Tobias De Zordo MD, Presenter: Nothing to Disclose

Rethy Kieth Chhem MD, PhD, Abstract Co-Author: Nothing to Disclose

Gudrun Feuchtner MD, Abstract Co-Author: Nothing to Disclose

Peter Franz Walter Soegner MD, Abstract Co-Author: Nothing to Disclose

Werner R. Jaschke MD, PhD, Abstract Co-Author: Nothing to Disclose

Andrea Klauser MD, Abstract Co-Author: Nothing to Disclose

To evaluate Sonoelastography (SEL) in Achilles tendon assessment compared to clinical examination and conventional Ultrasound (US).

Ethics committee approval and informed written consent were obtained. Achilles tendons of 25 consecutive patients with chronic Achilles tendinopathy (11 men, 14 women; mean age, 55 years; range, 37-79 years) and 25 healthy volunteers (11 men, 14 women; mean age, 46 years; range 25-76 years) were examined by clinical examination, US, and SEL, by assessing the proximal-, middle- and distal third. Clinical findings were used as reference standard and were compared to US and SEL findings. By using US, tendon thickening and/or intratendinous focal areas were defined as pathologic and by using SEL tissue softening was defined as pathologic. Contralateral tendons were assessed separately.

In healthy volunteers, normal findings were present in 100% of clinical examinations, in 100% of US images and in 93% of SEL images. In patients, alterations were found in 61% of clinical examinations, in 59% of US images and in 68% of SEL images. SEL showed a sensitivity of 94%, specificity of 99%, and accuracy of 97%, while US showed a sensitivity of 93%, specificity of 100% and accuracy of 99%. Correlation (κ) between SEL and US was 0.89. Furthermore, asymptomatic contralateral tendons of patients showed a more common involvement by using SEL (16 patients) when compared to US (13 patients).

SEL showed good sensitivity and specificity in the detection of alterations in Achilles tendinopathy with good correlation to conventional US. SEL detected slightly more tendon alterations in symptomatic Achilles tendons, but also of the asymptomatic contralateral tendons in patients, which might be due to an earlier detection of tendinopathy by using SEL. However, follow-up studies are required to confirm our preliminary results.

Detection of tissue softening could add knowledge regarding early development of Achilles tendinopathy, which might have an impact on therapeutic decisions.

De Zordo, T, Chhem, R, Feuchtner, G, Soegner, P, Jaschke, W, Klauser, A, Real-time Sonoelastography of Achilles Tendons: Comparison to Clinical Findings and Ultrasound Findings.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6016201.html