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Variation and correlation of ultrasound measurements in non-insertional achilles tendinopathy |
YANG Yiming1 WANG Baojian2 ZHANG Wei3 ZHANG Xiaoliang4 CHANG Qing4 CHEN Yuefeng2 PAN Xuyue5 MA Yufeng2 |
1.Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China;
2.Department of Muscle Injury(Pain), the Third Affiliated Hospital Beijing University of Chinese Medicine, Beijing 100029, China;
3.Department of Minimally Invasive Joint Surgery, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China;
4.Department of Ultrasound, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China;
5.Department of Foot and Ankle, the Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing 100029, China
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Abstract Objective To investigate the changes and correlation of ultrasound measurements of achilles tendon lesions in patients with non-insertional achilles tendinopathy. Methods A total of 55 patients with non-insertional achilles tendinopathy (NIAT) was NIAT group and 20 healthy adults was lualthy group of achilles tendon in the Third Affiliated Hospital of Beijing University of Chinese Medicine from November 2020 to August 2022 were collected. Musculobone ultrasound (MSK-US) and color Doppler flow imaging (CDFI) were used to measure the thickness and cross-sectional area of the achilles tendon and the thickness of the Kager fat pad in front of the achilles tendon, and the deepening saceffusion of the achilles tendon and the blood flow signals in the achilles tendon were explored, and the changes in the measured values of the Achilles tendon between the two groups were compared. Combined with visual analogue scale (VAS) and American Collgege of Foot and Ankle Surgery (AOFAS) scale, Pearson correlation analysis was used to explore the correlation of ultrasonic performance achilles tendon with VAS and AOFAS scores. Results The achilles tendon thickness, cross-sectional area, Kager fat pad thicknessin NIAT group were higher than those in healthy group, and the detection rate of deep bursae effusion and blood flow signal in NIAT group was higher than that in healthy group, with statistical significance (P<0.05). Achilles tendon thickness and achilles tendon blood flow detection rate were positively correlated with VAS score (r=0.249, 0.334, P<0.05), and blood flow signal was negatively correlated with AOFAS score (r=-0.309, P<0.05). Conclusion Patients with non-insertional achilles tendinopathy may develop lesions of achilles tendon and peri-tendon tissues. The thickness of achilles tendon and the detection rate of blood flow signal in achilles tendon are important indicators to evaluate the condition of achilles tendinopathy. MSK-US and CDFI play an important role in the evaluation of achilles tendinopathy.
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[1] 李守超,高越,曹军英,等.急诊超声在闭合性完全性跟腱断裂诊断中应用价值[J].临床军医杂志,2022,50(8):790-792.
[2] Winnicki K,Ocha?覥a-K?覥os A,Rutowicz B,et al. Functional anatomy,histology and biomechanics of the human Achilles tendon-A comprehensive review [J]. Ann Anat,2020,229:151461.
[3] Nielsen TG,Miller LL,Mygind-Klavsen B,et al. High-volume image-guided injection in the chronic recalcitrant non-insertional patellar tendinopathy:a retrospective case series [J]. J Exp Orthop,2020,7(1):1-6.
[4] Romero-Morales C,Martín-Llantino PJ,Calvo-Lobo C,et al. Vibration increases multifidus cross-sectional area versus cryotherapy added to chronic non-insertional achilles tendin- opathy eccentric exercise [J]. Physical Therapy in Sport,2020, 42:61-67.
[5] 王玉仲,温树正,郝江慧,等.非止点性跟腱病临床治疗策略的研究与分析[J].实用手外科杂志,2018,32(2):210- 214.
[6] Masci L,Spang C,van Schie H,et al. How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy-clinical and imaging findings [J]. BMC Musculoskeletal Disord,2016,17(1):1-6.
[7] 唐康来,徐林.曼氏足踝外科学[M].北京:人民卫生出版社,2015.
[8] Breivik H. Fifty years on the Visual Analogue Scale (VAS) for pain-intensity is still good for acute pain. But multidimensional assessment is needed for chronic pain [J]. Scand J Pain,2016,11:150-152.
[9] Kitaoka HB,Alexander IJ,Adelaar RS,et al. Clinical Rating Systems for the Ankle-Hindfoot,Midfoot,Hallux,and Lesser Toes [J]. Foot Ankle Int,1997,18(3):187-188.
