Use of Ultrasonography for Measuring Achilles Tendon Thickness: a Novel Measurement Method

Sakarya University180 enrolled

Overview

Background: Achilles tendon thickness has been associated with various diseases. Among imaging modalities, ultrasonography stands out because of its advantages in assessing Achilles tendon thickness. Previous studies typically recommend performing Achilles tendon ultrasonography with the patient in a prone position on an examination table. However, because it is not always possible or safe for each patient to assume the prone position, this study aimed to investigate the relationship between measurements obtained in the supine position and those obtained using the standard method. Methods: A total of 180 healthy volunteers aged ≥18 years (70 female and 110 male; 360 Achilles tendons), with no history of disease or medication use, were included in the study. Achilles tendon measurements (thickness, width, and cross-sectional area) were obtained via ultrasonography in four different positions, including the standard method. The alternative methods included the supine position with the leg extended (Method 2), the supine position with the ankle resting on the opposite knee (Method 3), and the supine position with the leg held in the air at 90 degrees of hip and knee flexion (Method 4). Measurements were taken 2 cm distal from the Achilles tendon insertion on the calcaneus.

Study Type

OBSERVATIONAL

Enrollment

180

Conditions

Achilles Tendon Emergency Medicine Ultrasonography

Interventions

Achilles tendon ultrasonography was performed on healthy volunteers included in the study by an emergency physician trained in both basic and advanced ultrasonography techniques. Measurements were conducted using a Butterfly iQ (Butterfly Network, Inc., Guilford, CT) ultrasound device in B-mode with a musculoskeletal preset, using biplane imaging. For Achilles tendon measurement, the image depth was set to 2.0 cm. A linear probe was placed longitudinally and perpendicular to the tendon. The distal portion of the Achilles tendon and the calcaneus were visualized in the long axis, whereas the short axis was used to center the Achilles tendon on the screen for an optimal measurement view. The measurement site was determined as 2 cm proximal to the Achilles tendon insertion at the calcaneus. In biplane imaging, Achilles tendon thickness was measured in the long axis, whereas thickness, width, and cross-sectional area were measured in the short axis. Measurements were performed bilaterally

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Healthy volunteers aged \>18 years who agreed to participate in the study Exclusion Criteria: * Individuals with tenosynovitis, tendinitis, bursitis, tuberculous arthritis, rheumatoid arthritis, a history of Achilles tendon surgery, or tendon injuries.

Outcomes

Primary Outcomes

A novel ultrasonographic technique for achilles tendon thickness measurement

The primary outcome of this study was to provide a practical method for Achilles tendon measurement in emergency departments by addressing the disadvantages of the prone measurement technique proposed in previous studies.

Time frame: Baseline