Actualización científica en ecografía y tendinopatía aquíleaimplicaciones anatómicas relacionadas, abordaje terapéutico y nuevas perspectivas basadas en la evidencia

  1. David Rodríguez Sanz 1
  2. Marta Losa Iglesias 2
  3. Ricardo Becerro de Bengoa Vallejo 1
  4. Alfredo Soriano Medrano 1
  5. Ángel Morales Ponce 3
  6. César Calvo Lobo 1
  7. Marta San Antolín 4
  8. Pedro Carlos Ramírez Navarro 5
  9. Daniel García García 4
  1. 1 Universidad Complutense. Madrid, España
  2. 2 Universidad Rey Juan Carlos. Madrid, España
  3. 3 Universidad Castilla-La Mancha. Talavera de la Reina, Toledo, España
  4. 4 Universidad Europea de Madrid, España
  5. 5 Universidad de Almería, España
Revista:
Revista española de podología

ISSN: 0210-1238

Año de publicación: 2022

Volumen: 33

Número: 1

Páginas: 66-72

Tipo: Artículo

DOI: 10.20986/REVESPPOD.2022.1632/2022 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Revista española de podología

Resumen

El tendón de Aquiles es uno de los que sufre lesiones con mayor frecuencia, pudiendo presentar diversos tipos de afecciones diferentes. Dentro de ellas, la tendinopatía de la porción media del Aquiles es la más frecuente. Su etiología es multifactorial, por lo que resulta fundamental realizar una correcta valoración con el fin de dirigir mejor nuestros tratamientos. Dentro de las herramientas de las que disponemos para valorar el tendón de Aquiles, la ecografía ha cobrado mayor importancia en los últimos años, gracias a las mejoras en los equipos y a la amplia formación que se ofrece. Esto ha posibilitado que la ecografía se haya convertido en un punto clave en nuestras investigaciones con este método cada vez más válido y fiable para la valoración morfofuncional del sistema musculoesquelético, además de servirnos como guía en tratamientos invasivos y como feedback visual a la hora de realizar ejercicio terapéutico.

