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Kandil NM, Hashem AMB, Toukhy MME, Yousef NMAA, Al-Feeshawy ASH, Havwana MAR. Ultrasound imaging and shear wave elastography for the differential diagnosis of heel pain: a comparative cross-sectional study. J Ultrasound 2024; 27:621-634. [PMID: 38879835 PMCID: PMC11333687 DOI: 10.1007/s40477-024-00906-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/16/2024] [Indexed: 08/21/2024] Open
Abstract
PURPOSE In correlation with magnetic resonance imaging (MRI), this study attempts to assess the effectiveness of the diagnostic of ultrasonography (US) features and shear wave elastography (SWE) in determining the different causes of heel pain. MATERIALS AND METHODS 55 heels with a mean age of 38.33 ± 10.8 were included in the study (10 control cases and 41 cases, 4 of which had bilateral heel pain). There were 23 female cases (56.1%) and 18 male cases (43.95%). Examinations using shear wave elastography (SWE) and ultrasound (US) were done in different positions. MRI and the obtained data were correlated. RESULTS When used to diagnose different heel pain causes, ultrasound demonstrated great sensitivity and specificity. SWE demonstrated a good correlation with MRI findings and enhanced the ultrasound's diagnostic precision in identifying plantar fasciitis early on (increased accuracy from 88.9 to 93.33% with 100% sensitivity and 83.3% specificity) and Achilles tendinopathy (increased accuracy from 88.9 to 97.8 with 94.7% sensitivity and 100% specificity). CONCLUSION In summary, we concluded that heel pain can be efficiently examined by both ultrasound (US) and shear wave elastography (SWE) with the former being used as the primary effective tool and the latter being done to increase diagnostic accuracy. We also concluded that SWE improved the ultrasound's diagnostic precision in identifying patients with early plantar fasciitis and Achilles tendinopathy and showed a robust relationship with clinical outcomes, enhancing patient evaluation and follow-up.
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Affiliation(s)
- Nour Mohamed Kandil
- Diagnostic and Interventional Radiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Aya Mohamed Bassam Hashem
- Diagnostic and Interventional Radiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwan Mohamed El Toukhy
- Diagnostic and Interventional Radiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Maged Abdel Rahman Havwana
- Diagnostic and Interventional Radiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Xergia SA, Tsarbou C, Liveris NI, Hadjithoma Μ, Tzanetakou IP. Risk factors for Achilles tendon rupture: an updated systematic review. PHYSICIAN SPORTSMED 2023; 51:506-516. [PMID: 35670156 DOI: 10.1080/00913847.2022.2085505] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Identifying risk factors for Achilles Tendon Rupture (ATR) is one of the first necessary steps for its prevention. This systematic review aimed to update the systematic review published in 2014 in ATR etiology. METHODOLOGY A systematic review was carried out using PubMed, EBSCO, and ScienceDirect databases. All types of research studies (Randomized Control Trials - RCTs, Cohort studies, Case-control studies and Cross-sectional studies) that considered ATR, were eligible. The inclusion criteria for eligibility of the studies were to be written in the English language, and to include populations of men and/or women, both athletes, and non-athletes, healthy individuals, and patients. Two independent reviewers used the assessment instrument Newcastle-Ottawa Scale independently, to evaluate the quality of each selected study. Further, two reviewers worked independently to extract the study characteristics, and the GRADE methodology was used to assess the level of certainty of each risk factor. RESULTS From 9526 studies initially identified, 19 studies were eligible for further analysis to identify risk factors for ATR. Seventeen studies were considered good quality, and two studies fair quality. Low to very low certainty of evidence was found for the following medications: steroids, quinolones, and oral bisphosphonate, as well as for other factors such as chronic tendon inflammation and Achilles' tendinopathy, spring season, diabetes, previous musculoskeletal injury, regular participation in athletic activity, hyperparathyroidism, renal failure, and genetic factors. CONCLUSIONS The risk factors found prove that ATR is a multifactorial injury. Appropriate methodologies and well-designed studies are needed to determine the factors and their significance in ATR risk. Finally, the role of biomechanical and psychological aspects in the ATR etiology may be of interest in future studies, as we could not extract relative data in our review.
