Evaluation of Achilles and patellar tendinopathy with greyscale ultrasound and colour Doppler: using a four-grade scale

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Web End = Knee Surg Sports Traumatol Arthrosc (2016) 24:19881996 DOI 10.1007/s00167-014-3270-4

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Web End = Evaluation of Achilles and patellar tendinopathy with greyscale ultrasound and colour Doppler: using a fourgrade scale

Kerstin Sunding Martin Fahlstrm Suzanne Werner Magnus Forssblad Lotta Willberg

Abstract

Purpose In tendon research, using ultrasound (US), studies often refer to tendon thickness, structural abnormalities and neovascularisation. The reliability concerning these measurements and evaluations is seldom reported. The aim of this study was to assess the intra- and inter-observer reliability for quantitative measures (thickness) and qualitative evaluations (structure and neovascularisation) of symptomatic and asymptomatic Achilles and patellar tendons with US and colour Doppler using a modied hberg score. Methods Twenty-eight consecutive patients with symptomatic and asymptomatic Achilles (n = 27) and patellar ten-

dons (n = 26) were included. Tendon anteroposterior thick

ness was measured. Tendon structure and neovascularisation were evaluated using a modied hberg score. US-images were evaluated twice by four independent observers.

Results Mean thickness for Achilles and patellar ten-dons was 8.4 mm (2.0) and 5.5 mm (1.7), respectively.

The reliability for measures of distance was high all over (ICC = 0.9630.999). A moderate-strong correlation was

found between observers concerning evaluation of neovascularisation (r = 0.7670.992) and poor-moderate

correlation concerning evaluation of structural changes

Electronic supplementary material The online version of this article (doi:http://dx.doi.org/10.1007/s00167-014-3270-4

Web End =10.1007/s00167-014-3270-4 ) contains supplementary material, which is available to authorized users.

K. Sunding (*) S. Werner M. Forssblad L. Willberg Stockholm Sports Trauma Research Centre/Karolinska Institutet, Capio Artro Clinic AB, Sophiahemmet, Box 5605, 114 86 Stockholm, Swedene-mail: [email protected]

M. Fahlstrm

Department of Clinical Sciences, Professional Development, Ume University, 901 87 Ume, Sweden

Received: 3 March 2014 / Accepted: 25 August 2014 / Published online: 6 September 2014 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2014

(r = 0.3790.837). Intra-observer reliability was moderate

strong for evaluations of both tendon structure (k = 0.537

0.873) and neovascularisation (k = 0.6390.864).

Conclusions With a strict method for how to measure tendon thickness and set criteria for evaluating structural changes and amount and distribution of...