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Achilles tendon and ultrasound

Olivier C Dams, Inge van den Akker-Scheek, Ron L Diercks, Klaus W Wendt, Eelke Bosma, Tom M van Raaij, Arvid V Munzebrock, Wierd P Zijlstra, Johannes Zwerver, Inge H F Reininga
BACKGROUND: Achilles tendon rupture (ATR) is a common sports injury, with a rising incidence and significant impairments. Due to the lack of treatment guidelines, there is no consensus about diagnostic methods, primary treatment (non-surgical or surgical) and rehabilitation. It is hypothesized that this lack of consensus and guidelines leads to sub-optimal recovery and higher societal costs. The primary aim of this study is to give a broad insight into the recovery after ATR. Secondarily this study aims to explore factors contributing to recovery and gain insight into the cost-effectiveness of ATR management...
February 11, 2019: BMC Musculoskeletal Disorders
Andrea Santamato, Raffaele Beatrice, Maria Francesca Micello, Francesca Fortunato, Francesco Panza, Christos Bristogiannis, Elsa Cleopazzo, Luca Macarini, Alessandro Picelli, Alessio Baricich, Maurizio Ranieri
Extracorporeal shock wave therapy (ESWT) has been found to have a positive effect in the treatment of pain in Achilles tendinopathy, although the exact mechanism is not yet completely understood. Among the mechanisms suggested to underlie ESWT effects are direct stimulation of healing, neovascularization and direct suppressive effects on nociceptors and hyperstimulation, which would block the gate-control system. The neovascularization observed in flogistic tissue is associated with stimulated nerve fibers around tendons and induces a painful condition...
February 7, 2019: Ultrasound in Medicine & Biology
Timm Dirrichs, Simone Schrading, Matthias Gatz, Markus Tingart, Christiane K Kuhl, Valentin Quack
RATIONALE AND OBJECTIVES: It has been shown that Shear Wave Elastography (SWE) is a useful tool to evaluate tendon stiffness, e.g. in diagnosing tendinopathies, as diseased or injured tendons are intra-individually softer than healthy ones. But reference values between different population groups are still missing. The purpose of this prospective clinical study was two-fold: First, to comparatively analyse Achilles tendon stiffness between asymptomatic semiprofessional athletes and an asymptomatic nonathletic control group...
January 14, 2019: Academic Radiology
Jørgen Guldberg-Møller, Lene Terslev, Sabrina M Nielsen, Merete Juhl Kønig, Søren T Torp-Pedersen, Arendse Torp-Pedersen, Robin Christensen, Henning Bliddal, Karen Ellegaard
OBJECTIVES: Ultrasound (US) examination of the entheses is increasingly used. However, little is known about US findings in the entheses in asymptomatic persons. The aim of this study was to investigate the appearance of US signs in the enthuses of the lower limb in asymptomatic subjects. METHODS: We recruited 64 subjects, eight women and eight men whose ages covered four decades, from 20 to 60 years. None had tendon or joint disease in the lower limbs. Participants were examined by a rheumatologist and blood samples were collected to rule out enthesis pathology...
December 19, 2018: Clinical and Experimental Rheumatology
Federica Rossi, Federico Zaottini, Riccardo Picasso, Carlo Martinoli, Alberto Stefano Tagliafico
OBJECTIVES: In sonography of clinically relevant small structures of the ankle and foot, the healthy contralateral side can be used as a reference to identify subtle abnormalities. Intrasubject side-to-side variability must be minimal. The aim of this study was to assess the reliability of side-to-side sonographic evaluation of small structures of the ankle and foot. METHODS: Thirty healthy volunteers were prospectively studied. Small structures of the ankle and foot were evaluated bilaterally by 2 musculoskeletal radiologists in separate sessions...
December 28, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Håkan Alfredson, Lorenzo Masci, Christoph Spang
Objectives: Surgical removal of the plantaris tendon can cure plantaris-associated Achilles tendinopathy, a condition in which Achilles and plantaris tendinopathy coexist. However, rare cases with plantaris tendinopathy alone are often misdiagnosed due to a normal Achilles tendon. Design and setting: Prospective case series study at one centre. Participants: Ten consecutive patients (9 men and one woman, mean age 35 years, range 19-67) with plantaris tendon-related pain alone in altogether 13 tendons were included...
