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How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy - clinical and imaging findings

BACKGROUND: The purpose of this investigation was to evaluate if clinical assessment, Ultrasound + Colour Doppler (US + CD) and Ultrasound Tissue Characterisation (UTC) can be useful in detecting plantaris tendon involvement in patients with midportion Achilles tendinopathy. METHODS: Twenty-three te...

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Autores principales: Masci, Lorenzo, Spang, Christoph, van Schie, Hans T. M., Alfredson, Håkan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765029/
https://www.ncbi.nlm.nih.gov/pubmed/26912241
http://dx.doi.org/10.1186/s12891-016-0955-5
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author Masci, Lorenzo
Spang, Christoph
van Schie, Hans T. M.
Alfredson, Håkan
author_facet Masci, Lorenzo
Spang, Christoph
van Schie, Hans T. M.
Alfredson, Håkan
author_sort Masci, Lorenzo
collection PubMed
description BACKGROUND: The purpose of this investigation was to evaluate if clinical assessment, Ultrasound + Colour Doppler (US + CD) and Ultrasound Tissue Characterisation (UTC) can be useful in detecting plantaris tendon involvement in patients with midportion Achilles tendinopathy. METHODS: Twenty-three tendons in 18 patients (14 men, mean age: 37 years and 4 women: 44 years) (5 patients with bilateral tendons) with midportion Achilles tendinopathy were surgically treated with a scraping procedure and plantaris tendon removal. For all tendons, clinical assessment, Ultrasound + Colour Doppler (US + CD) examination and Ultrasound Tissue Characterisation (UTC) were performed. RESULTS: At surgery, all 23 cases had a plantaris tendon located close to the medial side of the Achilles tendon. There was vascularised fat tissue in the interface between the Achilles and plantaris tendons. Clinical assessment revealed localised medial activity-related pain in 20/23 tendons and focal medial tendon tenderness in 20/23 tendons. For US + CD, 20/23 tendons had a tendon-like structure interpreted to be the plantaris tendon and localised high blood flow in close relation to the medial side of the Achilles. For UTC, 19/23 tendons had disorganised (type 3 and 4) echopixels located only in the medial part of the Achilles tendon indicating possible plantaris tendon involvement. CONCLUSIONS: US + CD directly, and clinical assessment indirectly, can detect a close by located plantaris tendon in a high proportion of patients with midportion Achilles tendinopathy. UTC could complement US + CD and clinical assessment by demonstrating disorganised focal medial Achilles tendon structure indicative of possible plantaris involvement.
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spelling pubmed-47650292016-02-25 How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy - clinical and imaging findings Masci, Lorenzo Spang, Christoph van Schie, Hans T. M. Alfredson, Håkan BMC Musculoskelet Disord Research Article BACKGROUND: The purpose of this investigation was to evaluate if clinical assessment, Ultrasound + Colour Doppler (US + CD) and Ultrasound Tissue Characterisation (UTC) can be useful in detecting plantaris tendon involvement in patients with midportion Achilles tendinopathy. METHODS: Twenty-three tendons in 18 patients (14 men, mean age: 37 years and 4 women: 44 years) (5 patients with bilateral tendons) with midportion Achilles tendinopathy were surgically treated with a scraping procedure and plantaris tendon removal. For all tendons, clinical assessment, Ultrasound + Colour Doppler (US + CD) examination and Ultrasound Tissue Characterisation (UTC) were performed. RESULTS: At surgery, all 23 cases had a plantaris tendon located close to the medial side of the Achilles tendon. There was vascularised fat tissue in the interface between the Achilles and plantaris tendons. Clinical assessment revealed localised medial activity-related pain in 20/23 tendons and focal medial tendon tenderness in 20/23 tendons. For US + CD, 20/23 tendons had a tendon-like structure interpreted to be the plantaris tendon and localised high blood flow in close relation to the medial side of the Achilles. For UTC, 19/23 tendons had disorganised (type 3 and 4) echopixels located only in the medial part of the Achilles tendon indicating possible plantaris tendon involvement. CONCLUSIONS: US + CD directly, and clinical assessment indirectly, can detect a close by located plantaris tendon in a high proportion of patients with midportion Achilles tendinopathy. UTC could complement US + CD and clinical assessment by demonstrating disorganised focal medial Achilles tendon structure indicative of possible plantaris involvement. BioMed Central 2016-02-24 /pmc/articles/PMC4765029/ /pubmed/26912241 http://dx.doi.org/10.1186/s12891-016-0955-5 Text en © Masci et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Masci, Lorenzo
Spang, Christoph
van Schie, Hans T. M.
Alfredson, Håkan
How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy - clinical and imaging findings
title How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy - clinical and imaging findings
title_full How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy - clinical and imaging findings
title_fullStr How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy - clinical and imaging findings
title_full_unstemmed How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy - clinical and imaging findings
title_short How to diagnose plantaris tendon involvement in midportion Achilles tendinopathy - clinical and imaging findings
title_sort how to diagnose plantaris tendon involvement in midportion achilles tendinopathy - clinical and imaging findings
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765029/
https://www.ncbi.nlm.nih.gov/pubmed/26912241
http://dx.doi.org/10.1186/s12891-016-0955-5
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