Estado actual de la validez y fiabilidad de la valoración ecográfica del tendón de Aquiles
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Objetivo: Conocer la validez y fiabilidad de la ecografía musculo esquelética en la valoración del tendón de Aquiles. Conocer los hallazgos ecográficos típicos en el tendón de Aquiles, tanto sano como lesionado.
Material y métodos: Se realizó una revisión bibilográfica desarrollando una búsqueda en PubMed que abarcó trabajos desde 1984 hasta el 30 de enero de 2018 Se usaron los siguientes términos: “Ultrasound achilles tendon”, “Ultrasound triceps surae”, “Achilles tendinopathy ultrasound”. Se incluyeron artículos en base a su calidad metodológica, relevancia científica, aportación de una visión novedosa y su utilidad clínica.
Resultados: Se encontraron artículos sobre la validez y fiabilidad de la evaluación del tendón de Aquiles, así como de estructuras próximas, con ecografía músculo esquelética. También se encontraron artículos sobre los hallazgos en la imagen del tendón de Aquiles sano y lesionado.
Conclusiones: La literatura parece confirmar que la ecografía músculo esquelética es un método valido y fiable para evaluar la tendinopatía aquilea. Existirían diferencias ecográficas entre tendones sanos y lesionados, y no parece diferenciarse éste entre lesión crónica y desgarro interno. El engrosamiento tendinoso y la neovascularización deberían tenerse al diagnosticar la tendinopatía aquilea, pero su simple presencia no determinaría la severidad clínica.
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De Jonge S, van den Berg C, de Vos RJ, van der Heide HJ, Weir A, Verhaar JA, et al. Incidence of midportion Achilles tendinopathy in the general population. Br J Sports Med 2011 Oct;45(13):1026-1028.
Chaudhry S, Morrissey D, Woledge RC, Bader DL, Screen H. Eccentric and concentric loading of the triceps surae: an in vivo study of dynamic muscle and tendon biomechanical parameters. J Appl Biomech. 2015;31(2):69-78.
Sunding K, Fahlström M, Werner S, Forssblad M, Willberg L. Evaluation of Achilles and patellar tendinopathy with greyscale ultrasound and colour Doppler: using a four-grade scale. Knee Surg Sports Traumatol Arthrosc 2014:1-9.
Del Baño-Aledo ME, Martínez-Payá JJ, Ríos-Díaz J, Mejías-Suárez S, Serrano-Carmona S, de Groot-Ferrando A. Ultrasound measures of tendon thickness: Intra-rater, Inter-rater and Inter-machine reliability. Muscles Ligaments Tendons J. 2017;7(1):192.
Kruse A, Stafilidis S, Tilp M. Ultrasound and magnetic resonance imaging are not interchangeable to assess the Achilles tendon cross-sectional-area. Eur J Appl Physiol 2017;117(1):73-82.
Martinoli C, Derchi LE, Pastorino C, Bertolotto M, Silvestri E. Analysis of echotexture of tendons with US. Radiology 1993 Mar;186(3):839-843
Bakkegaard M, Johannsen FE, Højgaard B, Langberg H. Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy: A prospective observational study. Eur J Radiol 2015;84(3):458-462.
Johannsen F, Jensen S, Stallknecht SE, Olsen LO, Magnusson SP. Sonographic measurements of the achilles tendon, plantar fascia, and heel fat pad are reliable: A test‐retest intra‐and intertester study. J. Clin. Ultrasound 2016;44(8):480-486.
Cheng J, Tsai W, Yu T, Huang K. Reproducibility of sonographic measurement of thickness and echogenicity of the plantar fascia. J. Clin. Ultrasound 2012;40(1):14-19.
Bohm S, Mersmann F, Schroll A, Mäkitalo N, Arampatzis A. Insufficient accuracy of the ultrasound-based determination of Achilles tendon cross-sectional area. J Biomech 2016;49(13):2932-2937.
Hodgson RJ, O'Connor PJ, Grainger AJ. Tendon and ligament imaging. Br J Radiol 2012 Aug;85(1016):1157-1172.
Maffulli N, Regine R, Angelillo M, Capasso G, Filice S. Ultrasound diagnosis of Achilles tendon pathology in runners. Br J Sports Med 1987 Dec;21(4):158-162.
Nazarian LN, Rawool NM, Martin CE, Schweitzer ME. Synovial fluid in the hindfoot and ankle: detection of amount and distribution with US. Radiology 1995 Oct;197(1):275-278.
Chan O, Morton S, Pritchard M, Parkes T, Malliaras P, Crisp T, et al. Intratendinous tears of the Achilles tendon-a new pathology? Analysis of a large 4-year cohort. Muscles Ligaments Tendons J 2017;7(1):53.
Neuhold A, Stiskal M, Kainberger F, Schwaighofer B. Degenerative Achilles tendon disease: assessment by magnetic resonance and ultrasonography. Eur J Radiol 1992;14(3):213-220.
