Diagnosing Achilles Tendon Rupture with Ultrasound in Patients Treated Surgically: A Systematic Review and...

Area of Science:

• Musculoskeletal imaging
• Orthopedic diagnostics
• Sports medicine

Background:

• Achilles tendon rupture incidence is rising due to sports and aging populations.
• Delayed or missed diagnosis is common, often mistaken for ankle sprains.
• Accurate diagnosis is crucial for effective treatment of Achilles tendon injuries.

Purpose of the Study:

• To systematically evaluate ultrasound's diagnostic accuracy for Achilles tendon rupture.
• To determine sensitivity, specificity, and likelihood ratios of ultrasound compared to surgical outcomes.
• To provide evidence for ultrasound's role in diagnosing Achilles tendon injuries.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Literature search of MEDLINE and EMBASE databases.
• Inclusion of 15 studies with 808 patients comparing ultrasound to surgical findings.

Main Results:

• Ultrasound demonstrated high sensitivity (94.8%) and specificity (98.7%) for complete Achilles tendon ruptures.
• Positive likelihood ratio was 74.0 and negative likelihood ratio was 0.05.
• These metrics indicate strong diagnostic performance in surgically treated patients.

Conclusions:

• Ultrasound is a reliable tool for diagnosing Achilles tendon ruptures.
• A negative ultrasound result can effectively rule out both complete and partial Achilles tendon ruptures.
• This supports the use of ultrasound in clinical decision-making for suspected Achilles injuries.