European Geriatric Medicine

, Volume 9, Issue 6, pp 739–757 | Cite as

Application of ultrasound for muscle assessment in sarcopenia: towards standardized measurements

  • Stany PerkisasEmail author
  • Stéphane Baudry
  • Jürgen Bauer
  • David Beckwée
  • Anne-Marie De Cock
  • Hans Hobbelen
  • Harriët Jager-Wittenaar
  • Agnieszka Kasiukiewicz
  • Francesco Landi
  • Ester Marco
  • Ana Merello
  • Karolina Piotrowicz
  • Elisabet Sanchez
  • Dolores Sanchez-Rodriguez
  • Aldo Scafoglieri
  • Alfonso Cruz-Jentoft
  • Maurits Vandewoude
Special Article



Measurement of muscle mass is paramount in the screening and diagnosis of sarcopenia. Besides muscle quantity however, also quality assessment is important. Ultrasonography (US) has the advantage over dual-energy X-ray absorptiometry (DEXA) and bio-impedance analysis (BIA) to give both quantitative and qualitative information on muscle. However, before its use in clinical practice, several methodological aspects still need to be addressed. Both standardization in measurement techniques and the availability of reference values are currently lacking. This review aims to provide an evidence-based standardization of assessing appendicular muscle with the use of US.


A systematic review was performed for ultrasonography to assess muscle in older people. Pubmed, SCOPUS and Web of Sciences were searched. All articles regarding the use of US in assessing appendicular muscle were used. Description of US-specific parameters and localization of the measurement were retrieved.


Through this process, five items of muscle assessment were identified in the evaluated articles: thickness, cross-sectional area, echogenicity, fascicle length and pennation angle. Different techniques for measurement and location of measurement used were noted, as also the different muscles in which this was evaluated. Then, a translation for a clinical setting in a standardized way was proposed.


The results of this review provide thus an evidence base for an ultrasound protocol in the assessment of skeletal muscle. This standardization of measurements is the first step in creating conditions to further test the applicability of US for use on a large scale as a routine assessment and follow-up tool for appendicular muscle.


Sarcopenia Ultrasound Muscle assessment 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Supplementary material

41999_2018_104_MOESM1_ESM.docx (137 kb)
Supplementary material 1 (DOCX 137 kb)


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Copyright information

© European Geriatric Medicine Society 2018

Authors and Affiliations

  • Stany Perkisas
    • 1
    • 18
    Email author
  • Stéphane Baudry
    • 2
    • 18
  • Jürgen Bauer
    • 3
  • David Beckwée
    • 4
    • 5
  • Anne-Marie De Cock
    • 1
  • Hans Hobbelen
    • 6
    • 19
  • Harriët Jager-Wittenaar
    • 6
    • 20
  • Agnieszka Kasiukiewicz
    • 7
  • Francesco Landi
    • 8
  • Ester Marco
    • 9
    • 10
    • 11
  • Ana Merello
    • 12
  • Karolina Piotrowicz
    • 13
  • Elisabet Sanchez
    • 12
  • Dolores Sanchez-Rodriguez
    • 11
    • 14
    • 15
    • 16
  • Aldo Scafoglieri
    • 17
    • 18
  • Alfonso Cruz-Jentoft
    • 12
  • Maurits Vandewoude
    • 1
    • 18
  1. 1.University of Antwerp—University Geriatric CenterAntwerpBelgium
  2. 2.Laboratory of Applied Biology and NeurophysiologieUniversité libre de BruxellesBrusselsBelgium
  3. 3.Department of Geriatric Medicine, KlinikumCarl von Ossietzky UniversityOldenburgGermany
  4. 4.Rehabilitation Sciences Research DepartmentVrije Universiteit BrusselBrusselsBelgium
  5. 5.Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
  6. 6.Research Group Healthy Ageing, Allied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
  7. 7.Department of GeriatricsMedical University in BialystokBiałystokPoland
  8. 8.Department of Geriatrics, Neuroscience and Orthopedics, Teaching Hospital “Agostino Gemelli”Catholic University of the Sacred Heart School of MedicineRomeItaly
  9. 9.Physical and Rehabilitation MedicineParc de Salut MarBarcelonaSpain
  10. 10.Rehabilitation Research GroupHospital del Mar Research InstituteBarcelonaSpain
  11. 11.Universitat Autònoma de BarcelonaBarcelonaSpain
  12. 12.University Hospital Ramón y CajalMadridSpain
  13. 13.Department of Internal Medicine and Gerontology, Faculty of MedicineJagiellonian University Medical CollegeKrakówPoland
  14. 14.Geriatrics DepartmentParc Salut MarBarcelonaSpain
  15. 15.Institut Hospital Del Mar d’Investigacions Mèdiques (IMIM)BarcelonaSpain
  16. 16.Universitat Pompeu FabraBarcelonaSpain
  17. 17.Faculty of Medicine and PharmacyVrije Universiteit BrusselBrusselsBelgium
  18. 18.Belgian Ageing Muscle SocietyLiegeBelgium
  19. 19.Department of General Practice and Elderly Care MedicineUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
  20. 20.Department of Maxillofacial SurgeryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands

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