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Abstract Our study also showed strong linear association between the MRI grade and the stiffness indicated by the strain ratios (p < 0.05). There was a perfect negative correlation grade of tendinopathy and SEL strain ratio. As tendinopathy increased, tendons became softer which was indicated by the reduced strain ratio values. These findings were in agreement with many previously published studies. The application of SEL in musculoskeletal system is not well established yet, but this study showed that SEL can detect differences between the normal and diseased rotator cuff tendons with good correlation to MRI. It can also add further important information to conventional shoulder imaging such as tendon quality which considered as a prognostic factor for rotator cuff repair. Application of SEL in clinical practice is recommended as it may provide early diagnosis/screening, monitoring response to recent treatment regimens or rehabilitation programs, time-effective and low cost follow up and prediction of surgical outcome. |