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What does normal tendon structure look like? : new insights into tissue characterization in the Achilles tendon

Evi Wezenbeek (UGent) , N Mahieu, Tine Willems (UGent) , Damien Van Tiggelen (UGent) , Martine De Muynck (UGent) , Dirk De Clercq (UGent) and Erik Witvrouw (UGent)
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Abstract
Recently, ultrasound tissue characterization (UTC) was introduced as a reliable method for quantification of tendon structure. Despite increasing publications on the use of UTC, it is striking that there is a lack of normative data in active adolescents. Therefore, the aim of this study was to provide normative values of the Achilles tendon as quantified by UTC. Seventy physiotherapy students (26 male and 44 female students) with no history of Achilles tendon injuries were recruited. The Achilles tendons were scanned with UTC to characterize tendon structure. This study demonstrated that Achilles tendons of active, healthy adolescents contained 54.6% echo type I, 42.8% echo type II, 2.2% echo type III, and 0.3% echo type IV at midportion. The comparison between insertion and midportion of the tendon showed more echo type II at insertion (P < 0.001). Furthermore, female tendons contained significantly more echo type II, in both insertion and midportion compared with male tendons (P = 0.004 and P = 0.003, respectively). The results of this study, with respect to the MDC (minimum detectable change), highlight differences in the UTC echopattern in the normal population (sex and regional location), which are important considerations for future studies.
Keywords
Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine, Biomechanics and Motor Control of Human Movement, Achilles tendon, adolescents, echo type distribution, ultrasound, ultrasound tissue characterization, IN-VIVO, TENDINOPATHY, INJURIES, PROTEOGLYCANS, PLAYERS

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Chicago
Wezenbeek, Evi, N Mahieu, Tine Willems, Damien Van Tiggelen, Martine De Muynck, Dirk De Clercq, and Erik Witvrouw. 2017. “What Does Normal Tendon Structure Look Like? : New Insights into Tissue Characterization in the Achilles Tendon.” Scandinavian Journal of Medicine & Science in Sports 27 (7): 746–753.
APA
Wezenbeek, E., Mahieu, N., Willems, T., Van Tiggelen, D., De Muynck, M., De Clercq, D., & Witvrouw, E. (2017). What does normal tendon structure look like? : new insights into tissue characterization in the Achilles tendon. SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS, 27(7), 746–753.
Vancouver
1.
Wezenbeek E, Mahieu N, Willems T, Van Tiggelen D, De Muynck M, De Clercq D, et al. What does normal tendon structure look like? : new insights into tissue characterization in the Achilles tendon. SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS. 2017;27(7):746–53.
MLA
Wezenbeek, Evi, N Mahieu, Tine Willems, et al. “What Does Normal Tendon Structure Look Like? : New Insights into Tissue Characterization in the Achilles Tendon.” SCANDINAVIAN JOURNAL OF MEDICINE & SCIENCE IN SPORTS 27.7 (2017): 746–753. Print.
@article{8501773,
  abstract     = {Recently, ultrasound tissue characterization (UTC) was introduced as a reliable method for quantification of tendon structure. Despite increasing publications on the use of UTC, it is striking that there is a lack of normative data in active adolescents. Therefore, the aim of this study was to provide normative values of the Achilles tendon as quantified by UTC. Seventy physiotherapy students (26 male and 44 female students) with no history of Achilles tendon injuries were recruited. The Achilles tendons were scanned with UTC to characterize tendon structure. This study demonstrated that Achilles tendons of active, healthy adolescents contained 54.6\% echo type I, 42.8\% echo type II, 2.2\% echo type III, and 0.3\% echo type IV at midportion. The comparison between insertion and midportion of the tendon showed more echo type II at insertion (P {\textlangle} 0.001). Furthermore, female tendons contained significantly more echo type II, in both insertion and midportion compared with male tendons (P = 0.004 and P = 0.003, respectively). The results of this study, with respect to the MDC (minimum detectable change), highlight differences in the UTC echopattern in the normal population (sex and regional location), which are important considerations for future studies.},
  author       = {Wezenbeek, Evi and Mahieu, N and Willems, Tine and Van Tiggelen, Damien and De Muynck, Martine and De Clercq, Dirk and Witvrouw, Erik},
  issn         = {0905-7188},
  journal      = {SCANDINAVIAN JOURNAL OF MEDICINE \& SCIENCE IN SPORTS},
  keyword      = {Physical Therapy,Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine,Biomechanics and Motor Control of Human Movement,Achilles tendon,adolescents,echo type distribution,ultrasound,ultrasound tissue characterization,IN-VIVO,TENDINOPATHY,INJURIES,PROTEOGLYCANS,PLAYERS},
  language     = {eng},
  number       = {7},
  pages        = {746--753},
  title        = {What does normal tendon structure look like? : new insights into tissue characterization in the Achilles tendon},
  url          = {http://dx.doi.org/10.1111/sms.12706},
  volume       = {27},
  year         = {2017},
}

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