Real-time sonoelastography and ultrasound evaluation of the Achilles tendon in patients with diabetes with or without foot ulcers: a cross sectional study

Evranos, Berna; İdilman, İlkay S.; İpek, Ali; Polat, Şefika Burçak; Çakır, Bekir; Ersoy, Reyhan

doi:10.1016/j.jdiacomp.2015.08.012

Cited by 26 publications

(54 citation statements)

References 39 publications

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“… USE had moderate to good correlation with conventional US ( κ = 0.80 for proximal third, κ = 0.58 for middle third, κ = 0.39 for distal third). Evranos et al 2015 [ 33 ] 78 patients with diabetes: 35 patients with foot ulcers, 43 patients without foot ulcers, 33 healthy individuals Cross-sectional, case–control study. The Achilles tendon was softer in diabetic patients with foot ulcers than in patients without ulcers ( p < 0.001) or in non-diabetics ( p = 0.03).…”

Section: Resultsmentioning

confidence: 99%

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Ultrasound elastography: compression elastography and shear-wave elastography in the assessment of tendon injury

et al. 2018

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Ultrasound elastography (USE) is a recent technology that has experienced major developments in the past two decades. The assessment of the main mechanical properties of tissues can be made with this technology by characterisation of their response to stress. This article reviews the two major techniques used in musculoskeletal elastography, compression elastography (CE) and shear-wave elastography (SWE), and evaluates the studies published on major electronic databases that use both techniques in the context of tendon pathology. CE accounts for more studies than SWE. The mechanical properties of tendons, particularly their stiffness, may be altered in the presence of tendon injury. CE and SWE have already been used for the assessment of Achilles tendons, patellar tendon, quadriceps tendon, epicondylar tendons and rotator cuff tendons and muscles. Achilles tendinopathy is the most studied tendon injury with USE, including the postoperative period after surgical repair of Achilles rupture tendon. In relation to conventional ultrasound (US), USE potentially increases the sensitivity and diagnostic accuracy in tendinopathy, and can detect pathological changes before they are visible in conventional US imaging. Several technical limitations are recognised, and standardisation is necessary to ensure repeatability and comparability of the results when using these techniques. Still, USE is a promising technique under development and may be used not only to promote an early diagnosis, but also to identify the risk of injury and to support the evaluation of rehabilitation interventions.Key Points• USE is used for the assessment of the mechanical properties of tissues, including the tendons.• USE increases diagnostic performance when coupled to conventional US imaging modalities.• USE will be useful in early diagnosis, tracking outcomes and monitoring treatments of tendon injury.• Technical issues and lack of standardisation limits USE use in the assessment of tendon injury.

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Section: Resultsmentioning

confidence: 99%

“…USE has also been studied in systemic diseases. A stiffness reduction of the Achilles tendon was observed in patients with ankylosing spondylitis [ 32 ], in diabetic patients with foot ulcers [ 33 ] and in acromegaly patients [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

Ultrasound elastography: compression elastography and shear-wave elastography in the assessment of tendon injury

et al. 2018

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“…Guney et al showed that the ATs of patients with diabetic foot were softer and the elasticity of ATs was less than the elasticity of ATs of non-diabetic patients [15]. Using sonoelastograpy, Evranos et al also observed decreased AT stiffness and elasticity in patients with diabetic foot [14]. In the same study, neuropathy was the only ▶Table 1 Demographic, anthropometric and biochemical characteristics of the patient and control groups.…”

Section: Discussionmentioning

confidence: 94%

“…Determining the changes in AT is relatively easy due to its size and localization. There is substantial evidence of increased AT thickness in type 1 and type 2 diabetic patients [10][11][12], but data concerning stiffness is inconclusive [13][14][15]. Acoustic radiation force impulse (ARFI) elastography, a newly developed elastography method, uses sound waves to quantify tissue elasticity, thus allowing tissues or focal lesions to be evaluated without external compression.…”

Section: Introductionmentioning

confidence: 99%

Acoustic Radiation Force Impulse Elastography and Ultrasonographic Findings of Achilles Tendon in Patients With and Without Diabetic Peripheral Neuropathy: A Cross-Sectional Study

İyidir

Rahatli

Bozkuş

et al. 2019

Exp Clin Endocrinol Diabetes

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Aims We aimed to evaluate the elastographic features of Achilles tendon with Acoustic Radiation Force Impulse in patients with and without diabetic neuropathy. Methods According to the presence of peripheral neuropathy, 45 patients with type 2 diabetes were divided into 2 subgroups. Those with peripheral neuropathy were defined as group I (22 patients) and those without peripheral neuropathy were defined as group II (23 patients). A total of thirty age-, gender-, and body mass index-matched healthy individuals were selected as controls. All participants underwent both ultrasonographic and Acoustic Radiation Force Impulse elastographic examination in order to evaluate Achilles Tendon thickness and stiffness. Results Achilles tendon thicknesses were similar between groups (p=0.991). Achilles tendon thicknesses of both patient groups were significantly higher than the control group (group I vs control p=0.01; group II vs control p=0.006). Stiffness values of Achilles tendons were similar between the control group and group II (p=0.993). Shear Wave Velocity was significantly lower in group I than group IIand control group (p<0.001). Conclusion Diabetic patients with neuropathy have thicker and softer Achilles tendon while the elasticity of Achilles tendon in diabetic patients without neuropathy is similar to the healthy controls. Softening of the Achilles tendon may be an early sign of diabetic foot and reveal the patients with a risk of diabetic foot.

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“…There are many studies that have evaluated the elastographic findings of the Achilles tendon in healthy populations and in various pathologic conditions in the literature 7 – 9 . A prior study observed increased stiffness in Achilles tendons on elastography of patients with tendon pain associated with amateur sporting activities 10 .…”

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confidence: 99%

Elastographic Findings of Achilles Tendons in Asymptomatic Professional Male Volleyball Players

Balaban

İdilman

İpek

et al. 2016

J of Ultrasound Medicine

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Real-time sonoelastography and ultrasound evaluation of the Achilles tendon in patients with diabetes with or without foot ulcers: a cross sectional study

Cited by 26 publications

References 39 publications

Ultrasound elastography: compression elastography and shear-wave elastography in the assessment of tendon injury

Ultrasound elastography: compression elastography and shear-wave elastography in the assessment of tendon injury

Acoustic Radiation Force Impulse Elastography and Ultrasonographic Findings of Achilles Tendon in Patients With and Without Diabetic Peripheral Neuropathy: A Cross-Sectional Study

Elastographic Findings of Achilles Tendons in Asymptomatic Professional Male Volleyball Players

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