Qi Zhang1, Yehua Cai2, Yinghui Hua3, Jun Shi1, Yuanyuan Wang4, Yi Wang5. 1. Institute of Biomedical Engineering, Shanghai University, Shanghai, 200444, China. 2. Department of Ultrasound, Huashan Hospital, Fudan University, No. 12, Urumqi Middle Road, Shanghai, 200438, China. sunnei@msn.com. 3. Department of Sports Medicine, Huashan Hospital, Fudan University, No. 12, Urumqi Middle Road, Shanghai, 200438, China. huayh_huashan@163.com. 4. Department of Electronic Engineering, Fudan University, Shanghai, 200433, China. 5. Department of Ultrasound, Huashan Hospital, Fudan University, No. 12, Urumqi Middle Road, Shanghai, 200438, China.
Abstract
PURPOSE: To seek differences of Achilles tendon hardness between insertional tendinopathy (IT) and asymptomatic controls by using computer-assisted quantification on axial-strain sonoelastography (ASE). METHODS: The study consisted of 37 non-athletic patients presenting with Achilles tendon pain in one or two tendons. Both tendons were examined clinically. Among the 74 tendons, 16 were diagnosed and categorized into an IT group and 29 into an asymptomatic group. The remaining 29 tendons were excluded due to non-insertional tendinopathy, ruptures, previous surgery or mixed disorders. The tendons in the IT and asymptomatic groups were examined with both ASE and conventional ultrasound. Computer-assisted quantification on ASE was conducted to extract parameters of tendon hardness, including the 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, as well as the ratio of the mean hardness within tendon to that outside tendon (Hratio). RESULTS: The H20 (p = 0.003), H50 (p = 0.004) and Hratio (p = 0.002) were larger and Hsk (p = 0.001) was smaller at distal thirds of IT tendons than those of asymptomatic tendons. For differentiation between two groups, the Hsk achieved the best value (0.815) of area under the receiver operating characteristic curve, with a sensitivity of 81.3 %, a specificity of 86.2 % and an accuracy of 84.4 %. CONCLUSIONS: Computer-assisted quantification on ASE shows that IT tendons are harder than asymptomatic tendons. It might act as a potentially useful technique for identification and risk stratification of IT patients and thus be valuable in day-by-day clinical practice for monitoring IT progression and for evaluating therapeutic effects. LEVEL OF EVIDENCE: III.
PURPOSE: To seek differences of Achilles tendon hardness between insertional tendinopathy (IT) and asymptomatic controls by using computer-assisted quantification on axial-strain sonoelastography (ASE). METHODS: The study consisted of 37 non-athletic patients presenting with Achilles tendon pain in one or two tendons. Both tendons were examined clinically. Among the 74 tendons, 16 were diagnosed and categorized into an IT group and 29 into an asymptomatic group. The remaining 29 tendons were excluded due to non-insertional tendinopathy, ruptures, previous surgery or mixed disorders. The tendons in the IT and asymptomatic groups were examined with both ASE and conventional ultrasound. Computer-assisted quantification on ASE was conducted to extract parameters of tendon hardness, including the 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, as well as the ratio of the mean hardness within tendon to that outside tendon (Hratio). RESULTS: The H20 (p = 0.003), H50 (p = 0.004) and Hratio (p = 0.002) were larger and Hsk (p = 0.001) was smaller at distal thirds of IT tendons than those of asymptomatic tendons. For differentiation between two groups, the Hsk achieved the best value (0.815) of area under the receiver operating characteristic curve, with a sensitivity of 81.3 %, a specificity of 86.2 % and an accuracy of 84.4 %. CONCLUSIONS: Computer-assisted quantification on ASE shows that IT tendons are harder than asymptomatic tendons. It might act as a potentially useful technique for identification and risk stratification of ITpatients and thus be valuable in day-by-day clinical practice for monitoring IT progression and for evaluating therapeutic effects. LEVEL OF EVIDENCE: III.
Authors: J I Wiegerinck; G M Kerkhoffs; M N van Sterkenburg; I N Sierevelt; C N van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-10-06 Impact factor: 4.342
Authors: Tobias De Zordo; Christian Fink; Gudrun M Feuchtner; Vinzenz Smekal; Markus Reindl; Andrea Sabine Klauser Journal: AJR Am J Roentgenol Date: 2009-08 Impact factor: 3.959
Authors: T De Zordo; R Chhem; V Smekal; G Feuchtner; M Reindl; C Fink; R Faschingbauer; W Jaschke; A S Klauser Journal: Ultraschall Med Date: 2009-11-27 Impact factor: 6.548