Referencias bibliográficas

  • Abate M, Salini V, Antinolfi P, Schiavone C. Ultrasound morphology of the Achilles in asymptomatic patients with and without diabetes. Foot Ankle Int. 2014;35(1):44-9. DOI: 10.1177/1071100713510496.
  • Afolabi BI, Idowu BM, Onigbinde SO. Achilles tendon degeneration on ultrasound in type 2 diabetic patients. J Ultrason. 2020;20(83):291-9. DOI: 10.15557/JoU.2020.0051.
  • Alfredson H, Masci L, Spang C. Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: a case series. BMJ Open Sports Exerc Med. 2021;7(1):e000979. DOI: 10.1136/bmjsem-2020-000979.
  • Barbachan Mansur NS, Furtado Fonseca L, Teruo Matsunaga F, Baumfeld DS, Nery CAS, Tamaoki MJS. Achilles tendon lesions-Part 1: Tendinopathies. Rev Bras Orthop. 2020;55(6):657-64.
  • Barfod KW, Riecke AF, Boesen A, Hansen P, Maier JF, Doessing S, et al. Validity and reliability of an ultrasound measurement of the free length of the Achilles tendon. Dan Med J. 2018;65(3):A5453.
  • Baxter JR, Corrigan P, Hullfish TJ, O’Rourke P, Silbernagel KG. Exercise progression to incrementally load the Achilles tendon. Med Sci Sports Exerc. 2021;53(1):124-30. DOI: 10.1249/MSS.0000000000002459.
  • Bisaccia M, Rinonapoli G, Meccariello L, isaccia O, Ceccarini P, Rollo G, et al. Validity and reliability of mini-invasive surgery assisted by ultrasound in Achilles tendon rupture. Acta Inform Med. 2019;27(1):40-4. DOI: 10.5455/aim.2019.27.40-44.
  • Boesen AP, Boesen MI, Torp-Pedersen S, Christensen R, Boesen L, Hölmich P, et al. Associations between abnormal ultrasound color Doppler measures and tendon pain symptoms in badminton players during a season: a prospective cohort study. Am J Sports Med. 2012;40(3):548-55. DOI: 10.1177/0363546511435478.
  • Brouwer EF, Myhrvold SB, Benth JS, Hoelsbrekken SE. Ultrasound measurements of Achilles tendon length using skin markings are more reliable than extended-field-of-view imaging. Knee Surg Sports Traumatol Arthrosc. 2018;26(7):2088-94. DOI: 10.1007/s00167-017-4815-0.
  • Capalbo E, Peli M, Stradiotti P. Sonoelastography of the distal third of the Achilles tendon in asymptomatic volunteers: correlation with anthropometric data, ultrasound findings and reproducibility of the method. Radiol Med. 2016;121(8):667-74. DOI: 10.1007/s11547-016-0642-5.
  • Chimenti RL, Chimenti PC, Buckley MR, Houck JR, Flemister AS. Utility of ultrasound for imaging osteophytes in patients with insertional Achilles tendinopathy. Arch Phys Med Rehabil. 2016;97(7):1206-9. DOI: 10.1016/j.apmr.2015.12.009.
  • Counsel P, Comin J, Davenport M, Connell D. Pattern of fascicular involvement in midportion achilles tendinopathy at ultrasound. Sports Health. 2015;7(5):424-8. DOI: 10.1177/1941738115595226.
  • Couppé C, Svensson RB, Josefsen CO, Kjeldgaard E, Magnusson SP. Ultrasound speckle tracking of Achilles tendon in individuals with unilateral tendinopathy: a pilot study. Eur J Appl Physiology. 2020;120(3):579-89. DOI: 10.1007/s00421-020-04317-5.
  • Cushman DM, Petrin Z, Eby S, Clements ND, Haight P, Snitily B, et al. Ultrasound evaluation of the patellar tendon and Achilles tendon and its association with future pain in distance runners. The Phys Sportsmed. 2021;49(4):410-9. DOI: 10.1080/00913847.2020.1847004.
  • De Jonge S, Van Den Berg C, De Vos RJ, van der Heide HJ, Weir A, Verhaar JA, et al. Incidence of midportion Achilles tendinopathy in the general population. Br J Sports Med. 2011;45(13):1026-8. DOI: 10.1136/bjsports-2011-090342.
  • De La Cruz Torres B, Barrera García-Martín I, Almazán Polo J, Jaén-Crespo G, Romero-Morales C. Ultrasound imaging evaluation of structural and textural features in asymptomatic Achilles tendons in pre-professional dancers: A cross-sectional study. Phys Ther Sport. 2020;44:85-91. DOI: 10.1016/j.ptsp.2020.05.008.
  • De La Cruz Torres B, Barrera García-Martín I, De La Cueva Reguera M, Bravo-Aguilar M, Abuin-Porras V, Romero-Morales C. Ultrasound imaging features of the Achilles tendon in dancers. Is there a correlation between the imaging and clinical findings? A cross-sectional study. Phys Therapy Sports. 2020;43:181-7. DOI: 10.1016/j.ptsp.2020.03.004.
