Evaluation of tendon involvement with Sonoelastography in follow-up of Familial Mediterranean Fever

Abstract

AIM : Sonoelastography (SE) is a new ultrasound-based imaging technique that provides information on tissue elasticity and stiffness. Strain sonoelastography is the most commonly used technique that allows real-time visualisation of the tissue. In this study, we searched the efficacy of SE for assessing Achilles tendon abnormalities in patients with familial mediterranean fever (FMF) suffering from talalgia. METHODS: Achilles tendons of 18 FMF patients suffering from unilateral talalagia with normal X-ray were evaluated by SE. Achilles tendon of symptomatic side is compared with normal (painless) side. Tendons were divided into proximal, middle, and distal segments. In B-mode examination, tendon thicknesses and echotextures were evaluated. Color-coded images of tendons were obtained by SE. Normal consistent tendon structures were coded as blue or green (type 1). Tendons including yellow areas and red areas were classified as type 2 and type 3 respectively. Moderately (yellow) or severely (red) coded areas were considered pathological. RESULTS: Achilles tendon thicknesses measured at three segments (proximal, middle ,distal). did not show any statistically significant difference in both painless and symptomatic side. Proximal part of achilles tendon’s elasticity did not show any difference in both side (p=0.31). In middle and distal segment , the elasticity was statistically different in symptomatic side than normal side p=0.005 and p=0.001 respectively). CONCLUSION: Sonoelastographic examination of Achilles tendons in patients with FMF suffering from talalgia may be useful for determining early dejenerative changes in tendons either in the absence of B-mode ultrasound findings.