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Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization ( UTC )
Author(s) -
Docking S. I.,
Cook J.
Publication year - 2016
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.12491
Subject(s) - achilles tendon , tendon , pathological , patellar tendon , ultrasound , tendinopathy , medicine , anatomy , patellar ligament , patella , pathology , radiology
Structural disorganization in the tendon is associated with tendinopathy, with little research investigating whether disorganization overwhelms the overall structural integrity of the tendon. This study investigated the mean cross‐sectional area ( CSA ) of aligned fibrillar structure as detected by ultrasound tissue characterization ( UTC ) in the pathological and normal A chilles and patellar tendons. Ninety‐one participants had their A chilles and/or patellar tendons scanned using UTC to capture a three‐dimensional image of the tendon and allow a semi‐quantification of the echopattern. The mean CSA of aligned fibrillar structure (echo type I + II ) and disorganized structure (echo type III + IV ) was calculated based on UTC algorithms. Each tendon was classified as either pathological or normal based solely on gray‐scale ultrasound. The mean CSA of aligned fibrillar structure was significantly greater ( P ≤ 0.001) in the pathological tendon compared with the normal tendon, despite the pathological tendon containing greater amounts of disorganized structure ( P ≤ 0.001). A significant relationship was observed between the mean CSA of disorganized structure and anteroposterior diameter of the A chilles ( R 2 = 0.587) and patellar ( R 2 = 0.559) tendons. This study is the first to show that pathological tendons have sufficient levels of aligned fibrillar structure. Pathological tendons may compensate for areas of disorganization by increasing in tendon thickness.