2018: BMJ Open Sport & Exercise Medicine
Carlos Romero-Morales, Pedro Javier Martín-Llantino, César Calvo-Lobo, Patricia Palomo-López, Daniel López-López, Helios Pareja-Galeano, David Rodríguez-Sanz
AIM: The aim of the present study was to evaluate and quantify with ultrasound imaging (USI) the Achilles tendon thickness, cross-sectional area (CSA), Kager's fat pad length and gastrocnemius-soleus pennation angle (PA) between chronic mid-portion Achilles tendinopathy (AT) and healthy subjects. METHODS: A total sample of 143 individuals (age: 41.3 ± 12.0 y; height: 1.74 ± 0.0 m; weight: 75.0 ± 11.4 kg; body mass index, BMI: 24.4 ± 2.6 kg/m2 ) was recruited and divided in two groups: chronic mid-portion AT group (n = 71) and a healthy group (n = 72)...
January 2019: Physical Therapy in Sport
Lei Zhang, Qiang Yong, Tianning Pu, Chao Zheng, Mingyue Wang, Sujun Shi, Liang Li
OBJECTIVE: To investigate the feasibility of grayscale ultrasound and quantitative shear wave elastography (SWE) for assessing the image features and stiffness of the Achilles tendon in patients with familial hypercholesterolemia (FH) compared with healthy controls. METHODS: A total of 38 Achilles tendons from healthy control participants and 94 from patients with FH were examined with grayscale ultrasound and SWE. Each Achilles tendon examination was performed on 3 different segments (proximal, middle, and distal)...
December 2018: European Journal of Radiology
Alex Scott, Thomas Michael Zahradnik, Kipling Squier, Charlotte Beck, Liam R Brunham
BACKGROUND: Achilles tendon xanthoma (ATX) results from tendon thickening and subclinical inflammation triggered by hypercholesterolemia, and is associated with more severe coronary artery disease and a higher risk of cardiovascular events. The ability to detect ATX by clinical examination is limited, and diagnostic imaging, for instance, using ultrasonography or magnetic resonance imagine (MRI), may improve the identification of ATX. However, the accuracy of ultrasound (US) imaging or MRI in identifying ATX in people with familial hypercholesterolemia (FH) has not been systematically reviewed...
November 7, 2018: Journal of Clinical Lipidology
Muhammad Salman, Karim G Sabra
Currently, noninvasive cost-effective techniques capable of quantifying non-uniform degradation of tendon's mechanical and structural properties associated with localized tendon injuries are not readily available. This study demonstrates the applicability of a simple surface-wave elastography (SURF-E) method for assessing the stiffness of the Achilles Tendon by measuring the propagation velocity of surface waves along the tendon in a much broader range of values than currently available Ultrasound-based or MRI-based elastography methods do...
November 15, 2018: Journal of Biomechanics
Y N Feng, Y P Li, C L Liu, Z J Zhang
The purposes of this study were to compare Young's modulus values determined by shear wave ultrasound elastography (SWUE) with stiffness index obtained using a hand-held MyotonPRO device on the resting stiffness of gastrocnemius muscle belly and Achilles tendon; and to examine the test-retest reliability of those stiffness measurement using hand-held MyotonPRO. Twenty healthy volunteers participated in the study. The measurement values of muscle and tendon was determined in dominant legs. Each marker point was assessed using MyotonPRO and SWUE, respectively...
November 20, 2018: Scientific Reports
Daniel Wadsack, Horst Sattler, Marcus E Kleber, Katharina Eirich, Hubert Scharnagl, Günter Fauler, Winfried März, Tanja B Grammer
A 33-year-old female had suffered from spontaneously recurrent bursitis and tendosynovitis/enthesitis of the patellar and Achilles tendons for about 10 years. The episodes of immobilization increased. Ultrasound imaging of the swollen and painful tendons showed chronic inflammation with neoangiogenesis within the tendons and hypoechoic lesions. Clinical and laboratory tests did not provide evidence for a rheumatic disease. Low density lipoprotein cholesterol was elevated. Biopsies of skin lesions did not confirm the suspicion of cutaneous xanthomas...
October 24, 2018: Journal of Clinical Lipidology
Vickie B Shim, Wencke Hansen, Richard Newsham-West, Leila Nuri, Steven Obst, Claudio Pizzolato, David G Lloyd, Rod S Barrett
Achilles tendon material properties and geometry are altered in Achilles tendinopathy. The purpose of this study was to determine the relative contributions of altered material properties and geometry to free Achilles tendon stress distribution during a sub-maximal contraction in tendinopathic relative to healthy tendons. Tendinopathic (n = 8) and healthy tendons (n = 8) were imaged at rest and during a sub-maximal voluntary isometric contraction using three-dimensional freehand ultrasound. Images were manually segmented and used to create subject-specific finite element models...
October 28, 2018: Journal of Biomechanics
Jason R Franz, Ashish Khanchandani, Hannah McKenny, William H Clark
In this combined in vivo and computational modeling study, we tested the central hypothesis that ankle joint rotation and triceps surae muscle loading have independent and combinatory effects on the calcaneal (i.e., Achilles) tendon moment arm (CTma) that are not fully captured in contemporary musculoskeletal models of human movement. We used motion capture guided ultrasound imaging to estimate instantaneous variations in the CTma during a series of isometric and isotonic contractions compared to predictions from scaled, lower extremity computational models...
