Clinical diagnosis of Achilles tendinopathy with tendinosis
Clinical diagnosis of Achilles tendinopathy with tendinosis
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DOI：
10.1097/00042752-200301000-00003
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发表时间：
2003-01-01
影响因子：
2.7
通讯作者：
King, JB
中科院分区：
文献类型：
--
作者：
Maffulli, N;Kenward, TG;King, JB
目标：评价10例跟腱病患者和14例无症状受试者触诊疼痛弧形征和皇家伦敦医院试验的敏感性、特异性、可重复性和预测价值。设计：测试-再测试研究。设置：大学教学医院。参与者：10名男性运动员在等待名单上的探索他们的跟腱的肌腱病变的主要机构的肌腱参加了一个特殊的诊所。每个人都被邀请带至少一名年龄在2年内的同一学科的同性运动员，没有跟腱病史和症状。A，总共有14个对照，因此招募。主要结果措施：疼痛和触诊，疼痛弧标志，和皇家伦敦医院test.Results的性能后压痛：有没有统计学上的显着差异，在5%的水平之间的影响，调查员或上午和下午之间的测量任何三种测量方法。三种评估方法之间无差异（p > 0.05）。当三种方法联合使用时，总体灵敏度为0.586（置信区间[CI]，0.469-0.741），总体特异性为0.833（CL 0.758-0.889）。跟腱病患者的腱内肿胀的压痛区域随肌腱移动，并且当使用当肌腱处于张力下时，可以制定肌腱病的临床诊断，具有肌腱将显示肌腱病的超声和组织学特征的高阳性预测机会。
Objective: To evaluate sensitivity, specificity, reproducibility, and predictive value of palpation of the painful arc sign and of the Royal London Hospital test in 10 patients with Achilles tendinopathy and in 14 asymptomatic subjects.Design: Test-retest study.Setting: University teaching hospital.Participants: Ten male athletes on the waiting list for exploration of one of their Achilles tendons for tendinopathy of the main body of the tendon attended a special clinic. Each was invited to bring at least one athlete of the same sex in the same discipline aged within 2 years of themselves with no history and no symptoms of Achilles tendinopathy. A,total of 14 controls were thus recruited.Main Outcome Measures: Pain and tenderness following performance of palpation, the painful arc sign, and the Royal London Hospital test.Results: There were no statistically significant differences at the 5% level among the effects of investigator or between morning and afternoon measurements for any of the three measurement methods. There was no evidence of a difference of the three assessment methods (p > 0.05). When the three methods were combined, the overall sensitivity was 0.586 (confidence interval [CI], 0.469-0.741), and the overall specificity was 0.833 (CL 0.758-0.889).Conclusions: In patients with tendinopathy of the Achilles tendon with a tender area of intratendinous swelling that moves with the tendon and whose tenderness significantly decreases or disappears when the tendon is put under tension, a clinical diagnosis of tendinopathy can be formulated, with a high positive predictive chance that the tendon will show ultrasonographic and histologic features of tendinopathy.