  • De Marchi A, Pozza S, Cenna E, Cavallo F, Gays G, Simbula L, et al. In Achilles tendinopathy, the neovascularization, detected by contrast-enhanced ultrasound (CEUS), is abundant but not related to symptoms. Knee Surg Sports Traumatol Arthrosc. 2018;26(7):2051-8. DOI: 10.1007/s00167-017-4710-8. De Sá A, Hart DA, Khan K, Scott A. Achilles tendon structure is negatively correlated with body mass index, but not influenced by statin use: A cross-sectional study using ultrasound tissue characterization. PLoS ONE. 2018;13(6):e0199645. DOI: 10.1371/journal.pone.0199645.
  • Expósito Molinero MR, De Miguel Mendieta E. Estudio sobre la validez discriminante de la ecografía de entesis aquílea. Reumatol Clin. 2016;12(4):206-9. DOI: 10.1016/j.reuma.2015.08.006.
  • Fredberg U, Bolvig L, Andersen NT. Prophylactic training in asymptomatic soccer players with ultrasonographic abnormalities in achilles and patellar tendons. The Danish Super League study. Am J Sports Med. 2008;36(3):451-60. DOI: 10.1177/0363546507310073.
  • Fredberg U, Bolvig L. Significance of ultrasonographically detected asymptomatic tendinosis in the patellar and achilles tendons of elite soccer players: a longitudinal study. Am J Sports Med. 2002;30(4):488-91. DOI: 10.1177/03635465020300040701.
  • Fu SC, Rolf C, Cheuk YC, Lui PP, Chan KM. Deciphering the pathogenesis of tendinopathy: a three-stages process. Sports Med Arthrosc Rehabil Ther Technol. 2010;2:30.
  • Gatz M, Bode D, Betsch M, Quack V, Tingart M, Kuhl C, et al. Multimodal ultrasound versus MRI for the diagnosis and monitoring of Achilles tendinopathy- A prospective longitudinal study. Orthop J Sports Med. 2021;9(4): 23259671211006826. DOI: 10.1177/23259671211006826.
  • He L, Genin J, Delzell P. Ultrasound diagnosis and percutaneous treatment of Achilles tendon tethering: A case series. Skeletal Radiol. 2016;45(9):1293-8. DOI: 10.1007/s00256-016-2416-5.
  • Järvinen T, Kannus P, Mafulli N, Khan KM. Achilles tendon disorders: Etiology and epidemiology. Foot Ankle Clin N Am. 2005;10(2):255-66. DOI: 10.1016/j.fcl.2005.01.013.
  • Jhingan S, Perry M, O´Driscoll G, Lewin C, Teatino R, Malliaras P, et al. Thicker Achilles tendon are a risk factor to develop Achilles tendinopathy in elite professional soccer players. Muscle, lig and tend J. 2011;1(2):51-6.
  • Jonsson P, Alfredson H, Sunding K, Fahlström M, Cook J. New regimen for eccentric calf-muscle training in patients with chronic insertional Achilles tendinopathy: results of a pilot study. Br J Sports Med. 2008;42(9):746-9. DOI: 10.1136/bjsm.2007.039545. Kammar H, Carmont MR, Kots E, Laver L, Mann G, Nyska M, et al. Anatomy of the sural nerve and its relation to the Achilles tendon by ultrasound examination. Orthopedics. 2013;37(3):298-301.
  • Kruse A, Stafilidis S, Tilp M. Ultrasound and magnetic resonance imaging are not interchangeable to assess the Achilles tendon cross-sectional-area. Eur J Appl Physiol. 2017;117:73-82. DOI: 10.1007/s00421-016-3500-1.
  • Kudron C, Carlson MJ, Meron A, Sridhar B, Brakke Holman R. Using ultrasound measurement of the Achilles tendon in asymptomatic runners to assist in predicting tendinopathy. J Ultras Med. 2020;39(3):491-6. DOI: 10.1002/jum.15125.
  • Lalumiere M, Larivière C, Nadeau MJ, Paquette P, Lamontagne M, Desmeules F, et al. Proposing a minimal data set of musculoskeletal ultrasound imaging biomarkers to inform clinical practice: an analysis founded on the Achilles tendon. Ultras Med Biol. 2020;46(9):2222-35. DOI: 10.1016/j.ultrasmedbio.2020.04.024.
  • Liu W, Zhuang H, Shao D, Wang L, Shi M. High-frequency color doppler ultrasound in diagnosis, treatment, and rehabilitation of Achilles tendon injury. Med Sci Monit. 2017;23:5752-9. DOI: 10.12659/MSM.904186.
  • Liu W, Zhuang H, Shao D, Wang L, Shi M. High-frequency color doppler ultrasound in diagnosis, treatment, and rehabilitation of Achilles tendon injury. Med Sci Monit. 2017;23:5752-9. DOI: 10.12659/MSM.904186.
