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

Abstract

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.

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

“…Porta et al 45 defined the normal appearance of patellar tendon at SE as a predominance of green pattern at proximal, middle, and distal portions. However the colour scale of sonographer ranged from red to green (red is defined as hard and green as soft tissue), and these results are in contrast with other Authors that found normal tendon to be harder and tendinopathic tendons to be softer 27,31,32 46 . Patellar tendon stiffness was found to be higher in male than female as well as in patients with lower BMI than obese individuals 47 .…”

“…Only few studies were found dealing with quadriceps tendon. Healthy volunteers had prevalence of hard characteristics 46 . Teber et al 52 reported that normal quadriceps tendon patterns tended to change in case of chronic renal failure, in particular a substantial intratendinous softening occurred.…”

The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018

“…SE proved to be superior to B-mode ultrasound (sensitivity 99 %, specificity 78 %, accuracy 95 %) [318], underlining the ability of SE to detect pathology before the appearance of the B-mode ultrasound morphologic changes [319,320]. No differences between athletes and controls nor between the dominant and nondominant leg were found in SE evaluation of the patellar tendon [321]. With age, a significant decrease in shear wave velocity values was detected, with SWE having the capacity to detect aging tendons before morphologic abnormalities were observed on B-mode ultrasound [322,323].…”

Sonoelastographic Features of the Patellar Ligament in Clinically Normal Dogs

“…For conventional ultrasonographic and sonoelastographic examinations, dogs were positioned in lateral recumbency with the stifle in maximal passive flexion, to avoid the anisotropy of the fibrillar structures of the ligament. 40 The elastosonographic images were obtained by applying light rhythmic pressure with the probe. Only longitudinal sections were acquired, and the operators evaluated each patellar ligament twice.…”