Sonoelastographic Findings in Clubfeet

Abstract

Purpose One of the main features of congenital idiopathic clubfoot is the increased stiffness of soft tissues. With the growing popularity and availability of sonoelastography as a method to assess the stiffness of different tissues, we considered applying it to congenital clubfeet in order to to determine whether sonoelastography can be a useful imaging method for the evaluation of clubfeet, to assess whether there are any differences in stiffness of specific tendons between clubfeet and normal contralateral feet and to observe which treatment methods have an impact on the aspect of these structures on the elastograms. Patients and Methods A case-control study was performed involving 10 adolescent patients with unilateral idiopathic congenital clubfeet who were treated either with the Ponseti method or surgically with posteromedial release (PMR) during early infancy. Using compression sonoelastography, we obtained semi-quantitative data expressed as fat to tendon ratios in treated clubfeet and normal contralateral feet. The tendons of the following muscles were examined: tibialis anterior, tibialis posterior, flexor hallucis longus, peroneus longus and Achilles tendon at three levels (calcaneal insertion, lengthened zone and musculotendinous junction). Results The only statistically significant difference in the strain ratio (p = 0.023) between clubfeet and normal feet was at the level of the calcaneal insertion of the Achilles tendon, which was stiffer in clubfeet. Although other differences were not statistically significant, they may reflect some of the pathological modifications of clubfeet. Conclusion Overall, sonoelastography may be a useful examination tool in the quantitative and qualitative assessment of soft tissue stiffness in clubfeet, but further research is necessary.

Diagnostic value of Achilles tendon shear wave elastography in patients with ankylosing spondylitis: A case–control study

“…Based on these features, sonoelastographic examination of the Achilles tendon has been performed in many diseases in the literature and the relationship between the disease and the measurements has been evaluated. [12][13][14][15][16][17] It has been concluded that in addition to rheumatological diseases, there are subclinical changes in sonoelastography in the Achilles tendon in metabolic and structural musculoskeletal system problems, which can be useful in predicting the prognosis of diseases.…”