Yudu - sportEX medicine - 1999-2010

INJURY DIAGNOSIS TENDINOPATHY

images, but other studies simply state the presence or absence of neovascularisation. Boesen et al (39) modified Öhberg’s grading system to five grades, numbered 0 to 4. In our opinion, the current methods are too crude or too impractical for a clinical setting, so a more comprehensive grading system should be used. Overall ultrasound has a vital role in the diagnosis and monitoring of Achilles tendinopathy as it has comparable accuracy to other imagining modalities, is easily accessible, and exhibits a high inter- and intra-observer reliability (45).

References

1. Kvist M. Achilles tendon injuries in athletes. Sports Medicine 1994;18:173–201 2. Jarvinen TA, Kannus P, Maffulli N, Khan KM. Achilles tendon disorders: Etiology and epidemiology. Foot and Ankle Clinics 2005;10:255–266

3. Rolf C, Movin T. Etiology, histopathology and outcome of

surgery in achillodynia. Foot and Ankle International 1997;18:565–569 4. Maffulli.N, Khan.K, Puddu.G. Overuse tendon conditions: Time to change a confusing terminology. Arthroscopy 1998;14(8):840–853

5. Jarvinen M, Jozsa L, Kannus P. Histopathological findings in chronic tendon disorders. Scandinavian Journal of Medicine and Science in Sports 1997;7:86–95 6. Khan K, Cook J, Kannus P. Time to abandon the tendinitis myth. British Medical Journal 2002;324;626–627 7. Puddu G, Ippolito E, Postacchini F. A classification of Achilles tendon disease. American Journal of Sports Medicine 1976;4:145–150 8. Fornage BD. Achilles tendon: US examination. Radiology 1986;159(3):759– 764

9. Maffulli N, Benazzo F. Basic science of tendons. Sports Medicine and Arthroscopy Review 2000;8:1–5 10. Kader D, Saxena A, Movin T, Maffulli N. Achilles tendinopathy: Some aspects of basic science and clinical management. British Journal of Sports Medicine 2002;36:239–249 11. Kannus P. Structure of the tendon connective tissue. Scandinavian Journal of Medicine and Science in Sports 2000;10:312–320 12. Chen TM, Rozen WM, Pan WR, Ashton MW, Richardson MD, Taylor GI. The arterial anatomy of the Achilles tendon: Anatomical study and clinical implications. Clinical Anatomy 2009;22(3):377–385 13. Ahmed IM, Lagopoulos M, McConnell P, Soames RW, Sefton GK. Blood supply of the Achilles tendon. Journal of Orthopaedic Research 1998;16(5):591–596 14. Tan SC, Chan O. Achilles and patellar tendinopathy: Current understanding of pathophysiology and management. Disability and Rehabilitation

www.sportEX.net

2008;30(20/22):1608–1615 15. Maffulli N, Sharma P, Luscombe K. Achilles tendinopathy: Aetiology and management. Journal of the Royal Society of Medicine 2004;97:472–476 16. Kannus P, Natri A. Etiology and pathophysiology of chronic tendon disorders in sports. Scandinavian Journal of Medicine and Science in Sports 1997;7:78–85 17. Khan KM, Maffulli N. Tendinopathy: An Achilles’ heel for athletes and clinicians. Clinical Journal of Sports Medicine 1998;8:151–154

18. Mahieu NN, Witvrouw E, Stevens V, Van Tiggelen D, Roget P. Intrinsic risk factors for the development of Achilles tendon overuse injury: A prospective study. American Journal of Sports Medicine 2006;34(2):226–235

19. Ireland D, Harrall R, Curry V, Holloway G, Hacknet R, Hazelman B, Riley G. Multiple changes in gene expression in chronic human Achilles tendinopathy. Matrix Biology 2001;20:159–169

20. Jozsa LG, Kannus P. Human tendons: Anatomy, physiology, and pathology. Champaign, IL: Human Kinet; 1997 (from £230.14). ISBN 0873224841. To Order from Amazon

http://bit.ly/99HZfZ 21. Leadbetter WB. Cell-matrix response in tendon injury. Clinical

