Ultrasound imaging/guidance for insertional Achilles tendinopathy

Area of Science:

• Musculoskeletal imaging
• Orthopedic ultrasonography
• Tendinopathy research

Background:

• Insertional Achilles tendinopathy (IAT) affects the tendon-bone junction (TBJ).
• Standardized sonographic evaluation of the TBJ in IAT is needed.
• Histological correlation is crucial for understanding sonographic findings.

Purpose of the Study:

• To establish a standardized sonographic method for assessing elementary lesions of the TBJ in IAT.
• To correlate sonographic findings with histological features of the TBJ.
• To identify specific sonographic signs for different stages of bony spurs.

Main Methods:

• Observational study utilizing high-frequency transducers.
• Matching histological microarchitecture and anatomical features of the TBJ.
• Employing Color/Power Doppler assessments alongside B-mode imaging.

Main Results:

• Fifty-eight patients with IAT were enrolled (mean age 54 years, 55.17% male).
• Five elementary sonographic lesions were defined: bone spur, calcified longitudinal fissuration, intra-tendinous bony formation, tendon-bone disjunction, and fibrocartilage hyperemia.
• Specific sonographic signs differentiating bony spur phases were identified.

Conclusions:

• High-frequency B-mode and Doppler ultrasound enable detailed sonographic assessment of the TBJ in IAT.
• The five defined elementary lesions provide a standardized approach for prompt examination of the TBJ in IAT.
• Advances in ultrasound technology facilitate accurate TBJ assessment in Achilles tendinopathy.