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Ultrasound assessment of tendons in asymptomatic volunteers: a study of reproducibility

  • Musculoskeletal
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Abstract

The purpose was to evaluate the inter-visit, inter-observer and intra-observer variation of quantitative and qualitative tendon examinations in vivo for a cohort of asymptomatic volunteers. Eleven healthy male subjects were recruited. The following tendons were assessed by ultrasonography: Achilles tendon, patellar tendon, triceps tendon, extensor pollicis longus, flexor carpi radialis and supraspinatus. For each tendon a quantitative measurement of tendon size was made at a predefined anatomical location. Two experienced sonologists, blind to one another’s findings, evaluated each of the tendons independently. Each tendon was evaluated on two occasions 1 week apart. No difference was found to be attributed to variation in tendon size between visits. Inter-observer variation was a source of error with intra-subject, inter-visit measurements proving more reproducible. There was some significant variation between observers. This variation was more marked with some tendon measures than others. Inter-observer variation for triceps, flexor carpi radialis and supraspinatus was most marked. Minimum detectable change in tendons varied from 13 to 57% depending on the plane of scanning and the tendon being examined. Good reproducibility of quantitative tendon measurements can be achieved within a study using two observers by following a defined scanning protocol. However, it is recommended that the same observer perform serial assessments. The data allow minimal detectable changes in tendon size to be calculated.

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References

  1. Grassi W, Filippucci E, Farina A, Cervini C (2000) Sonographic imaging of tendons. Arthritis Rheum 43:969–976

    Article  CAS  PubMed  Google Scholar 

  2. Martinoli C, Bianchi S, Derchi LE (1999) Tendon and nerve sonography. Radiol Clin North Am 37:691–711 (viii)

    CAS  PubMed  Google Scholar 

  3. Martinoli C, Bianchi S, Dahmane M, Pugliese F, Bianchi-Zamorani MP, Valle M (2002) Ultrasound of tendons and nerves. Eur Radiol 12:44–55

    Article  PubMed  Google Scholar 

  4. Curwin SL, Stanish WD (1984) Tendinitis: its etiology and treatment. Collamore/DC Health, Lexington

    Google Scholar 

  5. Riley G (2004) The pathogenesis of tendinopathy. A molecular perspective. Rheumatology (Oxford) 43:131–142

    CAS  Google Scholar 

  6. Robson MD, Gatehouse PD, Bydder M, Bydder GM (2003) Magnetic resonance: an introduction to ultrashort TE (UTE) imaging. J Comput Assist Tomogr 27:825–846

    Article  PubMed  Google Scholar 

  7. Gatehouse PD, Bydder GM (2003) Magnetic resonance imaging of short T2 components in tissue. Clin Radiol 58:1–19

    Article  CAS  PubMed  Google Scholar 

  8. Weidekamm C, Koller M, Weber M, Kainberger F (2003) Diagnostic value of high-resolution B-mode and Doppler sonography for imaging of hand and finger joints in rheumatoid arthritis. Arthritis Rheum 48:325–333

    Article  CAS  PubMed  Google Scholar 

  9. Jozsa L, Kannus P (1997). Human tendons: anatomy, physiology, and pathology. Human Kinetics, Champlein

    Google Scholar 

  10. Kainberger F, Mittermaier F, Seidl G, Parth E, Weinstabl R (1997) Imaging of tendons—adaptation, degeneration, rupture. Eur J Radiol 25:209–222

    Article  CAS  PubMed  Google Scholar 

  11. Kannus P, Jozsa L (1991) Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am 73:1507–1525

    CAS  PubMed  Google Scholar 

  12. Jarvinen M, Jozsa L, Kannus P, Jarvinen TL, Kvist M, Leadbetter W (1997) Histopathological findings in chronic tendon disorders. Scand J Med Sci Sports 7:86–95

    CAS  PubMed  Google Scholar 

  13. Jarvinen TA, Kannus P, Paavola M, Jarvinen TL, Jozsa L, Jarvinen M (2001) Achilles tendon injuries. Curr Opin Rheumatol 13:150–155

    Article  CAS  PubMed  Google Scholar 

  14. Backhaus M, Burmester GR, Gerber T, Grassi W, Machold KP, Swen WA, Wakefield RJ, Manger B (2001) Guidelines for musculoskeletal ultrasound in rheumatology. Ann Rheum Dis 60:641–649

