Evaluation of sonoelastography in Achilles tendon of healthy volunteers and patients with symptomatic Achilles tendon

Badry, Amr El; Ghieda, Usama Elsaied; Khouly, Radwa Mostafa El; Elreweny, Eman Abdel Sadek Taha

doi:10.1016/j.ejrnm.2017.09.004

Cited by 6 publications

(7 citation statements)

References 25 publications

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“…El Badry et al 7 , De Zordo et al, 4 8 Drakonaki et al, 9 and Ooi et al 10 agreed that healthy volunteers with asymptomatic Achilles tendons had a predominantly hard texture, whereas Achilles tendons with symptomatic tendinopathy and positive MRI signs of tendinopathy contained softened areas .…”

Section: Discussionmentioning

confidence: 98%

“…However, De Sconfienza et al, 11 found increased stiffness in the abnormal tendons, compared with the nonsymptomatic, which were softer .These results are contradictory, and correlation to histopathology was needed. El Badry et al, 7 disagreed with De Sconfienza et al, 11 and stated that “The disparities across various studies are likely attributable to inconsistent techniques, different methodologic approaches or the relatively small study populations in most studies reported. Sconfienza et al, used a different grading system and a lower-frequency-range transducer which may degrade the images acquired and, consequently, could affect their interpretation.…”

Section: Discussionmentioning

confidence: 99%

“…In our work, The elastographic blue color representing marked softening appears to correspond more frequently with marked ultrasound changes (focal hypoechoic areas and interstitial tears),While the green color representing mild softening corresponds more frequently with mild or no ultrasonographic changes (thickening, fibrillar pattern interruption, normal/minimal findings).These findings are in common ground with the work of 4 13 who found that mild softening was not correlated with conventional ultrasound abnormalities, whereas marked softening was found mainly in cases with ultrasound disease, so the authors suggest that only markedly soft areas should be considered as abnormal in Achilles tendon EUS. El Badry et al, 7 found that SEL revealed alterations in the mechanical properties of the Achilles tendon in 5 tendon segments in whom B-mode US findings were normal. This suggested that SEL is sensitive to small strain alterations in early Achilles tendon degeneration before pathologic changes can be seen with B-mode US.…”

Section: Discussionmentioning

confidence: 99%

“…The examination of all patients included B-mode scanning and SEL in the same setting using the same US system (Aplio mx, Toshiba Medical Systems, Japan) and the same linear transducer (7)(8)(9)(10)(11)(12).…”

Section: Ultrasound Examination Technique Of the Examinationmentioning

confidence: 99%

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In Achilles Tendon Disorders, Will Sonoelastography Add to Grey-Scale Ultrasound? Using MRI as Gold Standard

Kandil

Abdelkarim

Abdelwahab

et al. 2021

Indian J Radiol Imaging

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Background The aim of this study was to verify the findings of color-coded sonoelastography in Achilles tendon disorders against ultrasonographic and MR imaging findings, describing the elastographic patterns and correlating their diagnostic ability to magnetic resonance imaging (MRI) as a gold standard. Results Our study showed that sonoelastography appeared to be highly sensitive to ultrasonographically detected changes, with 100% sensitivity, 16.6% specificity, 73% positive predictive value, and 100% negative predictive value, making it a good negative test to exclude suspected tendinopathy in equivocal cases. MRI examination was used as a gold standard. Elastographic grades showed moderate agreement to those of MRI (κ = 0.44, p < 0.001), while elastography had overall sensitivity of 87.5%, 100% specificity, and 90% accuracy in differentiating normal and pathological tendons. Conclusion We concluded that sonoelastography is a sensitive method in the diagnosis of Achilles tendon pathologies detected by ultrasound examination and it can be well correlated to MRI with high specificity for pathological tendons.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Ultrasound Examination Technique Of the Examinationmentioning

confidence: 99%

See 2 more Smart Citations

In Achilles Tendon Disorders, Will Sonoelastography Add to Grey-Scale Ultrasound? Using MRI as Gold Standard

Kandil

Abdelkarim

Abdelwahab

et al. 2021

Indian J Radiol Imaging

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“…1,11 This is used for assessing the median nerve (MN) elasticity in carpal tunnel syndrome (CTS) 11 and sciatic nerve elasticity during passive limb movements and physiotherapy. 12 Soft tissue masses-Superficial focal masses can be easily accessed and identified malignant by CE. Cancerous lesions are heterogeneous with variable degrees of hard blue areas.…”

Section: Introductionmentioning

confidence: 99%

REAL-TIME strain elastography: Applications in musculoskeletal system

Dilip¹,

Khaladkar²,

Chanabasanavar³

et al. 2022

Journal of Clinical Orthopaedics and Trauma

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Background: Strain or compression sonoelastography (CE) provides a colour-coded elastogram representing tissue elasticity by measuring tissue deformability after repeated probe compression. Elastographic ultrasound (EUS) is a valuable tool for screening diagnosis and follow-up of inflammatory, degenerative, benign and malignant neoplastic pathologies of skin, subcutaneous tissue, muscles, tendons, ligaments, fascia and nerves; help in targeted biopsy; monitor healing tendons after surgery or nerve stiffness changes during physiotherapy. Objectives: To assess stiffness of normal tendons, muscles and nerve. To diagnose cellulitis, fasciitis, abscess, tendinopathy, myositis, muscle/tendon rupture/contusion and differentiate between benign and malignant soft tissue tumours. To derive elastic score (ES) and strain ratio (SR) in cases and controls. To correlate B-mode findings with CE. Materials and methods: A prospective study on 50 healthy subjects between 25 and 30 years and 50 cases of diffuse and focal musculoskeletal pathologies was done using B-mode and CE over 2 years. Statistical analysis of distribution, mean, associations, sensitivity, specificity, area under Receiver Operating Characteristic curve (AUROC) for B-mode, ES, SR combined B-mode/CE and their comparison was done. Results: Significant association was noted between SR in muscles and tendons with sex. Significant correlation was noted between ES/SR with B-mode. CE and B-mode had 100% and 52.4% sensitivity respectively for diagnosing diffuse pathologies. For differentiating benign and malignant masses sensitivity, specificity, and diagnostic accuracy of B-mode was 71.43%, 86.36% and 82.76%; of SR was 71.43%, 90.91% and 86.21%; of Combined B-mode with CE was 100%, 90.91% and 93.1% respectively. Elastographic pattern had highest diagnostic accuracy and largest AUROC. Conclusion: CE as a screening test had higher diagnostic accuracy, supporting need for standardizing it for clinical use in MSK. EUS being a widely available, fast and affordable modality, can aid follow up of chronic MSK pathologies, response to medication, physiotherapy and surgery and mitigate the need for MRI.

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Explaining Variability in the Prevalence of Achilles Tendon Abnormalities: A Systematic Review With Meta-analysis of Imaging Studies in Asymptomatic Individuals

Docking

Hart

Rio

et al. 2021

J Orthop Sports Phys Ther

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Evaluation of sonoelastography in Achilles tendon of healthy volunteers and patients with symptomatic Achilles tendon

Cited by 6 publications

References 25 publications

In Achilles Tendon Disorders, Will Sonoelastography Add to Grey-Scale Ultrasound? Using MRI as Gold Standard

In Achilles Tendon Disorders, Will Sonoelastography Add to Grey-Scale Ultrasound? Using MRI as Gold Standard

REAL-TIME strain elastography: Applications in musculoskeletal system

Explaining Variability in the Prevalence of Achilles Tendon Abnormalities: A Systematic Review With Meta-analysis of Imaging Studies in Asymptomatic Individuals

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