Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update

Stany Perkisas, Sophie Bastijns, Stéphane Baudry, Jürgen Bauer, Charlotte Beaudart, David Beckwée, Alfonso Cruz-Jentoft, Jerzy Gasowski, Hans Hobbelen, Harriët Jager-Wittenaar, Agnieszka Kasiukiewicz, Francesco Landi, Magdalena Małek, Ester Marco, Anna Maria Martone, Ana Merello de Miguel, Karolina Piotrowicz, Elisabet Sanchez, Dolores Sanchez-Rodriguez, Aldo ScafoglieriMaurits Vandewoude, Veronique Verhoeven, Zyta Beata Wojszel, Anne-Marie De Cock

Research output: Contribution to journalArticleAcademicpeer-review


PURPOSE: In 2018, the SARCUS working group published a first article on the standardization of the use of ultrasound to assess muscle. Recommendations were made for patient positioning, system settings and components to be measured. Also, shortcomings in knowledge were mentioned. An important issue that still required standardization was the definition of anatomical landmarks for many muscles.

METHODS: A systematic search was performed in Medline, SCOPUS and Web of Sciences looking for all articles describing the use of ultrasound in the assessment of muscle not described in the first recommendations, published from 01/01/2018 until 31/01/2020. All relevant terms used for older people, ultrasound and muscles were used.

RESULTS: For 39 muscles, different approaches for ultrasound assessment were found that likely impact the values measured. Standardized anatomical landmarks and measuring points were proposed for all muscles/muscle groups. Besides the five already known muscle parameters (muscle thickness, cross-section area, pennation angle, fascicle length and echo-intensity), four new parameters are discussed (muscle volume, stiffness, contraction potential and microcirculation). The former SARCUS article recommendations are updated with this new information that includes new muscle groups.

CONCLUSIONS: The emerging field of ultrasound assessment of muscle mass only highlights the need for a standardization of measurement technique. In this article, guidelines are updated and broadened to provide standardization instructions for a large number of muscles.

Original languageEnglish
Pages (from-to)45-59
Number of pages15
JournalEuropean Geriatric Medicine
Issue number1
Early online date2 Jan 2021
Publication statusPublished - 1 Feb 2021


  • ultrasound
  • sarcopenia
  • muscles


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