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Achilles tendon and ultrasound

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
Yu-Hong Shao, Ze Peng, Xun Kong, Bin Wang, Hui Zhang
OBJECTIVE: This study aims to evaluate the Achilles tendon's properties after rehabilitation training in patients with stroke using real-time ultrasound elastography. METHODS: A total of 24 patients with mild hemiplegic stroke in the past 6 to 12 months and unilateral lower limb movement disorder were prospectively enrolled. All patients accepted 9-week rehabilitation training with the same schema. The 2-dimensional elastography and real-time elastography findings in the impaired and contralateral normal Achilles tendon were measured at pretraining and at 3, 6, and 9 weeks after training, which included tendon length, thickness, elasticity score (grade 1-3), and strain ratio of fat to tendon...
October 2, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
J Benjamin Jackson, Christopher H Chu, Kevin A Williams, Paul H Bornemann
Tendinopathy of the foot and ankle is common and can lead to pain or functional limitations. The most frequently affected tendons in the foot and ankle are the posterior tibial, peroneal, and Achilles. We used ultrasound to determine normal values for these tendons. From 2015 to 2016, a prospective, standardized bilateral lower extremity ultrasound examination protocol was performed by a musculoskeletal ultrasonographer of the 4 tendons and above and below the malleoli as appropriate. A total of 199 patients with 398 extremities were identified, consented, and participated in the study...
September 28, 2018: Foot & Ankle Specialist
Kenton L Hagan, Todd J Hullfish, Ellen Casey, Josh R Baxter
Achilles tendinopathy is ten-times more common amongst running athletes compared to age-matched peers. Load induced tendon remodeling and its progression in an at-risk population of developing symptomatic tendinopathy is not well understood. The purpose of this study was to prospectively characterize Achilles and patellar tendon structure in competitive collegiate distance runners over different competitive seasons using quantitative ultrasound imaging. Twenty-two collegiate cross country runners and eleven controls were examined for this study...
September 27, 2018: Journal of Applied Physiology
Neal Washburn, Kentaro Onishi, James H-C Wang
Ultrasound elastography (UE) and ultrasound tissue characterisation (UTC) are two newer modes of ultrasound (US) which have begun to attract scientific interests as ways to improve tendon characterisation. These modes of US show early promise in improved diagnostic accuracy, prediction of at-risk tendons and prognostication capability beyond conventional grey-scale US. Here, we provide a review of the literature on UE and UTC for Achilles, patellar and rotator cuff tendons. The translational potential of this article: The present literature indicates that UE and UTC could potentially increase the clinician's ability to accurately diagnose the extent of tendon pathology, including preclinical injury...
October 2018: Journal of Orthopaedic Translation
L Paša, J Kužma, R Herůfek, J Prokeš, A Šprláková-Puková
INTRODUCTION The authors evaluate the results of endoscopic treatment and analyse the causes of persisting difficulties in retrocalcaneal bursitis unresponsive to conservative treatment. Stated as one of the causes is the possible chronic irritation of minor/partial tears of anterior parts of the distal portion of the Achilles tendon, which have no chance to heal due to continued overload and impingement syndrome of the superior prominence of the calcaneal tubercle. MATERIAL AND METHODS The authors evaluate the group of 24 patients (10 women and 14 men) diagnosed with retrocalcaneal bursitis, who reported more than 12 months of difficulties and in whom the conservative therapy options have already been exhausted...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Thomas W Kernozek, Allie Knaus, Tess Rademaker, Thomas G Almonroeder
BACKGROUND: Female runners that habitually use a forefoot/midfoot strike pattern (non-rearfoot runners) may be at greater risk for Achilles tendinopathy compared to runners that habitually use a rearfoot strike pattern. Differences in Achilles tendon loading between non-rearfoot and rearfoot strike runners may be a contributing factor. RESEARCH QUESTION: Our purpose was to determine if there were differences in Achilles tendon loading and cross-sectional area between female habitual rearfoot and non-rearfoot strike runners...
October 2018: Gait & Posture
Michal Marek Woyton, Stefan Kluzek, Thamindu Wedatilake, Madeleine A M Davies
This case presents symptom resolution for a long-distance runner with chronic Achilles tendinopathy (AT), following a partial tear of his Achilles tendon. The patient reported a sudden pain during a morning run, with preserved function. Three hours postinjury, he was reviewed in a musculoskeletal clinic. An ultrasound scan confirmed a partial Achilles tear, associated with significant Doppler activity. His index of AT severity The Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A) 4 hours postinjury was markedly higher compared with 2 weeks preinjury, indicating reduced symptom severity...
September 19, 2018: BMJ Case Reports
Laura Chernak Slane, Félix Dandois, Stijn Bogaerts, Hilde Vandenneucker, Lennart Scheys
There is increasing evidence that tendons are heterogeneous and take advantage of structural mechanisms to enhance performance and reduce injury. Fascicle-sliding, for example, is used by energy-storing tendons to enable them to undergo large extensions while protecting the fascicles from damage. Reductions in fascicle-sliding capacity may thus predispose certain populations to tendinopathy. Evidence from the Achilles tendon of significant superficial-to-deep non-uniformity that is reduced with age supports this theory...
