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Ultrasound Reveals Reduced Quadriceps Muscle in Cystic FibrosisUltrasound Shows Muscle Loss in People with Cystic Fibrosis

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Key Takeaway
Ultrasound detects reduced quadriceps muscle in cystic fibrosis, correlating with clinical status, but evidence is limited by heterogeneity.

A meta-analysis of observational studies assessed quadriceps muscle morphology via ultrasound in people with cystic fibrosis (PwCF) compared to controls. The primary outcome was quadriceps thickness and cross-sectional area. Results showed a significant reduction in rectus femoris muscle thickness in PwCF (mean difference -0.50 cm; 95% CI, -0.78 to -0.22; p = 0.0004). Quadriceps thickness and cross-sectional area were also reduced overall.

Moderate correlations were observed between ultrasound measurements and clinical parameters such as pulmonary function, fat-free mass index, and muscle strength. These findings suggest that ultrasound may be a useful tool for assessing muscle health in PwCF.

However, the evidence is limited by high heterogeneity (I² = 94%) and moderate risk of bias due to small sample sizes and methodological variability. The clinical utility of ultrasound for routine monitoring is not yet confirmed, and further research is needed to standardize protocols and establish predictive value.

Despite these limitations, the study highlights the potential of ultrasound to identify muscle wasting in PwCF, which could inform nutritional and exercise interventions. Clinicians should interpret these findings cautiously given the observational nature of the included studies.

How this fits prior evidence

This meta-analysis addresses a gap in objective monitoring tools for muscle health in cystic fibrosis. While prior evidence has explored pharmacological interventions like CFTR modulators and N-acetylcysteine, this finding provides data on using ultrasound to assess physical outcomes such as quadriceps morphology and its correlation with functional status.

Researchers analyzed data regarding muscle thickness in people living with cystic fibrosis. They used ultrasound technology to measure the quadriceps, which are the large muscles in the front of the thigh. The study found that these patients had a significant reduction in muscle thickness and cross-sectional area compared to healthy individuals.

The results also showed a moderate link between these ultrasound measurements and other health markers. These included lung function, fat-free mass index, and overall muscle strength. This suggests that measuring muscle size with ultrasound may help doctors track how well a patient is doing physically.

It is important to note that this evidence comes from a meta-analysis with some limitations. The data was varied across different studies, and many of the original studies had small sample sizes. While the findings show a clear link between muscle loss and cystic fibrosis, more research is needed to confirm how often ultrasound should be used in daily clinical care.

What this means for you:
Ultrasound shows thinner thigh muscles in people with cystic fibrosis, which may correlate with lung function.

Common questions

What did the ultrasound show about muscles in cystic fibrosis?

The study found a significant reduction in rectus femoris and quadriceps thickness in people with cystic fibrosis. Specifically, the rectus femoris muscle was found to be 0.50 cm thinner on average than in healthy individuals. These measurements help track muscle size and cross-sectional area.

Does muscle size affect other health factors in this condition?

The study found moderate correlations between ultrasound measurements of the thigh muscles and several clinical parameters. These included pulmonary function, fat-free mass index, and muscle strength. This suggests a link between muscle thickness and overall physical status.

Is ultrasound a standard way to treat cystic fibrosis?

The study does not show that ultrasound is a treatment. Instead, it suggests that ultrasound may be a useful tool for doctors to assess muscle morphology and its connection to nutritional and functional status in patients with cystic fibrosis.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJan 2026
View Original Abstract ↓
OBJECTIVE: To conduct a systematic review and meta-analysis of the evidence on the use of ultrasound to assess quadriceps morphology in people with cystic fibrosis (PwCF), focusing on muscle thickness, cross-sectional area, and associations with clinical outcomes. METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered on the International Prospective Register of Systematic Reviews platform (ID: CRD42024590549). The PubMed, Embase, Scopus, Web of Science, SciELO, and Cumulative Index to Nursing and Allied Health Literature databases were comprehensively searched without time restrictions. Gray literature and manual reference screening were also included. Observational studies assessing quadriceps morphology via ultrasound in people with CF and reporting quantitative outcomes were eligible. Two reviewers independently conducted study selection, data extraction, and risk of bias assessment using the Joanna Briggs Institute tool. Meta-analysis was performed with Cochrane's Review Manager software. RESULTS: Five studies met the inclusion criteria. People with CF showed reduced quadriceps thickness and cross-sectional area, particularly those who were malnourished. Moderate correlations were observed between ultrasound measurements and clinical parameters such as pulmonary function, fat-free mass index, and muscle strength. Meta-analysis revealed a significant reduction in rectus femoris muscle thickness in people with CF when compared with controls (mean difference: -0.50 cm; 95% CI, -0.78 to -0.22; p = 0.0004), with high heterogeneity (I2 = 94%). Risk of bias was moderate because of small sample sizes and methodological variability. CONCLUSIONS: Although the evidence is limited and heterogeneous, people with CF appear to show reduced quadriceps morphology, with associations with nutritional and functional status. Further high-quality studies are needed to confirm our findings and determine the clinical utility of ultrasound in this population.
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