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Affiliation(s)
- Sofia A Xergia
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Charis Tsarbou
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Nikolaos I Liveris
- Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Aigio, Greece
| | - Μaria Hadjithoma
- Department of Health Science, European University of Cyprus, Nicosia, Cyprus
| | - Irene P Tzanetakou
- Department of Life Sciences, European University of Cyprus, Nicosia, Cyprus
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Römer C, Legerlotz K, Czupajllo J, Fischer T, Wolfarth B, Lerchbaumer MH. Acute Effects of Running on Shear Wave Elastography Measures of the Achilles Tendon and Calf Muscles in Professional Female Handball and Volleyball Players. Diagnostics (Basel) 2023; 13:2957. [PMID: 37761324 PMCID: PMC10530130 DOI: 10.3390/diagnostics13182957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/27/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Shear Wave Elastography (SWE) is currently used to detect tissue pathologies, i.e., tendinopathy. For preventive medicine, it is important to examine the sensitivity of SWE and to investigate how stiffness measures are affected by methodological variables. The aim of this study is to examine shear wave elastography (SWE) measures in order to compare the pre- and post-running values and to determine the correlation between the shear wave speed values (m/s). SWE examinations of the Achilles tendon (AT), soleus muscle (MS) and gastrocnemius muscle (MG)) were performed in 24 healthy professional female athletes. Measurements of the shear wave speed (m/s) were taken before and after incremental treadmill running until exhaustion. Correlations were investigated using the Pearson correlation coefficient and were examined for significance using the Student's t-test. The pre- and post-exercise shear wave speed did not differ. The pre-exercise and post-exercise stiffness for MS (r = 0.613), MG (r = 0.609) and AT (r = 0.583) correlated strongly. The pre-exercise values and changes in stiffness showed a significant correlation (p < 0.001). In professional athletes, acute exercise induces different tissue stiffness changes in AT, MS and MG for each individual. Thus, exercise activity immediately prior to the SWE measurement needs to be factored in when evaluating tissue stiffness.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Kirsten Legerlotz
- Movement Biomechanics, Institute of Sport Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Thomas Fischer
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
- Department of Radiology, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
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Römer C, Zessin E, Czupajllo J, Fischer T, Wolfarth B, Lerchbaumer MH. Effect of Anthropometric Parameters on Achilles Tendon Stiffness of Professional Athletes Measured by Shear Wave Elastography. J Clin Med 2023; 12:jcm12082963. [PMID: 37109299 PMCID: PMC10145458 DOI: 10.3390/jcm12082963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/07/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Shear wave elastography (SWE) is currently used to detect tissue pathologies and, in the setting of preventive medicine, may have the potential to reveal structural changes before they lead to functional impairment. Hence, it would be desirable to determine the sensitivity of SWE and to investigate how Achilles tendon stiffness is affected by anthropometric variables and sport-specific locomotion. METHODS To investigate the influence of anthropometric parameters on Achilles tendon stiffness using SWE and examine different types of sports to develop approaches in preventive medicine for professional athletes, standardized SWE of Achilles tendon stiffness was performed in 65 healthy professional athletes (33 female, 32 male) in the longitudinal plane and relaxed tendon position. Descriptive analysis and linear regression were performed. Furthermore, subgroup analysis was performed for different sports (soccer, handball, sprint, volleyball, hammer throw). RESULTS In the total study population (n = 65), Achilles tendon stiffness was significantly higher in male professional athletes (p < 0.001) than in female professional athletes (10.98 m/s (10.15-11.65) vs. 12.19 m/s (11.25-14.74)). Multiple linear regression for AT stiffness did not reveal a significant impact of age or body mass index (BMI) (p > 0.05). Subgroup analysis for type of sport showed the highest AT stiffness values in sprinters (14.02 m/s (13.50-14.63)). CONCLUSION There are significant gender differences in AT stiffness across different types of professional athletes. The highest AT stiffness values were found in sprinters, which needs to be considered when diagnosing tendon pathologies. Future studies are needed to investigate the benefit of pre- and post-season musculoskeletal SWE examinations of professional athletes and a possible benefit of rehabilitation or preventive medicine.
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Affiliation(s)
- Claudia Römer
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Enrico Zessin
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Julia Czupajllo
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany
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ÇAKIR PEKÖZ B, YILDIRIM A. Aşil tendonu gerinim oranı ile mitral anulus kalsifikasyonu varlığı arasındaki ilişki. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1132997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Amaç: Aşil tendonu (AT)- ultrasonografisi (US) ve gerinim elastografisi (SE) ile elde edilen AT- kalınlığı (T) ve AT- gerinim oranının (SR) mitral kapak kalsifikasyonlu (MAC) hastaları belirlemedeki önemini araştırmayı amaçladık.
