Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy: A prospective observational study

Bakkegaard, Mads; Johannsen, Finn Elkjær; Højgaard, Betina; Langberg, Henning

doi:10.1016/j.ejrad.2014.11.028

Cited by 38 publications

(53 citation statements)

References 20 publications

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“…In terms of standard conservative treatment, there are controversies regarding imaging studies (US or MRI) as a prognostic parameter. Bakkegaard et al [12] have reported that US findings influence outcome of conservative treatment of chronic Achilles tendinopathy, in which pretreatment abnormal US findings (hyper- or hypo-echogenicity) were correlated with poor outcome after 6 months. In contrast, Khan et al [17] revealed that US changes could not predict 12 months outcome of Achilles tendinopathy.…”

Section: Discussionmentioning

confidence: 99%

“…There have been conflicting results about association of Achilles tendon thickness with symptoms of patient. Some studies have suggested that Achilles tendon thickness is related to the level of pain and dysfunction, and improvement of discomfort is accompanied with reduction in tendon thickness [123031]. On the contrary, Kulig et al [32] reported that there was no significant difference in thickness of Achilles tendon between asymptomatic and symptomatic dancers.…”

Section: Discussionmentioning

confidence: 99%

“…The findings were compared with the Achilles tendon of opposite side. US abnormality was defined as thickening of maximum anteroposterior thickness of tendon (>6 mm) [1314], or abnormal echogenicity of Achilles tendon (hypoechoic area evident in both the longitudinal and transverse scans and heterogeneous appearance of fibrillar pattern), or hypervascularity within the Achilles tendon or peritendon [1215161718] (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, it becomes important to know which patient is more amenable to ESWT. With regard to standard conservative treatment, Bakkegaard et al [12] have reported that ultrasonography (US) findings influence the outcome of chronic Achilles tendinopathy. However, no study has investigated the factors associated with the therapeutic outcome of ESWT in patients with chronic refractory Achilles tendinopathy.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcome and Factors Affecting Prognosis of Extracorporeal Shockwave Therapy for Chronic Refractory Achilles Tendinopathy

Lee

Yoon

et al. 2017

Ann Rehabil Med

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ObjectiveTo investigate the factors affecting prognosis of extracorporeal shockwave therapy (ESWT) for chronic refractory Achilles tendinopathy (AT).MethodsThirty-six patients (48 consecutive feet) with chronic AT (>6 months) and who underwent ESWT for ‘poor’ or ‘fair’ grade in Roles-Maudsley Score (RMS) after unsuccessful conservative treatment were included in the present study. A maximum of 12 sessions of ESWT were conducted until treatment success: RMS reached ‘good’ or ‘excellent’. Termination of ESWT for no response, or ‘poor’ or ‘fair’ grade was regarded as treatment failure. Immediate outcome, long-term outcome (telephone interview after mean 26 months), and factors affecting treatment success were analyzed.ResultsNumeric Rating Scale was significantly decreased at immediate and long-term follow-up. Success rate was 71.1% and 90.3%, respectively. Univariate logistic regression identified that immediate treatment success was associated with retrocalcaneal enthesophyte on X-ray (odds ratio [OR], 0.06; 95% confidence interval [CI], 0.01–0.28), pretreatment abnormal ultrasonography echogenicity within Achilles tendon (OR, 18.89; 95% CI, 2.08–171.96), mean duration of ‘post-treatment soreness’ (OR, 0.55; 95% CI, 0.33–0.94), and duration of ‘post-treatment soreness after first ESWT’ (OR, 0.06; 95% CI, 0.01–0.34). The duration of ‘post-treatment soreness after first ESWT’ was found to be the only factor associated with long-term success (OR, 0.32; 95% CI, 0.10–0.99).ConclusionESWT appears to be effective in achieving long-term success in chronic refractory AT. Immediate success was associated with absence of retrocalcaneal enthesophyte on X-ray, presence of pretreatment abnormal ultrasonography echogenicity, shorter mean duration of ‘post-treatment soreness’, and shorter duration of ‘post-treatment soreness after first ESWT’. The shorter duration of ‘post-treatment soreness after first ESWT’ was identified as the only positive prognostic parameter in achieving long-term success.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-Term Outcome and Factors Affecting Prognosis of Extracorporeal Shockwave Therapy for Chronic Refractory Achilles Tendinopathy

Lee

Yoon

et al. 2017

Ann Rehabil Med

View full text Add to dashboard Cite

show abstract

“…13 Signs of tendinopathy on imaging do not necessarily indicate the presence of IAT and vice versa, as demonstrated in several level IV * and level II studies. 4,23 For example, the reported percentage of asymptomatic tendons with signs of Achilles tendinopathy on imaging range from 0% to 35% † and the percentage of symptomatic tendons without signs of Achilles tendinopathy range from 0% to 19%. 4,24,37,101,106,111 …”

Section: Imagingmentioning

confidence: 99%