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Quantifying the integrity of the Achilles tendon (AT) is a rehabilitation challenge. Adopting quantitative ultrasound measurements (QUS measurements) of the AT could fill this gap by 1) evaluating the test-retest reliability and accuracy of QUS measurements of the AT; 2) determining the best protocol for collecting QUS measurements in clinical practice.
A total of 23 ATs with symptoms of Achilles tendinopathy and 63 asymptomatic ATs were evaluated. Eight images were recorded for each AT (2 visits × 2 evaluators × 2 images). Multiple sets of QUS measurements were taken: geometric (thickness, width, area), first-order statistics (computed from a grayscale histogram distribution: echogenicity, variance, skewness, kurtosis, entropy) and texture features (computed from co-occurrence matrices: contrast, energy, homogeneity). A generalizability study quantified the reliability and standard error of measurement (accuracy) of each QUS measurement, and a decision study identified the best measurement taking protocols.
Geometric QUS measurements demonstrated excellent accuracy and reliability. QUS measurements computed from the grayscale histogram distribution revealed poor accuracy and reliability. QUS measurements derived from co-occurrence matrices showed variable accuracy and moderate to excellent reliability. In clinical practice, using an average of the results of three images collected by a single evaluator during a single visit is recommended.
The use of geometric QUS measurements enables quantification of AT integrity in clinical practice and research settings. More studies on QUS measurements derived from co-occurrence matrices are warranted.
Krolo I, Višković K, Ikić Đ, Klarić-Ćustović R, Marotti M, Cicvara T. The risk of sports activities–the injuries of the Achilles tendon in sportsmen. Coll Antropol. 2007;31(1):275–8. PubMed
McShane JM, Ostick B, McCabe F. Noninsertional Achilles tendinopathy: pathology and management. Curr Sports Med Rep. 2007;6(5):288–92. PubMed
Brasseur J, Zeitoun-Eiss D, Renoux J, Bach G. Apport de l’échographie dans l’exploration du pied et de la cheville. EM-Consulte Podologie. 2010. doi: 10.1016/S0292-062X(10)53770-X.
Bianchi S, Martinoli C. Ultrasound of the Musculoskeletal System. 1st ed. Berlin Heidelberg: Springer; 2007.
Jacobson JA. Fundamentals of musculoskeletal ultrasound. 1st ed. Philadelphia: Elsevier Health Sciences; 2007.
Sharma P, Maffulli N. Biology of tendon injury: healing, modeling and remodeling. J Musculoskelet Neuronal Interact. 2006;6(2):181. PubMed
Bharati MH, Liu JJ, MacGregor JF. Image texture analysis: methods and comparisons. Chemometr Intell Lab Syst. 2004;72(1):57–71. CrossRef
Vestergrd Iversen J, Bartels EM, Langberg H. The Victorian Institute of Sports Assessment-Achilles Questionnaire (VISA-A)-reliable tool for measuring Achilles tendinopathy. Int J Sports Phys Ther. 2012;7(1):76–84. PubMed
Roebroeck ME, Harlaar J, Lankhorst GJ. The application of generalizability theory to reliability assessment: an illustration using isometric force measurements. Phys Ther. 1993;73(6):386–95. PubMed
Portney LG, Watkins MP. Foundations of clinical research: Applications to practice. 3rd ed. Prentice Hall; 2007
Nielsen PK, Jensen BR, Darvann T, Jørgensen K, Bakke M. Quantitative ultrasound image analysis of the supraspinatus muscle. Clin Biomech (Bristol, Avon). 2000;15:S13–6. CrossRef
Haralick RM, Shanmugam K, Dinstein IH. Textural features for image classification. IEEE Trans Syst Man Cybern Syst. 1973;3(6):610–21. CrossRef
Lagergren C, Lindholm Å. Vascular distribution in the Achilles tendon; an angiographic and microangiographic study. Acta Chir Scand. 1959;116(5–6):491. PubMed
Clain MR, Baxter DE. Achilles tendinitis. Foot Ankle Int. 1992;13(8):482–7. CrossRef
- Quantitative ultrasound imaging of Achilles tendon integrity in symptomatic and asymptomatic individuals: reliability and minimal detectable change
Dany H. Gagnon
- BioMed Central