Purpose: Sonoelastography is a recently developed ultrasound (US) technique that allows in vivo assessment of tissue mechanical properties. Up to now, this technique has been mainly used to investigate prostatic tumours and breast masses. The aim of our paper is to use sonoelastography to evaluate Achilles tendon in amateurs symptomatic runners.
Materials and Methods: Sixteen patients referred for unilateral Achilles tendon pain due to overuse associated with amateur sporting activities and 24 healthy controls were studied. US and sonoelastography were performed on 16 symptomatic tendons and 48 control tendons with a system equipped with a 10-6 MHz broadband linear array. The array was positioned at the calcaneal enthesis, retrocalcaneal bursa and in 3 different areas of the tendon body. The elastogram colour range was translated in a numeric score. Results were compared by the Kruskall Wallis test.
Results: At grey scale US, symptomatic tendons showed a variety of basic changes in fibrillar pattern (2): increased tendon thickness (12), interruption (5), fragmentation (5), and disappearance of fibrillar echotexture (5). In the control group, we observed 1 case of increased tendon thickness and 5 cases of disappearance of fibrillar echotexture. By sonoelastography, no difference was observed between symptomatic and control tendons at the enthesis and bursa. Symptomatic tendons bodies were significantly harder than control ones, showing a prevalence of blue to green colour (p<0.0001).
Conclusion: Sonoelastography shows increased stiffness in symptomatic enlarged Achilles tendons in comparison to normal ones. Long-term studies are needed to evaluate if these findings have a prognostic value.