Utility of Ultrasound for Imaging Osteophytes in Patients With Insertional Achilles Tendinopathy
Utility of Ultrasound for Imaging Osteophytes in Patients With Insertional Achilles Tendinopathy
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DOI：
10.1016/j.apmr.2015.12.009
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发表时间：
2016-07-01
影响因子：
4.3
通讯作者：
Flemister, A. Samuel
中科院分区：
文献类型：
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作者：
Chimenti, Ruth L.;Chimenti, Peter C.;Flemister, A. Samuel
目的：检查(1)超声成像测量骨赘的有效性和(2)骨赘与跟腱附着性病变(IAT)的关系。设计：病例对照研究。地点：学术医学中心。参与者：慢性单侧IAT患者(n=20；平均年龄58.7+/-8.3岁；10[50%]女性)和年龄和性别匹配的对照组(n=20；平均年龄，57.4+/-9.8岁；10名(50%)女性)参与了这项病例对照研究(N=40)。干预措施：不适用。主要观察指标：使用足部和踝关节能力测量、维多利亚运动评估协会跟腱问卷和数字评定量表评估症状严重程度。使用超声成像测量两组患者双侧骨赘的长度，同时使用X线片测量IAT组症状侧的骨赘长度。使用组内相关系数来检验超声和放射学测量之间的一致性。采用McNemar、Wilcoxon符号等级和Fisher精确检验比较骨赘出现的频率和长度在两组间的差异。采用皮尔逊相关分析骨赘长度与症状严重程度之间的关系。结果：超声和X线片骨赘测量结果具有良好的一致性(组内相关系数>；=.75)。骨赘的出现频率在两侧或组之间没有统计学意义(P>；0.05)。IAT组有症状侧的骨赘大于无症状侧(P=.01)和对照组左侧(P=.03)。骨赘长度与症状严重程度无关。结论：超声成像是骨赘长度的有效测量方法，与IAT相关。虽然较大的骨赘表示肌腱病变，但并不表示IAT症状更严重。(C)2016年度美国康复医学大会
Objectives: To examine (1) the validity of ultrasound imaging to measure osteophytes and (2) the association between osteophytes and insertional Achilles tendinopathy (IAT).Design: Case-control study.Setting: Academic medical center.Participants: Persons with chronic unilateral IAT (n=20; mean age, 58.7 +/- 8.3y; 10 [50%] women) and age- and sex-matched controls (n = 20; mean age, 57.4 +/- 9.8y; 10 [50%] women) participated in this case-control study (N=40).Interventions: Not applicable.Main Outcome Measures: Symptom severity was assessed using the Foot and Ankle Ability Measure, the Victorian Institute of Sport Assessment Achilles questionnaire, and the numerical rating scale. Length of osteophytes was measured bilaterally in both groups using ultrasound imaging, as well as on the symptomatic side of the IAT group using radiography. The intraclass correlation coefficient was used to examine the agreement between ultrasound and radiograph measures. McNemar, Wilcoxon signed-rank, and Fisher exact tests were used to compare the frequency and length of osteophytes between sides and groups. Pearson correlation was used to examine the association between osteophyte length and symptom severity.Results: There was good agreement (intraclass correlation coefficient, >=.75) between ultrasound and radiograph osteophyte measures. There were no statistically significant differences (P>.05) in the frequency of osteophytes between sides or groups. Osteophytes were larger on the symptomatic side of the IAT group than on the asymptomatic side (P=.01) and on the left side of controls (P=.03). There was no association between osteophyte length and symptom severity.Conclusions: Ultrasound imaging is a valid measure of osteophyte length, which is associated with IAT. Although a larger osteophyte indicates tendinopathy, it does not indicate more severe IAT symptoms. (C) 2016 by the American Congress of Rehabilitation Medicine