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MANAGEMENT OF TENDINOPATHIES WITH ULTRASOUND TISSUE CHARACTERISATION


Achilles and patella tendon pain is very common, but the precise nature of the complaint is difficult to diagnose and treat. The new imaging modality of ultrasound tissue characterisation (UTC) produces high resolution scans of the tendon, providing an in- depth analysis of the health of the tendon tissue. In the future this technology will become indispensable for preventing tendon overload, diagnosing tendon conditions and monitoring rehabilitation.


BY JARROD ANTFLICK BAPP BHSC PGCERT AND CHRIS MYERS BSC MSC PGCERT


TENDONS AND TENDINOPATHY Tendons connect muscle to bone and are able to withstand very high tensile loads. Tendon complaints are very common in recreational and elite sportsmen and women, particularly the Achilles tendon. Epidemiology data on recreational runners indicates 5–34% will develop Achilles tendon pain, and in elite runners and elite sportsmen and women, tendon pain is responsible for significant time off training and competition. Achilles tendon pain provides a challenge to any health professional. Tendinopathy is characterised by matrix disintegration as a consequence of overstraining, ageing, degeneration and/or partial ruptures. The differential


(UTC™) PROVIDES A MORE DETAILED IMAGING PROFILE OF THE TENDON


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ULTRASOUND TISSUE CHARACTERISATION


diagnosis of Achilles tendon complaints is paramount to implementing the most effective treatment plan (Table 1).


IMAGING MODALITIES Currently, ultrasound is the imaging modality of choice for the assessment of tendons as it has far superior spatial resolution to MRI and can assess for neovessels in and around the tendon. However, clinical improvement is not correlated with changes in imaging status or the amount of neovascularity (1). Also, ultrasound is dependent on the skills of the operator and produces a 2D image of a 3D structure, which introduces further limitations in assessing the structural integrity of the tendon.


ULTRASOUND TISSUE CHARACTERISATION A new novel imaging modality ultrasound tissue characterisation (UTC™) provides a more detailed imaging profile of the tendon (Fig. 1). UTC imaging produces a multi-planar and 3D coronal view to assess in detail the structural integrity of the tendon (2).


sportEX medicine 2014;61(July):26-30


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