Fig. 3: Ultrasound imaging (USI) and Ultrasound elastography (USE).

USI acquired at a different positions, which are often combined with activity such as arm or leg raising or torso bending, can be used to estimate disc kinematics and muscle activation as contraction-induced thickness change. b Sagittal disc USI showing L3–L5 spinous process locations in supine and flexion, adapted from ref. 97. c USI of lumbar multifidus muscle thickness at rest and during contraction to measure change in thickness, adapted from ref. 238. USE extends USI to provide mechanical properties rather than just anatomical information. Advanced technology to induce vibration or shear waves are required (not shown). d USE of an adolescent disc at the L3–L4 annulus fibrosus, where warmer color indicates greater shear wave speed, adapted from ref. 127. e USE of L4–L5 multifidus muscle superficial (top ROI) and deeper (bottom ROI) layer, where warmer color indicates greater stiffness, adapted from ref. 135.