November 1, 2018: Annals of Biomedical Engineering
Michele Abate, Vincenzo Salini
INTRODUCTION: Running is a very popular modality of physical activity, which may help to lose weight and normalize pathological values of blood parameters in subjects suffering from metabolic disorders. Given that both overuse and metabolic pathologies are responsible for the onset of tendon damage, aim of the present study was to evaluate whether the first group of pathogenetic factors or the latter was more responsible for mid-portion Achilles tendinopathy. METHOD: Thirty-six and 28 subjects with and without mid-portion Achilles tendinopathy, who were regular runners and started running for metabolic disorders, were enrolled, respectively...
October 26, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Xi Xiang, Qianying Leng, Yuanjiao Tang, Liyun Wang, Jianbo Huang, Yi Zhang, Li Qiu
Ultrasound-targeted microbubble destruction (UTMD), which has been successfully used for the treatment of many diseases, offers a promising noninvasive approach for target-specific gene delivery. This study investigated the UTMD delivery of insulin-like growth factor 1 (IGF-1) cDNA and transforming growth factor beta (TGF-β) short hairpin RNA for Achilles tendon injury in rats. Briefly, 168 rats with an injured Achilles tendon were randomly divided into seven groups: (1) IGF-1 + UTMD, (2) TGF-β + UTMD, (3) IGF-1 + TGF-β + UTMD, (4) control, (5) IGF-1, (6) TGF-β, and (7) IGF-1 + TGF-β...
October 25, 2018: Human Gene Therapy. Clinical Development
Stephanie Tom, Yujie Zhong, Richard Cook, Sibel Zehra Aydin, Gurjit Kaeley, Lihi Eder
OBJECTIVE: To assess the performance of various sonographic elemental entheseal lesions in distinguishing between psoriatic arthritis (PsA) and controls to inform the development of a novel sonographic enthesitis score for PsA. METHODS: A total of 100 age- and sex-matched individuals (50 PsA and 50 controls) were evaluated. Eleven entheseal sites were scanned bilaterally according to a standardized protocol by 2 sonographers. Based on the Outcome Measures in Rheumatology (OMERACT) definition of sonographic enthesitis, the following lesions were assessed: structural entheseal changes (hypoechogenicity), thickening, bone erosion, enthesophytes, calcification, and Doppler signal, in addition to bursitis and bone irregularities...
October 15, 2018: Journal of Rheumatology
Justin J Ernat, John D Johnson, Claude D Anderson, Paul M Ryan, Duke G Yim
The purpose of this study was to determine if clinical palpation and ultrasound determination of apposition compares with magnetic resonance imaging (MRI) findings in patients with an acute Achilles tendon rupture. A review of 18 consecutive patients presenting with an acute Achilles tendon tear was performed. All tears were diagnosed by clinical exam and confirmed by ultrasound. Ankles were then plantarflexed to a point where tendon apposition was achieved as determined by palpation and ultrasound. Dorsally based equinus splints were applied, and approximation was reconfirmed by palpation and ultrasound...
October 9, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Finn Johannsen, Signe Jensen, Eva Wetke
Background: Achilles tendinopathy is a common and often long-lasting injury. We present a 10-year follow-up on a pragmatic study on Achilles tendinopathy treated with controlled exercises supplemented with corticosteroid injections if necessary in order to continue training. Methods: All patients who completed the original study (n=93) were invited for a 10-year follow-up. 83% participated. Patients were evaluated with ultrasound scanning (n=58) and with a questionnaire (n=77) using the same outcome measures as in the primary study...
2018: BMJ Open Sport & Exercise Medicine
Emrah Caglar, Ibrahim Ilker Oz, Serkan Guneyli, Muammer Bilici, Fatih Yılmaz, Sevil Uygun Ilikhan, Ali Borazan
PURPOSE: To evaluate the sonoelastographic changes in the Achilles tendon in patients with chronic renal failure (CRF) using virtual touch imaging quantification (VTIQ) elastography. METHODS: Twenty-six patients undergoing three hemodialysis sessions per week and 26 subjects admitted to our institution between January 2016 and April 2016 were included in this prospective study. The characteristics and body mass index of the patients were noted. Ultrasonography was performed parallel to the long axis of the bilateral Achilles tendons during relaxation of the legs using the Siemens Acuson S3000™ ultrasound device (Siemens HealthCare, Erlangen, Germany)...
October 5, 2018: Journal of Medical Ultrasonics
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