HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 35/10/1696    most recent 0363546507303116v2 0363546507303116v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by de Vos, R.-J. Articles by Tol, J. L. Search for Related Content PubMed PubMed Citation Articles by de Vos, R.-J. Articles by Tol, J. L. Related Collections Imaging Studies Achilles tendon Nonoperative

The Value of Power Doppler Ultrasonography in Achilles Tendinopathy

A Prospective Study

Robert-Jan de Vos^*, Adam Weir, MD^*, Lodewijk P. J. Cobben, MD and Johannes L. Tol, MD, PhD^*,

From the ^* Sports Medicine Department and the Radiology Department, The Hague Medical Centre Antoniushove, Leidschendam, The Netherlands

Address correspondence to Johannes L. Tol, MD, PhD, The Hague Medical Centre Antoniushove, Sports Medicine Department, PO Box 411, Burgemeester Banninglaan 1, 2260 AK Leidschendam, The Netherlands (e-mail: h.tol{at}mchaaglanden.nl).

Background: Neovascularization, detected with power Doppler ultrasonography (PDU), is thought by some to play a central role in pathogenesis of Achilles tendinopathy.

Hypothesis: Power Doppler ultrasonography neovascularization score is correlated with clinical severity at baseline and after conservative treatment.

Study Design: Cohort study (prognosis); Level of evidence, 2.

Methods: Seventy tendons from 58 patients with chronic midportion Achilles tendinopathy were included, and 63 symptomatic tendons were analyzed. All patients were prescribed a 12-week heavy-load eccentric training program and evaluated with PDU at baseline and 12 weeks. Patient satisfaction, Victorian Institute of Sports Assessment–Achilles (VISA-A) score, and mean visual analog scale (VAS) score were correlated with degree of neovascularization (5-grade scale).

Results: Of the 63 symptomatic tendons, baseline neovascularization scores were 23 grade 0 (37% no neovessels), 18 grade 1, 8 grade 2, 8 grade 3, and 6 grade 4 (63% neovascularization grades 1–4). At baseline, neovascularization was not significantly correlated with the mean VAS score (r= .19, P= .131) and VISA-A score (r=–.23, P= .074). At 12-week follow-up, the neovascularization score significantly correlated with the mean VAS score (r= .43, P< .001) and VISA-A score (r=–.46, P< .001). No significant differences were found in improvement of VISA-A score after treatment between patients with neovessels (grades 1–4) or without neovessels (grade 0) at baseline.

Conclusion: Sixty-three percent of the symptomatic tendons were found to have neovessels at baseline. There was no significant correlation between neovascularization score and clinical severity at baseline, but at follow-up, there was a significant correlation. Neovascularization at baseline did not predict clinical outcome after conservative treatment.

Key Words: Achilles • eccentric • tendinopathy • neovascularization • power Doppler ultrasound

This article has been cited by other articles:

				K. Knobloch and U. Fredberg Letter to the Editor * Authors' Response Am. J. Sports Med., June 1, 2008; 36(6): e1 - e2. [Full Text] [PDF]

				K. Knobloch, R.-J. de Vos, A. Weir, and J. L. Tol Letters to the Editor * Authors' Response Am. J. Sports Med., February 1, 2008; 36(2): 395 - 397. [Full Text] [PDF]