    Article  CAS  PubMed  Google Scholar 

  15. Chen YJ, Liang SC (1997) Diagnostic efficacy of ultrasonography in stage I posterior tibial tendon dysfunction: sonographic-surgical correlation. J Ultrasound Med 16:417–423

    CAS  PubMed  Google Scholar 

  16. Rand T, Bindeus T, Alton K, Voegele T, Kukla C, Stanek C, Imhof H (1998) Low-field magnetic resonance imaging (0.2 T) of tendons with sonographic and histologic correlation. Cadaveric study. Invest Radiol 33:433–438

    Article  CAS  PubMed  Google Scholar 

  17. Rockett MS, Waitches G, Sudakoff G, Brage M (1998) Use of ultrasonography versus magnetic resonance imaging for tendon abnormalities around the ankle. Foot Ankle Int 19:604–612

    CAS  PubMed  Google Scholar 

  18. Waitches GM, Rockett M, Brage M, Sudakoff G (1998) Ultrasonographic-surgical correlation of ankle tendon tears. J Ultrasound Med 17:249–256

    CAS  PubMed  Google Scholar 

  19. Fornage BD (1986) Achilles tendon: US examination. Radiology 159:759–764

    CAS  PubMed  Google Scholar 

  20. Koivunen-Niemela T, Parkkola K (1995) Anatomy of the Achilles tendon (tendo calcaneus) with respect to tendon thickness measurements. Surg Radiol Anat 17:263–268

    CAS  PubMed  Google Scholar 

  21. Astrom M, Gentz CF, Nilsson P, Rausing A, Sjoberg S, Westlin N (1996) Imaging in chronic achilles tendinopathy: a comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases. Skeletal Radiol 25:615–620

    Article  CAS  PubMed  Google Scholar 

  22. Soila K, Karjalainen PT, Aronen HJ, Pihlajamaki HK, Tirman PJ (1999) High-resolution MR imaging of the asymptomatic Achilles tendon: new observations. Am J Roentgenol 173:323–328

    CAS  Google Scholar 

  23. Kainberger FM, Engel A, Barton P, Huebsch P, Neuhold A, Salomonowitz E (1990) Injury of the Achilles tendon: diagnosis with sonography. Am J Roentgenol 155:1031–1036

    CAS  Google Scholar 

  24. Ying M, Yeung E, Li B, Li W, Lui M, Tsoi CW (2003) Sonographic evaluation of the size of Achilles tendon: the effect of exercise and dominance of the ankle. Ultrasound Med Biol 29:637–642

    Article  PubMed  Google Scholar 

  25. Richards PJ, Dheer AK, McCall IM (2001) Achilles tendon (TA) size and power Doppler ultrasound (PD) changes compared to MRI: a preliminary observational study. Clin Radiol 56:843–850

    Article  CAS  PubMed  Google Scholar 

  26. Civeira F, Castillo JJ, Calvo C, Ferrando J, de Pedro C, Martinez-Rodes P, Pocovi M (1998) Achilles tendon size by high resolution sonography in healthy population. Relationship with lipid levels. Med Clin (Barc) 111:41–44

    CAS  Google Scholar 

  27. Leotta DF, Martin RW (2000) Three-dimensional ultrasound imaging of the rotator cuff: spatial compounding and tendon thickness measurement. Ultrasound Med Biol 26:509–525

    Article  CAS  PubMed  Google Scholar 

  28. Pickersgill CH, Marr CM, Reid SW (2001) Repeatability of diagnostic ultrasonography in the assessment of the equine superficial digital flexor tendon. Equine Vet J 33:33–37

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Clinical Radiology, Leeds Teaching Hospitals Trust, The General Infirmary, Great George Street, Leeds, LS1 3EX, UK

    Philip J. O’Connor & Andrew J. Grainger

  2. AstraZeneca, Alderley Park, Macclesfield, Cheshire, UK

    S. R. Morgan, K. L. Smith, J. C. Waterton & A. F. P. Nash

Authors
  1. Philip J. O’Connor
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  2. Andrew J. Grainger
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  3. S. R. Morgan
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  4. K. L. Smith
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  5. J. C. Waterton
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  6. A. F. P. Nash
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Correspondence to Andrew J. Grainger.

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O’Connor, P.J., Grainger, A.J., Morgan, S.R. et al. Ultrasound assessment of tendons in asymptomatic volunteers: a study of reproducibility. Eur Radiol 14, 1968–1973 (2004). https://doi.org/10.1007/s00330-004-2448-4

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  • DOI: https://doi.org/10.1007/s00330-004-2448-4

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