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Preoperative Ultrasound Helps Predict Rotator Cuff Repair

By MedImaging International staff writers
Posted on 02 Feb 2022

Image: SWE in 37-Year-Old Man together with coronal T2-weighted MR image (Photo courtesy of AJR)

A new study suggests that shear wave elastography (SWE) of the shoulder prior to rotator cuff surgery can serve as a prognostic marker for success.

Researchers at Hallym University Dongtan Sacred Heart Hospital (Hwaseong, Republic of Korea) conducted a prospective study of 74 patients (37 men, mean age 64 year) who underwent rotator cuff repair from May 2019 to January 2021, in order to explore the effectiveness of preoperative SWE measurements of the supraspinatus muscle to predict successful rotator cuff repair. All patients underwent preoperative shoulder magnetic resonance imaging (MRI) and investigational shoulder ultrasound, including SWE using shear modulus.

Mean elasticity was measured of the supraspinatus and trapezius muscles, and mean elasticity ratio between them was calculated. On SWE, muscular fatty infiltration score was recorded on grayscale ultrasound; on MRI, muscular fatty infiltration was assessed by Goutallier's grade, and muscular atrophy was assessed by the occupation ratio between cross-sectional areas of supraspinatus muscle and supraspinatus fossa, and by muscle atrophy grade. After repair, the procedures were classified as achieving sufficient (60 patients) or insufficient (14 patients) repair.

The results showed that patients with insufficient repair more commonly exhibited a large (3-5 cm) tear, higher mean Goutallier's score, mean muscle atrophy score, mean supraspinatus elasticity and elasticity ratios, higher grayscale fatty infiltration grade, and lower occupation ratio. The elasticity ratio derived from the SWE measurements achieved a sensitivity of 100% and a specificity of 90% for predicting insufficient repair. The study was published on January 19, 2022, in American Journal of Roentgenology (AJR).

“SWE-derived elasticity is higher in patients with insufficient rotator cuff repair; elasticity ratio independently predicts insufficient repair,” concluded corresponding author Eun Kyung Khil, MD, of the department of radiology, and colleagues. “At multivariable analysis, including tear size, the three MRI measures, elasticity ratio, and grayscale fatty infiltration grade, the only independent predictors of insufficient repair were muscle atrophy grade of 2-3 and elasticity ratio.”

SWE relies on the generation of shear waves determined by the displacement of tissues induced by the force of a focused ultrasound beam or by external pressure. The shear waves are lateral waves, with a motion perpendicular to the direction of the generating force, travel slowly, and are rapidly attenuated by tissue. The propagation velocity of the shear waves correlates with the elasticity of tissue.

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Hallym University Dongtan Sacred Heart Hospital

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61 (!!!!! 2408.9813232422): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (725.98457336426): SELECT fid FROM jos_deeppockets WHERE id=294791446 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294791446 AND published='1' LIMIT 1

63 (47.922134399414): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

64 (!!!!! 4184.9613189697): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 1334.9056243896): select jos_facebook.link from jos_facebook where cat=10

66 (249.14741516113): select jos_google_plus.link from jos_google_plus where cat=10

67 (41.961669921875): select jos_linkedin.link from jos_linkedin where cat=10

68 (952.95906066895): SELECT fid FROM jos_deeppockets WHERE id=294791446 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294791446 AND published='1' LIMIT 1

69 (349.99847412109): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

70 (!!!!! 1827.9552459717): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294791446 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 2290.0104522705): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294791446 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (92.983245849609): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (!!!!! 4330.8734893799): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (549.0779876709): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (393.15223693848): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (164.98565673828): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (663.04206848145): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (!!!!! 3826.8566131592): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (345.94535827637): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (285.14862060547): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (339.98489379883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 1684.9040985107): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294791446 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (159.02519226074): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294791446 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (525.95138549805): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (685.9302520752): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (159.97886657715): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (502.8247833252): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (40.769577026367): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (157.11784362793): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (442.0280456543): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1960.9928131104): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

105 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

106 (!!!!! 1712.0838165283): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294791446 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1187.801361084): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294791446 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 3133.7738037109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

109 (85.830688476562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

110 (510.93101501465): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294791446 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (610.8283996582): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294791446 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1573.8010406494): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (790.11917114258): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (!!!!! 5889.892578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

115 (!!!!! 1279.8309326172): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

116 (!!!!! 2057.0755004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

117 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

118 (!!!!! 1123.9051818848): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

119 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

120 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

121 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

122 (!!!!! 7889.986038208): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 163933.03871155): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (!!!!! 4310.8463287354): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294791446 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294791446 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7870.9125518799): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 7842.0639038086): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (!!!!! 11661.052703857): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (!!!!! 5098.1044769287): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (!!!!! 3666.877746582): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (!!!!! 1542.0913696289): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (697.13592529297): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (293.01643371582): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (267.02880859375): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (44.107437133789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 1770.9732055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (690.93704223633): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (214.81513977051): SELECT name FROM jos_deeppockets WHERE id=214

138 (145.91217041016): SELECT name FROM jos_deeppockets WHERE id=214

139 (!!!!! 1022.1004486084): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (950.81329345703): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (831.84242248535): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

142 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

143 (!!!!! 17760.038375854): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 4909.0385437012): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294791446 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (177.14500427246): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294791446 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 8237.1234893799): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (226.97448730469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (342.84591674805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

149 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

150 (!!!!! 2907.0377349854): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (!!!!! 1470.0889587402): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

152 (!!!!! 1579.0462493896): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

153 (805.85479736328): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294791446 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294791446 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 1176.8341064453): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

155 (333.07075500488): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

156 (!!!!! 3697.1569061279): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 2291.9178009033): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

158 (!!!!! 1267.9100036621): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294791446 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294791446 AND published='1' LIMIT 1

159 (!!!!! 1098.1559753418): select jos_twitters.link from jos_twitters where cat=10

160 (454.90264892578): select jos_facebook.link from jos_facebook where cat=10

161 (329.01763916016): select jos_google_plus.link from jos_google_plus where cat=10

162 (127.07710266113): select jos_linkedin.link from jos_linkedin where cat=10

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