Sonoelastography in the diagnosis of tendinopathies: an added value

Abstract

Background: sonoelastography helps in the detection of abnormalities not yet evident on Bmode exam. Methods: in this observational study, we report a collection of cases of symptomatic patients without alterations at ultrasound imaging but with evidence of pathological findings at sonoelastography. Patients, with clinical history suggestive for tendinopathies or surgically treated, and negative at the ultrasound exam, were submitted to sonoelastography. Out of 846, 632 patients with positive ultrasound exam were excluded. Sonoelastography was therefore performed in the remaining 214. Results: the examination was positive in 168 cases: 78 patients were affected with shoulder diseases, while elbow pathology was observed in 31 subjects; patellar, Achilles and plantar fascia disorders were reported in 19, 27, and 13 patients, respectively. Conclusion: sonoelastography can reveal tendon abnormalities of clinical relevance in a high percentage of cases, where the ultrasound exam was negative, making the method a complementary tool to ultrasound evaluation.

Spanish Consensus Statement: Clinical Management and Treatment of Tendinopathies in Sport

“…It was also generally accepted that availability of such means of diagnosis would depend on the exact injury, the location of the injured tendon, and the clinician’s place of work (eg, hospital, sports club). 12,14,16,19…”

“…We did not consider overload as a cause of injury, as other authors have, 20,23 or biochemical findings. 3 The term tendinosis refers to any tendinopathy showing structural alterations, with or without pain, thus requiring imaging studies such as echography, 6 sonoelastography, 16 or MRI. 19 The diagnosis of tendinosis is thus an issue in everyday practice because of the need for an imaging test.…”

“…It was also generally accepted that availability of such means of diagnosis would depend on the exact injury, the location of the injured tendon, and the clinician's place of work (eg, hospital, sports club). 12,14,16,19 Participants discussed difficulties in diagnosing an intratendinous condition (tendinopathy) especially when differentiating the diagnosis of an extratendinous condition (peritendinitis), due to the specific anatomic features and locations of some tendons that do not allow for certain tests to be performed. Such circumstances force physicians to rely on clinical signs such as surface pain, local warmth, or redness of the affected area.…”

Low Molecular Weight Hyaluronic Acid (500–730 Kda) Injections in Tendinopathies—A Narrative Review

“…Recently, thanks also to the ultrasound high-definition evaluation and guide [ 29 ], injection therapy has also carved out an important role in the treatment of tendinopathies through different proposals with different levels of success, as hyaluronic acid [ 30 ], PRP [ 31 ], high volume injections [ 32 ], prolotherapy [ 33 , 34 ], autologous conditioned serum [ 35 ], sclerotherapy [ 34 ], percutaneous electrolysis [ 36 ], etc.…”

Relationships between cardiovascular disease risk factors and Achilles tendon structural and mechanical properties in people with Type 2 Diabetes

“…These measures, collected during maximal isometric contractions (7) or during walking, (8) are time consuming and can be problematic in patient cohorts due to deficits in strength (7,8) or differences in moment arm (7). There is a growing interest in ultrasound elastography in the evaluation of healthy and pathological tendon (9,10). Shear wave elastography uses ultrafast imaging to measure the speed of propagation of shear waves generated by acoustic radiation force from the ultrasound transducer in the tissue of interest (11).…”