Gereç ve Yöntem: Çalışmaya ekokardiyografi sonrası MAC tanısı alan 100 hasta (65 kadın, 35 erkek ve ortalama yaş 64.7 ± 12.1) ve kardiyovasküler risk faktörü benzer olan 50 kontrol (32 kadın, 18 erkek ve ortalama yaş 63.2 ± 12.8) alındı. Laboratuvar incelemeler ve AT US yapıldı. AT-T ve AT-SR hesaplandı.
Bulgular: MAC olan hastalarda AT-T ve AT-SR belirgin olarak yüksek olduğu bulundu. Logistic regresyon analizinde, AT-T ve AT-SR değerlerinin MAC olma riskini bağımsız olarak belirlediği bulundu. Bu analize göre AT-T (her 1 mm) ve AT-SR (her 0.1)’nin MAC olma riskini sırası ile %69.9 ve %12.7 oranlarında artırdığı saptandı. AT-T ve AT-SR değerlerinin MAC olan hastaları belirlemesi açısından ROC analizi yapıldığında, ROC eğri altında kalan alanın sırası ile 0.684 ve 0.819 belirlendi. Aynı analizde, AT-SR için sınır değer 1.25 olarak alındığında %94.1 sensitivite ve %76.2 spesivite ile MAC varlığını belirlediği tespit edildi.
Sonuç: AT SE incelemesinde saptanan AT-SR, MAC olan hastaları önceden belirlemede kullanılabilecek basit, ucuz, tekrarlanabilir ve non-invaziv bir parametredir. Bu durum MAC ve AT-SR artışının benzer fizyopatolojik mekanizma ile meydana gelebilmesinin bir sonucu olabilir.
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Affiliation(s)
- Burçak ÇAKIR PEKÖZ
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ADANA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
| | - Arafat YILDIRIM
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ADANA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
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Tang X, Wang J, Guo R, Huang S, Qiu L. Quantitative evaluation of the Achilles tendon and supraspinatus tendon in end-stage kidney disease patients: A potential tool for predicting spontaneous tendon rupture. Ther Apher Dial 2021; 26:734-742. [PMID: 34817901 DOI: 10.1111/1744-9987.13763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 11/09/2021] [Accepted: 11/21/2021] [Indexed: 02/05/2023]
Abstract
Many cases of spontaneous tendon rupture in end-stage kidney disease (ESKD) patients have been reported worldwide. Quantitative assessment of tendon has become an important way to improve the prognosis of patients. In the recruited healthy volunteers and ESKD patients, the thickness and shear wave velocity (SWV) of supraspinatus tendons and Achilles tendons were measured and compared among groups. Potential factors related to the tendon SWV of ESKD patients were screened in multiple linear regression. There was no significant difference in the tendon thickness and supraspinatus tendon SWV among groups. SWV of Achilles tendons in long-term dialysis ESKD patients were significantly lower than those in healthy volunteers (5.1 vs. 5.6 m/s, p < 0.01). Ca2+ , creatinine, body mass index, and genders are the significant factors related to the tendon SWV. Shear wave elastography can be used as a potential tool for predicting spontaneous tendon rupture in ESKD patients.
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Affiliation(s)
- Xinyi Tang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Wang
- Department of Medical Ultrasound, Sichuan Provincial Orthopedics Hospital, Chengdu, China
| | - Ruiqian Guo
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Songya Huang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Li Qiu
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
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Antolič V, Bumbaširević M, Pećina M. Central and Eastern Europe actual orthopaedics profile. INTERNATIONAL ORTHOPAEDICS 2021; 45:811-814. [PMID: 33738518 PMCID: PMC7971353 DOI: 10.1007/s00264-021-05000-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Vane Antolič
- University Medical Centre Ljubljana, Zaloska 9 Street, 1000 Ljubljana, Slovenia
| | - Marko Bumbaširević
- Clinic of Orthopedic Surgery and Traumatology, Clinical Centre of Serbia, 26 Visegradska Street, 11 000 Belgrade, Serbia
| | - Marko Pećina
- University of Zagreb, School of Medicine, Salata 3, 10000 Zagreb, Croatia
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