  • Macchi M, Spezia M, Elli S, Schiaffini G, Chisari E. Obesity increases the risk of tendinopathy, tendon tear and rupture, and postoperative complications: A systematic review of clinical studies. Clin Orthop Relat Res. 2020;478(8):1839-47. DOI: 10.1097/CORR.0000000000001261.
  • Mafulli N, Via AG, Oliva F. Chronic Achilles tendon disorders. Tendinopathy and chronic rupture. Clin Sports Med. 2015;34(4):607-24.
  • Mafulli N, Via AG, Oliva F. Chronic Achilles tendon rupture. Open Orthop J. 2017;11:660-9. DOI: 10.2174/1874325001711010660.
  • Magnussen RA, Dunn WR, Thomson AB. Nonoperative treatment of midportion Achilles tendinopathy: A systematic review. Clin J Sports Med. 2009;19(1):54-64. DOI: 10.1097/JSM.0b013e31818ef090. Mascarenhas S. A narrative review of the classification and use of diagnostic ultrasound for conditions of the Achilles tendon. Diagnostics. 2020;10(11):944. DOI: 10.3390/diagnostics10110944.
  • Mascaró A, Cos MA, Morral A, Roig A, Purdam C, Cook J. Load management in tendinopahty: Clinical progression for Achilles and patellar tendinopathy. Apunts Med Esports. 2018;53(197):19-27. DOI: 10.1016/j.apunts.2017.11.005.
  • Masci L, Spang C, Van Schie HTM, Alfredson H. Achilles tendinopathy-do plantaris tendon removal and Achilles tendon scraping improve tendon structure? A prospective study using ultrasound tissue characterization. BMJ Open Sports Exerc Med. 2015;1(1):e000005. DOI: 10.1136/bmjsem-2015-000005.
  • Matthews W, Ellis R, Furness JW, Rathbone E, Hing W. Staging Achilles tendinopathy using ultrasound imaging: the development and investigation of a new ultrasound imaging criteria based on the continuum model of tendon pathology. BMJ Open Sport and Exerc Med. 2020;6:e000699. DOI: 10.1136/bmjsem-2019-000699.
  • McAuliffe S, McCreesh K, Culloty F, Purtill H, O’Sullivan K. Can ultrasound imaging predict the development of Achilles and patellar tendinopathy? A systematic review and meta-analysis. Br J Sports Med. 2016;50(24):1516-23. DOI: 10.1136/bjsports-2016-096288.
  • Mubark I, Abouelela A, Arya S, Buchanan D, Elgalli M, Parker J, et al. Achilles tendon rupture: Can the tendon gap on ultrasound scan predict the outcome of functional rehabilitation program? Cureus. 2020;12(9):e10298. DOI: 10.7759/cureus.10298.
  • Nadeau MJ, Desrochers A, Lamontagne M, Larivière C, Gagnon DH. Quantitative ultrasound imaging of Achilles tendon integrity in symptomatic and asymptomatic individuals: reliability and minimal detectable change. J Foot and Ankle Res. 2016;9:30. DOI: 10.1186/s13047-016-0164-3. Risch L, Cassel M, Messerschmidt J, Intziegianni K, Fröhlich K, Kopinski S, et al. Is sonographic assessment of intratendinous blood flow in Achilles tendinopathy patients reliable? Ultras Int Open. 2016;2(1):e13-e18. DOI: 10.1055/s-0035-1569286.
  • Roesch HJ, Milanese S, Osborne B, Spurrier DJ, Thoirs KA. The acute effects of exercise on tendon dimensions and vascularity. An exploratory study using diagnostic ultrasound of the male Achilles tendon. J Sci Med Sports. 2018;21(10):982-7. DOI: 10.1016/j.jsams.2017.11.009.
  • Romero Morales C, Martín Llantino P, Calvo Lobo C, Beltran-Alacreu H, López-López D, Sánchez-Gómez R, et al. Effectiveness of eccentric exercise and a vibration or cryotherapy program in enhancing rectus abdominis muscle thickness and inter-rectus distance in patients with chronic mid-portion Achilles tendinopathy: A randomized clinical trial. Int J Med Sci. 2018;15(14):1764-70. DOI: 10.7150/ijms.28656.
  • Romero Morales C, Martín Llantino P, Calvo Lobo C, Palomo-López P, López-López D, Fernández-Carnero J, et al. Ultrasonography effectiveness of the vibration vs cryotherapy added to an eccentric exercise protocol in patients with chronic mid-portion Achilles tendinopathy: A randomized clinical trial. Int Wound J. 2019;16(2):542-9. DOI: 10.1111/iwj.13074.
  • Romero Morales C, Martín Llantino P, Calvo Lobo C, San-Antolín M, López-López D, Blanco-Morales M, et al. Ultrasound imaging of the abdominal wall and trunk muscles in patients with Achilles tendinopathy versus healthy participants. Diagnostics. 2019;10(1):17. DOI: 10.3390/diagnostics10010017.
