Imaging modalities in the diagnosis and monitoring of Achilles tendon ruptures: A systematic review.

Injury

University of Groningen, University Medical Center Groningen, Department of Sport and Exercise Medicine, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.

Published: November 2017

Objective: To determine the role of imaging in the diagnosis and monitoring of the Achilles tendon rupture (ATR).

Study Design: Systematic review.

Data Sources: PubMed and EMBASE in November 2016.

Eligibility Criteria: Clinical studies providing information on the methods and role of imaging in the diagnosis and monitoring of the ATR were included.

Results: Fifty-six studies were included, most concerning the use of ultrasound (n=37) or MRI (n=18). Seven studies provided data on the diagnostic accuracy of imaging. Most ultrasound studies used a 7.5MHz probe (19/32 studies) and scanned the patient bilaterally in prone position, with recent studies tending to use higher frequency probes (r=0.42). Sensitivity [for detecting a rupture] ranged from 79.6 to 100%; the spread in specificity was large but two studies showed perfect (100%) data. Negative and positive likelihood ratios ranged from 0 to 0.23 and 1.0 to 10 respectively. MRI examination was generally performed with 1.5Tesla (T) MRI (6/12 studies) with a strong trend for higher T strength in more recent studies (r=0.71). One study reported a sensitivity of 90.9% and one a specificity of 100%. Although imaging can visualize structure and healing, these results were generally not related to the clinical picture. Overall, ultrasound was recommended over MRI for diagnosis and monitoring. Results of other imaging modalities remain inconclusive.

Conclusion: The adjunct role of imaging, especially of ultrasound and MRI, in the diagnosis and monitoring of ATRs was established. It is therefore recommended to rely primarily on the clinical examination and evaluation and to use imaging for ruling out other injuries and providing additional clinical information. More high-quality research is warranted into the diagnostic accuracy of imaging as well as less conventional imaging modalities' diagnostic and monitoring capabilities.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.injury.2017.09.013DOI Listing

Publication Analysis

Top Keywords

diagnosis monitoring
20
role imaging
12
imaging
10
studies
9
imaging modalities
8
monitoring achilles
8
achilles tendon
8
imaging diagnosis
8
diagnostic accuracy
8
accuracy imaging
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!