Journal of Sports Medicine 1992;11:533– 578 22. Waterston SW, Maffulli N, Ewen SWB. Subcutaneous rupture of the Achilles tendon: Basic science and aspects of clinical practice. British Journal of Sports Medicine 1997;31:285–298 23. Almekinders LC, Temple JD. Etiology, diagnosis, and treatment of tendonitis: An analysis of the literature. Medicine and Science in Sports and Exercise 1998;30:1183–1190

24. Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Update and implications for clinical management. Sports Medicine 1999;27:393–408

25. Khan KM, Cook JL, Maffulli N, Kannus P. Where is the pain coming from in tendinopathy? It may be biochemical, not only structural, in origin. British Journal of Sports Medicine 2000;34:81–83 26. Alfredson H. In situ microdialysis in tendon tissue: High levels of glutamate, but not prostaglandin E2 in chronic Achilles tendon pain. Knee Surgery Sports Traumatology Arthroscopy 1999;7:378– 381 27. Galloway MT, Jokl P, Dayton OW. Achilles tendon overuse injuries. Clinical Sports Medicine 1992;11:771–782

28. Ohberg L, Lorentzon R, Alfredson H. Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: An ultrasonographic investigation. Knee Surgery, Sports Traumatology Arthroscopy 2001;994:233–238 29. Alfredson H, Ohberg L, Forsgren S. Is vasculo–neural ingrowth the cause of pain in chronic Achilles tendinosis? An

investigation using ultrasonography and colour Doppler, immunohistochemistry, and diagnostic injections. Knee Surgery Sports Traumatology Arthroscopy 2003;11(5):334–338 30. de Vos RJ, Weir A, Cobben LP, Tol JL. The value of power Doppler ultrasonography in Achilles tendinopathy: A prospective study. American Journal of Sports Medicine 2007;35(10):1696–1701

31. Fredericson M. Common injuries in runners. Diagnosis, rehabilitation and prevention. Sports Medicine 1996;21:49– 72

32. Clement DB, Taunton JE, Smart GW. Achilles tendinitis and peritendinitis: Etiology and treatment. American Journal of Sports Medicine 1984;12:179–184 33. Gibbon WW, Cooper JR, Radcliffe GS. Distribution of sonographically detected tendon abnormalities in patients with a clinical diagnosis of chronic Achilles tendinosis. Journal of Clinical Ultrasound 2001;28(2):61–66

34. Kvist M. Achilles tendon injuries in athletes. Annales Chirurgiae et Gynaecologiae 1991;80:188–201 35. Robinson JM, Cook JL, Purdam C, Visentini PJ, Ross J, Maffulli N, Taunton JE, Khan KM. The VISA-A questionnaire: A valid and reliable index of the clinical severity of Achilles tendinopathy. British Journal of Sports Medicine 2001;35(5):335–341 36. Alfredson H, Pietila T, Jonsson P, Lorentzon R. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. American Journal of Sports Medicine 1998;26:360–366 37. Aström M, Gentz CF, Nilsson P, Rausing A, Sjoberg S, Westlin N. Imaging in chronic Achilles tendinopathy: A comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases. Skeletal Radiology 1996;25(7):615–620 38. Khan KM, Forster BB, Robinson J, Cheong Y, Louis L, Maclean L, Taunton JE. Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two-year prospective study. British Journal of Sports Medicine 2003;37(2):149–153 39. Boesen MI, Koenig MJ, Torp-Pedersen S, Bliddal H, Langberg H. Tendinopathy and Doppler activity: The vascular response of the Achilles tendon to exercise. Scandinavian Journal of Medicine and Science in Sports 2006;16(6):463–469 40. Leung JL, Griffith JF. Sonography of chronic Achilles tendinopathy: A case–control study. Journal of Clinical Ultrasound 2008;36(1):27–32 41. Gibbon WW, Cooper JR, Radcliffe GS. Distribution of sonographically detected tendon abnormalities in patients with a clinical diagnosis of chronic Achilles tendinosis. Journal of Clinical Ultrasound 2001;28(2):61–66

42. Ohberg L, Alfredson H. Effects on neovascularisation behind the good results with eccentric training in chronic mid- portion Achilles tendinosis? Knee Surgery Sports Traumatology Arthroscopy 2004;12(5):465–70.