tissues and the high individual variation mean that reference values from this study are specific to the gluteal region and should be used alongside side-to-side comparison.