Current Concepts Review: Acute Ruptures of the Achilles Tendon

Chiodo, Christopher P.; Wilson, Michael G.

doi:10.1177/107110070602700415

Cited by 74 publications

(61 citation statements)

References 95 publications

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“…Delays in treatment result from decreased pain after the initial injury and misdiagnosis by the first evaluator in as much as 20% to 36% of patients [1,4,8,10,12,14,15,17,19]. These delays reportedly compromise the end clinical result [4,5,7,18,21,22].…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of acute Achilles ruptures is based on clinical findings; imaging generally is not indicated except in cases of equivocal examination findings [4,6,8,10,12,14,17,20]. In this study, we retrospectively reviewed patient records to determine the sensitivity of our physical examination criteria, compare it with reported MRI sensitivity and our own, and determine if obtaining MRI led to delays in diagnosis and treatment and their implications.…”

Section: Discussionmentioning

confidence: 99%

“…Delay in treatment, whether operative or nonoperative, reportedly has detrimental effects on the final outcomes [4,5,7,18,21,22]. Therefore, it is important to accurately diagnose an acute injury and begin the treatment early.…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of Achilles ruptures is estimated to be 18 per 100,000 and has been steadily increasing during the past few decades [4,6,[10][11][12]20]. Achilles ruptures currently account for approximately 40% of all operative tendon repairs [10].…”

Section: Introductionmentioning

confidence: 99%

“…Diagnosis of acute Achilles tendon ruptures most often is based on clinical criteria [4,6,8,10,12,14,17,20]. Various physical examination techniques have been described to this end [4, 8, 12-15, 17, 19, 24, 25].…”

Section: Introductionmentioning

confidence: 99%

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MRI is Unnecessary for Diagnosing Acute Achilles Tendon Ruptures: Clinical Diagnostic Criteria

Garras

Raikin

Bhat

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Achilles tendon ruptures are common in middle-aged athletes. Diagnosis is based on clinical examination or imaging. Although MRI is commonly used to document ruptures, there is no literature supporting its routine use and we wondered whether it was necessary. Questions/purposes We (1) determined the sensitivity of physical examination in diagnosing acute Achilles ruptures, (2) compared the sensitivity of physical examination with that of MRI, and (3) assessed care delays and impact attributable to MRI. Methods We retrospectively compared 66 patients with surgically confirmed acute Achilles ruptures and preoperative MRI with a control group of 66 patients without preoperative MRI. Clinical diagnostic criteria were an abnormal Thompson test, decreased resting tension, and palpable defect. Time to diagnosis and surgical procedures were compared with those of the control group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

MRI is Unnecessary for Diagnosing Acute Achilles Tendon Ruptures: Clinical Diagnostic Criteria

Garras

Raikin

Bhat

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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Assessment of Achilles Tendon Changes After Long‐Distance Running Using Ultrashort Echo Time Magnetization Transfer MR Imaging

Fang

Zhu

et al. 2022

Magnetic Resonance Imaging

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Background Long‐distance running is a common cause of Achilles tendinopathy. A reliable magnetic resonance imaging (MRI) technique to track early changes in the tendon caused by running could facilitate more effective interventions to combat progression. Purpose To evaluate an ultrashort echo time sequence with magnetization transfer preparation (UTE‐MT) in the detection of changes in Achilles tendons of amateur marathon runners before and after long‐distance running. Study Type Prospective. Population Thirty‐two runners (19 enrolled for full marathons and 13 enrolled for half‐marathons) and 5 healthy non‐runners. Field Strength/Sequence 3.0 T; UTE‐MT and dual‐echo UTE for T2* assessment (UTE‐T2*). Assessment MRI was performed 1‐week pre‐race, 2‐days post‐race, and 4‐weeks post‐race. UTE‐MT ratio (UTE‐MTR) and UTE‐T2* of tendon were measured by two independent radiologists who were blinded to the scan time point and participant data. The Achilles tendon was divided into six regions of interest (ROIs) for data analysis, namely the insertion part (INS), middle part (MID), muscle‐tendon junction (MTJ), tendon‐bone insertion (TBI), tendon‐muscle insertion (TMI), and whole tendon (bulk). Statistical Tests Analysis of variance and Friedman's rank tests were used to evaluate changes in UTE‐MTR and UTE‐T2* between time points. Tukey test and Bonferroni method were used for further comparisons. P < 0.05 was considered significant. Results The UTE‐MTR values of most tendon ROIs changed significantly between the measured time points, except for the INS region (P = 0.1977). Conversely, the UTE‐T2* values only showed significant changes in the MID and TBI regions. Paired comparisons showed that the UTE‐MTR decreases in the MTJ, MID, TMI, and bulk regions at 2‐days post‐race were significant compared to measures taken pre‐race and 4‐weeks post‐race. For UTE‐T2* measurements, significant differences were observed only for the MID region between pre‐race and 2‐days post‐race (P = 0.0408, 95% CI: 0.0061, 0.1973), and for the TBI region between pre‐race and 4‐weeks post‐race (P = 0.0473, 95% CI: 0.0013, 0.1766). Data Conclusion The UTE‐MT sequence is able to detect biochemical changes in the Achilles tendon after long‐distance running. Level of Evidence 2 Technical Efficacy Stage 1

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