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Clinical Trial
. 2016:2016:2580969.
doi: 10.1155/2016/2580969. Epub 2016 Nov 28.

Utility of Ultrasonography in Assessing the Effectiveness of Extracorporeal Shock Wave Therapy in Insertional Achilles Tendinopathy

Yi Cheng  1 , Jian Zhang  2 , Yehua Cai  1
Affiliations
Clinical Trial

Utility of Ultrasonography in Assessing the Effectiveness of Extracorporeal Shock Wave Therapy in Insertional Achilles Tendinopathy

Yi Cheng et al. Biomed Res Int. 2016.

Abstract

Introduction. The aim of this study was to investigate the utility of ultrasonography (US) for predicting and assessing the effectiveness of extracorporeal shock wave therapy (ESWT) in insertional Achilles tendinopathy (IAT). Methods. A total of 42 patients with an established diagnosis of chronic IAT were examined by US before ESWT and at 4 weeks and 12 weeks after ESWT. The thickness and cross-sectional area (CSA) of the Achilles tendon, size of calcific plaques, tendon structure score, and neovascularization score were measured at each time point. Results. After therapy, Victorian Institute of Sport Assessment-Achilles (VISA-A) scores increased significantly, and the size of calcific plaques decreased (P < 0.05). Neovascularization scores increased at the 4th week and then decreased at the 12th week (P < 0.05). The thickness, CSA, and structure of the Achilles tendon did not change. Variables observed by US at baseline were not associated with changes in VISA-A scores at follow-up. However, the changes in calcific plaque size and neovascularization scores were related to the improvement of VISA-A scores between pre- and posttherapy (P < 0.01). Conclusion. Ultrasonography can reveal some changes in the insertion of the Achilles tendon after ESWT, but the outcome of ESWT in IAT cannot be predicted by the variables observed by US.

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Conflict of interest statement

The authors confirm that there is no conflict of interests associated with this publication and there has been no financial support for this work that could have influenced its outcome.

Figures

Figure 1
Figure 1
Transverse sonograms show 4-grade scale of tendon structure (outline of Achilles tendon traced by dotted line). (a) Grade 0—normal structure (homogenous echogenicity). (b) Grade 1—light structural changes (discrete hypoechogenic areas). (c) Grade 2—moderate structural changes (some well-defined hypoechogenic areas). (d) Grade 3—severe structural changes (extended hypoechogenic areas).
Figure 2
Figure 2
(a) Transverse sonogram shows plentiful calcific plaques (arrows) in the insertion of the Achilles tendon before therapy (outline of Achilles tendon traced by dotted line). (b) The calcific plaques reduced by the 4th week after therapy.
Figure 3
Figure 3
(a) Color Doppler shows no vessels in the insertion of the Achilles tendon before therapy. (b) There was neovascularization at the 4th week after therapy.
Figure 4
Figure 4
Changes in the VISA-A scores of patients with and without neovascularization at baseline, week 4, and week 12.
Figure 5
Figure 5
Changes in the VISA-A scores of patients with and without calcific plaques at baseline, week 4, and week 12.
See this image and copyright information in PMC

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