[10] 潘旭月,王梅青,黄法森,等.超声引导下针刀治疗跖间神经瘤的临床研究[J].中国中医骨伤科杂志,2021,29(7):34-38.
[11] Ayyaswamy B,Vaghela M,Alderton E,et al. Early Outcome of a Single Peri-Tendinous Hyaluronic Acid Injection for Mid-Portion Non-Insertional Achilles Tendinopathy-A Pilot Study [J]. The Foot,2021,49:101738.
[12] Wang L,Wen D,Yin Y,et al. Musculoskeletal Ultrasound Image-Based Radiomics for the Diagnosis of Achilles Tendinopathy in Skiers [J]. J Ultrasound Med,2023,42(2): 363-371.
[13] 方建强,朱文峰,李维芝,等.声触诊组织成像量化技术在诊断急性跟腱炎中的应用价值[J].临床超声医学杂志,2017,19(2):99-101.
[14] Romero-Morales C,Martín-Llantino PJ,Calvo-Lobo C,et al. Comparison of the sonographic features of the Achilles Tendon complex in patients with and without achilles tendinopathy:A case-control study [J]. Phys Ther Sport,2019, 35:122-126.
[15] Bakkegaard M,Johannsen FE,H?覬jgaard B,et al. Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy:a prospective observational study [J]. European journal of radiology,2015,84(3):458-462.
[16] 程浩,陆伟萍,高献忠,等.超声引导下高容量注射与冲击波治疗慢性非止点跟腱腱病的比较[J].临床麻醉学杂志,2019,35(12):1201-1204.
[17] Malagelada F,Stephen J,Dalmau-Pastor M,et al. Pressure changes in the Kager fat pad at the extremes of ankle motion suggest a potential role in Achilles tendinopathy[J]. Knee Surg Sports Traumatol Arthrosc,2020,28(1):148-154.
[18] He L,Genin J,Delzell P. Ultrasound diagnosis and percutaneous treatment of Achilles tendon tethering:a case series[J]. Skeletal Radiol,2016,45(9):1293-1298.
[19] Risch L,Cassel M,Messerschmidt J,et al. Is Sonographic Assessment of Intratendinous Blood Flow in Achilles Tend- inopathy Patients Reliable?:Consistency of Doppler Ultrasound Modes and Intra- and Inter-observer Reliability[J]. Ultrasound Int Open,2016,2(1):E13-E18.
[20] Mascarenhas S. A Narrative Review of the Classification and Use of Diagnostic Ultrasound for Conditions of the Achilles Tendon [J]. Diagnostics,2020,10(11):944.
[21] 龚海燕,杨雅婷,王平.超声在跟腱疾病诊疗中的应用进展[J].临床超声医学杂志,2021,23(7):533-536.
[22] Sunding K,Fahlstr?觟m M,Werner S,et al. Evaluation of Achilles and patellar tendinopathy with greyscale ultrasound and colour Doppler:using a four-grade scale[J]. Knee Surg Sports Traumatol Arthrosc,2016,24(6):1988- 1996.
[23] Vlist AC,Veen JM,Oosterom RF,et al. Ultrasound Doppler Flow in Patients With Chronic Midportion Achilles Tendin- opathy:Is Surface Area Quantification a Reliable Method? [J]. J Ultrasound Med,2019,39(4):731-739.
[24] Mahlfeld K,Kayser R,Mahlfeld A,et al. Value of ultrasound in diagnosis of bursopathies in the area of the Achilles tendon [J]. Ultraschall Med,2001,22(2):87-90.
[25] Vinod KK,Sujai S,Siddalingaswamy MK. Surgical management of refractory retro-calcaneal bursitis evaluation of its results [J]. Journal of Evolution of Medical and Dental Sciences,2015,4(50):8712-8716.
[26]] Corrigan P,Hornsby S,Pohlig RT,et al. Tendon loading in runners with Achilles tendinopathy:Relations to pain,structure,and function during return-to-sport [J]. Scand J Med Sci Sports,2022,32(8):1201-1212.
[27] Demir Benli M,Tatari H,Balc?覦 A,et al. A comparison between the efficacy of eccentric exercise and extracorporeal shock wave therapy on tendon thickness,vascularity,and elasticity in Achilles tendinopathy:A randomized controlled trial [J]. T J Phys Med Rehabil,2022,68(3):372-380. |
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