Phenotype of Achilles Tendon Ultrasonographic Abnormalities and Their Relationship to Future Time-Loss Injury

To identify specific tendon morphologies on ultrasonography of the Achilles tendon (AT) that later develop time-loss injury.

Blinded post hoc analysis of a 2-year prospective, observational study of 944 AT sonographic videos to identify morphologic characteristics of diagnosed Achilles tendinopathies associated with future time-loss injury. The second year was used to validate the findings from the first year.

N/A.

Four hundred seventy-three National Collegiate Athletic Association student-athletes from 3 institutions over 2 years of data collection (57.7% females; 20.1 ± 1.6 years of age; 23.1 ± 2.8 kg/m 2 of body mass index; 9.4 ± 3.6 years of sport experience).

Particular tendon morphologies were used to develop 3 ultrasonographic imaging rules that were used to predict AT injury leading to time loss in sport.

Positive predictive value (PPV) and negative predictive values of particular tendon morphologies associated with the development of time-loss injury within 1 year.

One of 3 morphologies, a deep mid-substance focal hypoechogenic area, was validated on 2 separate data sets and found to have a 33.3% PPV in both years for the development of time-loss injury.

Results suggest a specific phenotype of sonographic abnormality of the AT that suggests a 1-in-3 chance of developing time-loss injury within a year. Detecting abnormality of future AT before symptoms develop may allow for rehabilitation strategies to prevent or reduce time-loss.