Ruth L Chimenti1, Peter C Chimenti2, Mark R Buckley3, Jeff R Houck4, A Samuel Flemister2. 1. Department of Biomedical Engineering, University of Rochester, Rochester, NY. Electronic address: ruth-chimenti@uiowa.edu. 2. Department of Orthopedic Surgery, University of Rochester, Rochester, NY. 3. Department of Biomedical Engineering, University of Rochester, Rochester, NY. 4. Doctor of Physical Therapy program, George Fox University, Newberg, OR.
Abstract
OBJECTIVES: To examine (1) the validity of ultrasound imaging to measure osteophytes and (2) the association between osteophytes and insertional Achilles tendinopathy (IAT). DESIGN: Case-control study. SETTING: Academic medical center. PARTICIPANTS: Persons with chronic unilateral IAT (n=20; mean age, 58.7±8.3y; 10 [50%] women) and age- and sex-matched controls (n=20; mean age, 57.4±9.8y; 10 [50%] women) participated in this case-control study (N=40). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Symptom severity was assessed using the Foot and Ankle Ability Measure, the Victorian Institute of Sport Assessment-Achilles questionnaire, and the numerical rating scale. Length of osteophytes was measured bilaterally in both groups using ultrasound imaging, as well as on the symptomatic side of the IAT group using radiography. The intraclass correlation coefficient was used to examine the agreement between ultrasound and radiograph measures. McNemar, Wilcoxon signed-rank, and Fisher exact tests were used to compare the frequency and length of osteophytes between sides and groups. Pearson correlation was used to examine the association between osteophyte length and symptom severity. RESULTS: There was good agreement (intraclass correlation coefficient, ≥.75) between ultrasound and radiograph osteophyte measures. There were no statistically significant differences (P>.05) in the frequency of osteophytes between sides or groups. Osteophytes were larger on the symptomatic side of the IAT group than on the asymptomatic side (P=.01) and on the left side of controls (P=.03). There was no association between osteophyte length and symptom severity. CONCLUSIONS: Ultrasound imaging is a valid measure of osteophyte length, which is associated with IAT. Although a larger osteophyte indicates tendinopathy, it does not indicate more severe IAT symptoms.
OBJECTIVES: To examine (1) the validity of ultrasound imaging to measure osteophytes and (2) the association between osteophytes and insertional Achilles tendinopathy (IAT). DESIGN: Case-control study. SETTING: Academic medical center. PARTICIPANTS: Persons with chronic unilateral IAT (n=20; mean age, 58.7±8.3y; 10 [50%] women) and age- and sex-matched controls (n=20; mean age, 57.4±9.8y; 10 [50%] women) participated in this case-control study (N=40). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Symptom severity was assessed using the Foot and Ankle Ability Measure, the Victorian Institute of Sport Assessment-Achilles questionnaire, and the numerical rating scale. Length of osteophytes was measured bilaterally in both groups using ultrasound imaging, as well as on the symptomatic side of the IAT group using radiography. The intraclass correlation coefficient was used to examine the agreement between ultrasound and radiograph measures. McNemar, Wilcoxon signed-rank, and Fisher exact tests were used to compare the frequency and length of osteophytes between sides and groups. Pearson correlation was used to examine the association between osteophyte length and symptom severity. RESULTS: There was good agreement (intraclass correlation coefficient, ≥.75) between ultrasound and radiograph osteophyte measures. There were no statistically significant differences (P>.05) in the frequency of osteophytes between sides or groups. Osteophytes were larger on the symptomatic side of the IAT group than on the asymptomatic side (P=.01) and on the left side of controls (P=.03). There was no association between osteophyte length and symptom severity. CONCLUSIONS: Ultrasound imaging is a valid measure of osteophyte length, which is associated with IAT. Although a larger osteophyte indicates tendinopathy, it does not indicate more severe IAT symptoms.
Authors: J M Robinson; J L Cook; C Purdam; P J Visentini; J Ross; N Maffulli; J E Taunton; K M Khan Journal: Br J Sports Med Date: 2001-10 Impact factor: 13.800
Authors: Ruth L Chimenti; Adolph S Flemister; Joshua Tome; James M McMahon; Marie A Flannery; Ying Xue; Jeff R Houck Journal: J Orthop Sports Phys Ther Date: 2014-08-07 Impact factor: 4.751
Authors: Ruth L Chimenti; Mary Bucklin; Meghan Kelly; John Ketz; Adolph Samuel Flemister; Michael S Richards; Mark R Buckley Journal: J Orthop Res Date: 2016-06-23 Impact factor: 3.494
Authors: Ibrahima Bah; Ninoshka R J Fernandes; Ruth L Chimenti; John Ketz; A Samuel Flemister; Mark R Buckley Journal: J Mech Behav Biomed Mater Date: 2020-08-19
Authors: Jennifer A Zellers; Bradley C Bley; Ryan T Pohlig; Nabeel Hamdan Alghamdi; Karin Grävare Silbernagel Journal: Int J Sports Phys Ther Date: 2019-09