August 23, 2018: Journal of Biomechanics
Vickie B Shim, Geoff G Handsfield, Justin W Fernandez, David G Lloyd, Thor F Besier
The Achilles tendon (AT), the largest tendon in the human body has a unique structural feature, that is the fascicles in the AT display spiral twist. However, their functional and structural roles are still unclear. We used subject-specific computational models and tissue mechanical experiment to quantitatively characterize the role of fascicle twist in the Achilles tendon. Ten subject-specific finite element (FE) models of the Achilles tendon were developed from ultrasound images. Fascicle twist was implemented in these models using the material coordinate system available in our FE framework...
September 14, 2018: Scientific Reports
Kamal Mezian, Ayşe Merve Ata, Murat Kara, Şule Şahin Onat, Eda Gürçay, Aslı Çalışkan, Maria Ines Taboas Simoes, Ayşen Akıncı, Levent Özçakar, Franco Franchignoni
BACKGROUND: Specific attention on the musculoskeletal impact of wearing high-heeled shoes (HHS) has mainly focused on knee osteoarthritis and the literature is limited to biomechanical changes. Herewith, the distal femoral cartilage (DFC) has not been morphologically studied. Additionally, although heel elevation is coupled with a shear stress at the heel and overloaded calf muscles, Achilles tendon and plantar fascia thicknesses have not been assessed either. OBJECTIVE: To investigate whether the DFC, Achilles tendon (AT), and plantar fascia (PF) were different in women wearing HHS and flat-heeled shoes (FHS) and specifically, different in terms of AT/PF and DFC thicknesses...
September 11, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Matthew D Johnson, Diego Rafael Sobrino, Daniel Dean Lewis, Justin Shmalberg
A three-and-a-half-year-old neutered male Standard Schnauzer presented with a 5-week history of inability to bear full weight on the right pelvic limb following a traumatic injury to the right stifle. Clinical, radiographic, and ultrasound findings were consistent with a proximal patellar tendon rupture with a distal patellar avulsion fragment. A proprietary Achilles repair jig system was used to reattach the patellar tendon to the patella, allowing for direct approximation of the tissues. The primary repair was supported with a protective patella-to-tibia suture, and the dog was fitted with an orthosis to restrict range of motion of the stifle...
2018: Open Veterinary Journal
Rui Prado-Costa, João Rebelo, João Monteiro-Barroso, Ana Sofia Preto
Ultrasound elastography (USE) is a recent technology that has experienced major developments in the past two decades. The assessment of the main mechanical properties of tissues can be made with this technology by characterisation of their response to stress. This article reviews the two major techniques used in musculoskeletal elastography, compression elastography (CE) and shear-wave elastography (SWE), and evaluates the studies published on major electronic databases that use both techniques in the context of tendon pathology...
August 17, 2018: Insights Into Imaging
Sean I Docking, Ebonie Rio, Jill Cook, David Carey, Lauren Fortington
BACKGROUND: Tendon pathology on imaging has been associated with an increased risk of developing symptoms. This evidence is based on classifying the tendon as normal or pathological. It is unclear whether the extent of tendon pathology is associated with the development or severity of symptoms. OBJECTIVES: To investigate whether the presence and extent of tendon pathology on ultrasound tissue characterisation (UTC), or a previous history of symptoms, were associated with the development of symptoms over a football season...
July 27, 2018: Journal of Science and Medicine in Sport
Jared R Fletcher, Brian R MacIntosh
During prolonged running, the magnitude of Achilles tendon (AT) length change may increase, resulting in increased tendon strain energy return with each step. AT elongation might also affect the magnitude of triceps surae (TS) muscle shortening and shortening velocity, requiring greater activation and increased muscle energy cost. Therefore, we aimed to quantify the tendon strain energy return and muscle energy cost necessary to allow energy storage to occur prior to and following prolonged running. 14 trained male (n = 10) and female (n = 4) distance runners (24±4 years, 1...
2018: PloS One
Sean I Docking, Michael A Girdwood, Jill Cook, Lauren V Fortington, Ebonie Rio
OBJECTIVE: To investigate whether the mean cross-sectional area (mCSA) of aligned fibrillar structure (AFS) was associated with the presence and severity of symptoms. DESIGN: Prospective cohort study. PARTICIPANTS: One hundred seventy-five elite male Australian football players completed monthly Oslo Sports Trauma Research Center overuse injury questionnaires for both the Achilles and patellar tendon over the season to ascertain the presence and severity of symptoms...
July 31, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
William H Clark, Jason R Franz
The human Achilles tendon (AT) consists of sub-tendons arising from the gastrocnemius and soleus muscles that exhibit non-uniform tissue displacements thought to facilitate some independent actuation. However, the mechanisms governing non-uniform displacement patterns within the AT, and their relevance to triceps surae muscle contractile dynamics, have remained elusive. We used a dual-probe ultrasound imaging approach to investigate triceps surae muscle dynamics (i.e., medial gastrocnemius-GAS, soleus-SOL) as a determinant of non-uniform tendon tissue displacements in the human AT...
2018: PeerJ
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