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Achilles tendon and ultrasound

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
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...
October 26, 2018: Journal of Biomechanics
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