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Published (Version of record)CC BY-NC V4.0, Open Access
Published (Version of record)CC BY V4.0, Open
Journal article
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 & Exercise Medicine, Vol.6(1), pp.1-10
25/03/2020
PMID: 32341798
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Abstract
Aim: To develop a standardised ultrasound imaging (USI)-based criteria for the diagnosis of tendinopathy that aligns with the continuum model of tendon pathology. Secondary aims were to assess both the intra-rater and inter-rater reliability of the criteria.
Methods: A criteria was developed following a face validity assessment and a total of 31 Achilles tendon ultrasound images were analysed. Intra-rater and inter-rater reliability were assessed for overall tendinopathy stage (normal, reactive/early dysrepair or late dysrepair/degenerative) as well as for individual parameters (thickness, echogenicity and vascularity). Quadratic weighted kappa (k w) was used to report on reliability.
Results: Intra-rater reliability was 'substantial' for overall tendinopathy staging (k w rater A; 0.77, 95%CI 0.59 to 0.94, rater B; 0.70, 95%CI 0.52 to 0.89) and ranged from 'substantial' to 'almost perfect' for thickness (k w rater A; 0.75, 95%CI 0.59 to 0.90, rater B; 0.84, 95%CI 0.71 to 0.98), echogenicity (k w rater A; 0.78, 95%CI 0.62 to 0.95, rater B; 0.73, 95%CI 0.58 to 0.89) and vascularity (k w rater A; 0.86, 95%CI 0.74 to 0.98, rater B; 0.89, 95%CI 0.79 to 0.99). Inter-rater reliability ranged from 'substantial' to 'almost perfect' for overall tendinopathy staging (k w round 1; 0.75, 95%CI 0.58 to 0.91, round 2; 0.81, 95%CI 0.63 to 0.99), thickness (k w round 1; 0.65, 95%CI 0.48 to 0.83, round 2; 0.77, 95%CI 0.60 to 0.93), echogenicity (k w round 1; 0.70, 95%CI 0.54 to 0.85, round 2; 0.76, 95%CI 0.58 to 0.94) and vascularity (k w round 1; 0.89, 95%CI 0.79 to 0.99, round 2; 0.86, 95%CI 0.74 to 0.98). Inter-rater reliability increased from 'substantial' in round 1 (k w 0.75, 95%CI 0.58 to 0.91) to 'almost perfect' in round 2 (0.81, 95%CI 0.63 to 0.99).
Conclusion: Intra-rater and inter-rater reliability were 'substantial' to 'almost perfect' when utilising an USI-based criteria to diagnose Achilles tendinopathy. This is the first study to use the continuum model of tendon pathology to develop an USI-based criteria to diagnose tendinopathy.
Details
- Title
- Staging achilles tendinopathy using ultrasound imaging: the development and investigation of a new ultrasound imaging criteria based on the continuum model of tendon pathology
- Creators
- Wesley Matthews - Bond UniversityRichard Ellis - Auckland University of TechnologyJames W. Furness - Bond UniversityEvelyne Rathbone - Bond UniversityWayne Hing - Bond University
- Publication Details
- BMJ Open Sport & Exercise Medicine, Vol.6(1), pp.1-10
- Publisher
- BMJ Publishing Group Ltd
- Number of pages
- 10
- Grant note
- This research was supported by an Australian Government Research Training Program Scholarship.
- Identifiers
- 991013323324802368
- Copyright
- © Author(s) (or their employer(s)) 2020.
- Academic Unit
- Faculty of Health
- Language
- English
- Resource Type
- Journal article