A soft patellar tendon on ultrasound elastography is associated with pain and functional deficit in volleyball players

Ooi, Chin-Chin; Richards, Paula J.; Maffulli, Nicola; Ede, David; Schneider, Michal; Connell, David; Morrissey, Dylan; Malliaras, Peter

doi:10.1016/j.jsams.2015.06.003

Cited by 57 publications

(63 citation statements)

References 30 publications

(33 reference statements)

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“…The high prevalence of subclinical tendinopathy and structural tendon abnormalities in the non-dominant side of the investigated group of thrower players can be related to the repetitive overload of the non-dominant lower limb: in fact, the throwing performance of these players is similar to that of javelin throwers who commonly present both subclinical and clinical patellar tendinopathy. Patellar tendinopathy is commonly evaluated through the ultrasonographic assessment of localized tendon thickening, presence of hypoechoic areas, and altered vascularity 8,13,17 . The two approaches (qualitative and quantitative) we adopted to evaluate the patellar tendons of throwers enabled to assess all these ultrasonographic features: tendon size, tendon echogenicity, and tendon vascularity.…”

Section: Discussionmentioning

confidence: 99%

Quantitative analysis of patellar tendon size and structure in asymptomatic professional players: sonographic study

Giacchino

Caresio

Gorji

et al. 2017

MLTJ

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SummaryBackground: Ultrasonographic abnormalities of the patellar tendon frequently occur in asymptomatic athletes and it is not always clear whether they precede (and may predict) the development of tendinopathy. Objective: This study aimed to investigate by ultrasonography the prevalence of patellar tendon abnormalities in players of "pallapugno" and to establish whether structural tendon abnormalities predict tendinopathy development. Methods: Ultrasound B-mode images of the patellar tendon of both sides were acquired in fourteen throwers. Qualitative assessments of tendon structure and neovascularization and quantitative assessments of tendon thickness, cross sectional area (CSA), and echo-intensity were performed. Results: Qualitative assessments showed a subclinical tendinopathy of the non-dominant tendon in 5 out of 14 throwers (35% of cases), while quantitative assessments showed abnormalities of the nondominant tendon in 8 out of 14 players (57% of cases). Echo-intensity and CSA were the quantitative variables most discriminant between asymptomatic players without structural tendon abnormalities and those with tendon abnormalities. Two players (2 out of 8 cases: 25%) developed a clinical tendinopathy after a follow-up of six months. Conclusion: The prevalence of subclinical tendinopathy in the non-dominant patellar tendon of throwers was high. Patellar tendon abnormalities at baseline seem to increase the risk of development of subsequent patellar tendinopathy. Level of evidence: II b (individual cohort study).

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Section: Discussionmentioning

confidence: 99%

Quantitative analysis of patellar tendon size and structure in asymptomatic professional players: sonographic study

Giacchino

Caresio

Gorji

et al. 2017

MLTJ

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“…Ooi et al analyzed the patellar tendon as two groups -hard and soft -in their prospective study [20]. In the present study, we used four types of elasticity pattern, as detailed in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Real-time sonoelastography of the patellar and quadriceps tendons: pattern description in profesional athletes and healthy volunteers.

et al. 2016

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Aims: The comparison of elastographic features of quadriceps and patellar tendons in a group of professional athletes and healthy volunteers and the description of elasticity characteristics of these tendons. Material and methods: Thirtynine professional athletes (22 male, 17 female; mean age 18.5 years) and 35 healthy volunteers (21 male, 14 female; mean age 19 years) were included. They were divided into two groups by gender. Quadriceps tendon, patellar side of the patellar tendon, and tibial side of the patellar tendon elasticity patterns and strain ratios were investigated with real-time ultrasound elastography. The elasticity features of the dominant leg and non-dominant leg of athletes and volunteers legs were compared. In addition quadriceps and patellar tendons were compared separately for three distinct tendon locations. Results: There was no difference between the athletes and the healthy volunteers and also between the dominant leg and non-dominant leg of athletes. At tendon comparison, the quadriceps tendon was harder than the patellar tendon at both side and patellar side of patellar tendon was found to be stiffer than the tibial side of patellar tendon. Conclusions: Although biomechanical studies showed that tendon stiffness increased after long exercise, no significant difference was found between athletes' and healthy volunteers' tendon elasticity. These three tendon locations exhibit different elasticity features and the knowledge of the elasticity feature will be useful in assessing tendon pathologies.

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“…Moreover, symptomatic tendons were also thicker and had lower clinical score 49 that closely correlated with SE values 27 . The combination of US and SE achieved higher sensitivity and accuracy, but a lower specificity than the combination of Doppler and US 49 . However, when SE was coupled with US and Doppler, the diagnostic accuracy reached 100% 27 .…”

Section: Patellar Ad Quadriceps Tendonsmentioning

confidence: 79%

“…Despite these results, the role of SE as a predictive screening test for tendon rupture is still debated and the evidence is not sufficient. We are confident that future developments will be able to increase our ability in identifying tendon abnormalities and in predicting tendon ruptures, especially in athletes 27,49,58 . Similarly, many Authors agree that SE is a valuable tool in recognizing tendon abnormalities and in implementing the information available with US 17,28,31,49,62 .…”

Section: Discussionmentioning

confidence: 97%

Real-time sonoelastography: principles and clinical applications in tendon disorders.

Fusini

Langella

Busilacchi

et al. 2017

MLTJ

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SummaryBackground: Sonoelastography (SE) is a new ultrasound-based method adopted in an increased number of scientific reports to analyse normal and pathological tendons. The aim of this study is to provide a systematic overview of clinical applications of SE in normal and pathological tendons. Methods: A systematic research of PubMed, Ovid, and Cochrane Library electronic databases was performed according to PRISMA guideline. Two Authors searched and evaluated the articles independently; a third Author was involved to solve any disagreement. The Oxford Level of Evidence (LoE) was used to assess each article. Results. There is an increasing interest in the application of SE in the evaluation of healthy and diseased tendons. Many different tendons are amenable for SE evaluation, such as the Achilles and patellar tendons, rotator cuff, common extensor tendons, quadriceps tendon, and the plantar fascia.Conclusion. SE appears to be a very useful diagnostic tool, in particular in tendon pathology. This is a dynamic examination, provides an immediate evaluation of the tissue elasticity, and may be useful in recognizing tendon abnormalities and in implementing the information available with conventional US. Level of evidence: IV.

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A soft patellar tendon on ultrasound elastography is associated with pain and functional deficit in volleyball players

Cited by 57 publications

References 30 publications

Quantitative analysis of patellar tendon size and structure in asymptomatic professional players: sonographic study

Quantitative analysis of patellar tendon size and structure in asymptomatic professional players: sonographic study

Real-time sonoelastography of the patellar and quadriceps tendons: pattern description in profesional athletes and healthy volunteers.

Real-time sonoelastography: principles and clinical applications in tendon disorders.

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