  • Romero Morales C, Martín Llantino PJ, Calvo Lobo C, Almazán-Polo J, López-López D, de la Cruz-Torres B, et al. Intrinsic foot muscles morphological modifications in patients with Achilles tendinopathy: A novel case-control research study. Phys Ther Sports. 2019;40:208-12. DOI: 10.1016/j.ptsp.2019.09.014.
  • Romero Morales C, Martín Llantino PJ, Calvo Lobo C, López-López D, Sánchez-Gómez R, De-La-Cruz-Torres B, et al. Ultrasonography features of the plantar fascia complex in patients with chronic non-insertional Achilles tendinopathy: A case-control study. Sensors. 2019;19(9):2052. DOI: 10.3390/s19092052.
  • Romero Morales C, Martín Llantino PJ, Calvo Lobo C, Palomo-López P, López-López D, Pareja-Galeano H, et al. Comparison of the sonographic features of the Achilles tendon complex in patients with and without Achilles tendinopathy: A case-control study. Phys Ther Sport. 2019;35:122-6. DOI: 10.1016/j.ptsp.2018.12.003.
  • Romero Morales C, Martín Llantino PJ, Calvo Lobo C, Sánchez-Gómez R, López-López D, Pareja-Galeano H, et al. Ultrasound evaluation of extrinsic foot muscles in patients with chronic non-insertional Achilles tendinopathy: A case-control study. Phys Ther Sport. 2019;37:44-8. DOI: 10.1016/j.ptsp.2019.02.006.
  • Sahr M, Sturnick DR, Nwawka OK. Quantitative ultrasound assessment of the Achilles tendon under varied loads. J Ultrasound Med. 2018;37(10):2413-8. DOI: 10.1002/jum.14589. Sánchez Sánchez JL, Calderón Díez L, Herrero Turrión J, Méndez-Sánchez R, Arias-Buría JL, Fernández-de-Las-Peñas C. Changes in gene expression associated with collagen regeneration and remodeling of extracellular matrix after percutaneous electrolysis on collagenase-induced Achilles tendinopathy in an experimental animal model: A pilot study. J Clin Med. 2020;9(10):3316. DOI: 10.3390/jcm9103316.
  • Santamato A, Beatrice R, Micello MF, Fortunato F, Panza F, Bristogiannis C, et al. Power doppler ultrasound findings before and after focused extracorporeal shock wave therapy for Achilles tendinopathy: a pilot study on pain reduction and neovascularization effect. Ultrasound Med Biol. 2019;45(5):1316-23. DOI: 10.1016/j.ultrasmedbio.2018.12.009.
  • Sanz López F, Berzosa C, Hita Contreras F, Cruz-Diaz D, Martínez-Amat A. Ultrasound changes in Achilles tendon gastrocnemius medialis muscle on squat eccentric overload and running performance. J Strength Condition Research. 2015;30(7):2010-8. DOI: 10.1519/JSC.0000000000001298.
  • Schmidt EC, Hullfish TJ, O´Connor KM, Hast MW, Baxter JR. Ultrasound echogenicity is associated with fatigue-induced failure in a cadaveric Achilles tendon model. J Biomech. 2020;105: 109784. DOI: 10.1016/j.jbiomech.2020.109784.
  • Shao YH, Peng Z, Kong X, Wang B, Zhang H. Real-time ultrasound elastography evaluation of Achilles tendon properties in patients with mild hemiplegic stroke after rehabilitation training. J Ultrasound Med. 2019;38(3):713-23. DOI: 10.1002/jum.14755.
  • Sobhani S, Dekker R, Postema K, Dijkstra PU. Epidemiology of ankle and foot overuse injuries in sports: A systematic review. Scand J Med Sci Sports. 2013;23(6):669-86. DOI: 10.1111/j.1600-0838.2012.01509.x.
  • Stenroth L, Sefa S, Arokoski J, Töyräs J. Does magnetic resonance imaging provide superior reliability for Achilles and patellar tendon cross-sectional area measurements compared with ultrasound imaging? Ultras in Med and Biol. 2019;45(12):3186-98. DOI: 10.1016/j.ultrasmedbio.2019.08.001.
  • Thoirs KA, Childs J. Are ultrasound measurements of Achilles tendon size reliable? A systematic review of rater reliability. Ultras in Med and Biol. 2018;44(12):2476-91. DOI: 10.1016/j.ultrasmedbio.2018.07.011.
  • Tweedell AJ, Ryan ED, Scharville MJ, Rosenberg JG, Sobolewski EJ, Kleinberg CR. The influence of ultrasound measurement techniques on the age-related differences in Achilles tendon size. Experimental Geront. 2016;76:68-71. DOI: 10.1016/j.exger.2016.01.015.
  • Weinfeld S. Achilles tendon disorders. Med Clin N Am. 2014;98(2):331-8. DOI: 10.1016/j.mcna.2013.11.005.