Quantifying the Dimensions of Achilles Tendon Insertional Area Using Ultrasound Imaging A Validity and Reliability Study

Abstract

Background. The purpose of this study was to evaluate the reliability and validity of using US imaging for measuring Achilles tendon insertion area to the calcaneus. Methods. Sixteen cadaveric tendons were used to compare the agreement between Achilles tendon insertion length measurements from US images with actual measurements after dissection. In addition, test-retest reliability was performed on six healthy subjects for tendon insertion length (IL), before calcaneal bone cross-sectional area (CSA) and tendon insertion angle (IA). The reliability and validity of the measurements was analyzed with intra-class correlation coefficient (ICC) and standard error of measurement (SEM). Results. There were significant differences and poor to good agreement between US measurements and Anthropometric measurements. Using cadaveric tendons images, the measurements agreement between the observers were good to excellent for IL, bone-to-insertion length and width before calcaneal bone (ICC 2,4 =.784, .935, .952). Test-retest reliability was excellent for US measurements for tendon IL (ICC 2,4 =.977,SEM=0.53mm), bone to IL (ICC 2,4 =.96, SEM=0.44mm), width before calcaneal bone (ICC 2,4 =.946, SEM=0.51mm), CSA (ICC 2,4 =.918, SEM=5.93mm 2), and IA (ICC 2,4 =.933, SEM=1.9°) on healthy tendons. Conclusions. US imaging was found to be reliable and valid to determine IL, width, and CSA of the Achilles tendon. The use of US imaging to determine Achilles tendon insertional size may be beneficial for evaluating the structural changes on disease development and progression.

The correlations between dimensions of the normal tendon and tendinopathy changed Achilles tendon in routine magnetic resonance imaging

“…In practice, the measurement concerned the length of the enthesis organ, and not only the tendon-bone connection. The insertion length reveled in our study is slightly longer than previously reported by ultrasound or research performed on the cadavers 40 . The differences in methods and population differences may explain these discrepancies.…”

“…The attachment measurement included the direct connection of the tendon with the bone and the area of the fibrocartilage layer on the calcaneus. Ultrasound could help distinguish between the part of the calcaneus covered by fibrocartilage and the connection between the tendon and bone 40 .…”

Minimum 3.5-year outcomes of operative treatment for Achilles tendon partial tears in the midportion and retrocalcaneal area

“…Diagnostic ultrasound imaging, colour Doppler, and/or MRI can underline the clinical suspicion [3,[7][8][9]. Ultrasound and power Doppler investigations demonstrated unspecific findings like localised swelling, reduced echogenicity, and neovascularisation related to the injured area [3,7].…”

Cross-Cultural Adaptation of Chinese Victorian Institute of Sports Assessment–Achilles (VISA-A) Questionnaire for Achilles Tendinopathy

“…VISA-A was commonly used in research and was translated to many languages, including Brazilian, Danish, Dutch, French, German, Italian, Spanish, Persian, and Portuguese. 1 , 3 , 7 - 10 , 13 , 14 , 16 However, the original version was developed in English-speaking countries. VISA-A should be translated, adapted, and validated before applying to the Chinese-speaking population.…”