Docking S, Cook J. Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization (UTC). Scand J Med Sci Sports 2015.
Calleja M, Connell DA. The Achilles tendon. Semin Musculoskelet Radiol 2010 Sep;14(3):307-322.
Stecco A, Busoni F, Stecco C, Mattioli-Belmonte M, Soldani P, Condino S, et al. Comparative ultrasonographic evaluation of the Achilles paratenon in symptomatic and asymptomatic subjects: an imaging study. Surg Radiol Anat 2014;37(3):281-285.
Arya S, Kulig K. Tendinopathy alters mechanical and material properties of the Achilles tendon. J Appl Physiol (1985) 2010 Mar;108(3):670-675.
Gibbon WW, Cooper JR, Radcliffe GS. Sonographic incidence of tendon microtears in athletes with chronic Achilles tendinosis. Br J Sports Med 1999 Apr;33(2):129-130.
Cassel M, Baur H, Hirschmüller A, Carlsohn A, Fröhlich K, Mayer F. Prevalence of Achilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes. Scand J Med Sci Sports 2015;25(3):e310-e318.
Yang X, Coleman DP, Pugh ND, Nokes LD. The volume of the neovascularity and its clinical implications in Achilles tendinopathy. Ultrasound Med Biol 2012;38(11):1887-1895.
Divani K, Chan O, Padhiar N, Twycross-Lewis R, Maffulli N, Crisp T, et al. Site of maximum neovascularisation correlates with the site of pain in recalcitrant mid-tendon Achilles tendinopathy. Man Ther 2010;15(5):463-468.
Mahieu N, Van Tiggelen D, De Muynck M, Dumalin M, Witvrouw E. Blood flow of the Achilles tendon during military training. Int J Sports Med 2010;31(12):901.
Counsel P, Comin J, Davenport M, Connell D. Pattern of Fascicular Involvement in Midportion Achilles Tendinopathy at Ultrasound. Sports Health 2015 Sep;7(5):424-428.
Hirschmuller A, Frey V, Konstantinidis L, Baur H, Dickhuth HH, Sudkamp NP, et al. Prognostic value of Achilles tendon Doppler sonography in asymptomatic runners. Med Sci Sports Exerc 2012 Feb;44(2):199-205.
Jhingan S, Perry M, O’Driscoll G, Lewin C, Teatino R, Malliaras P, et al. Thicker Achilles tendons are a risk factor to develop Achilles tendinopathy in elite professional soccer players. Muscles, Ligaments and Tendons Journal 2011;1(2):51.
Fisker, F. Y., Kildegaard, S. , Thygesen, M. , Grosen, K. and Pfeiffer‐Jensen, M. Acute tendon changes in intense CrossFit workout: an observational cohort study. Scand J Med Sci Sports, 2017 27: 1258-1262.
Pingel J, Harrison A, Simonsen L, Suetta C, Bulow J, Langberg H. The microvascular volume of the Achilles tendon is increased in patients with tendinopathy at rest and after a 1-hour treadmill run. Am J Sports Med 2013 Oct;41(10):2400-2408.
Malliaras P, Chan O, Simran G, Martinez de Albornoz P, Morrissey D, Maffulli N. Doppler ultrasound signal in Achilles tendinopathy reduces immediately after activity. Int J Sports Med 2012;33(6):480.
Docking, S. I., Rosengarten, S. D., Daffy, J., & Cook, J. Structural integrity is decreased in both Achilles tendons in people with unilateral Achilles tendinopathy. J Sci Med Sport 2015 18(4), 383-387.
De Jonge S, Rozenberg R, Vieyra B, Stam HJ, Aanstoot HJ, Weinans H, et al. Achilles tendons in people with type 2 diabetes show mildly compromised structure: an ultrasound tissue characterisation study. Br J Sports Med 2015 Aug;49(15):995-999.
De Jonge S, Warnaars J, De Vos R, Weir A, Schie H, Bierma‐Zeinstra S, et al. Relationship between neovascularization and clinical severity in Achilles tendinopathy in 556 paired measurements. Scand J Med Sci Sports 2014;24(5):773-778.
Boesen AP, Boesen MI, Torp-Pedersen S, Christensen R, Boesen L, Holmich P, et al. Associations between abnormal ultrasound color Doppler measures and tendon pain symptoms in badminton players during a season: a prospective cohort study. Am J Sports Med 2012 Mar;40(3):548-555.
Jonge, S. de, Tol, J. L., Weir, A., Waarsing, J. H., Verhaar, J. A. N., & de Vos, R.-J. (2015). The Tendon Structure Returns to Asymptomatic Values in Nonoperatively Treated Achilles Tendinopathy but Is Not Associated With Symptoms: A Prospective Study. Am J Sports Med, 43(12), 2950–2958.