Lower Limb Tendinopathy Tissue Changes Assessed through Ultrasound: A Narrative Review.

Eleuterio A Sánchez Romero,José Luis Alonso Pérez,Alberto Carlos Muñoz Fernández,Sebastián Martín Pérez,Paolo Pedersini,Carlos Barragán Carballar,Jorge Hugo Villafañe,Joel Pollet

doi:10.3390/medicina56080378

Abstract

Tendinopathy is a common disease that affects athletes, causing pain and dysfunction to the afflicted tendon. A clinical diagnose is usually combined with imaging and, among all the existing techniques, ultrasound is widely adopted. The aim of this review is to sum up the existing evidence on ultrasound as an imaging tool and guide for treatments in lower limbs tendinopathy. Using three different databases—PubMed, MEDLINE and CENTRAL—a literature search has been performed in May 2020 combining MeSH terms and free terms with Boolean operators. Authors independently selected studies, conducted quality assessment, and extracted results. Ultrasound imaging has a good reliability in the differentiation between healthy and abnormal tendon tissue, while there are difficulties in the identification of tendinopathy stages. The main parameters considered by ultrasound imaging are tendon thickness, hypoechogenicity of tendon structure and neovascularization of the tendon bound tissue. Ultrasound-guide is also used in many tendinopathy treatments and the available studies gave encouraging results, even if further studies are needed in this field.

Highlights

Soft tissue injuries of the lower limb are widely diffuse and put a significant financial burden on the health care systems worldwide
The results showed but adopting these techniques should be considered as an outcome measure for studies on the effectiveness of treatments for tendinopathy
The role of the clinician is fundamental in the diagnosis of tendinopathy, and ultrasonography is the tool that allows the identification of the typical pathological features of tendinopathy

Summary

Introduction

Soft tissue injuries of the lower limb are widely diffuse and put a significant financial burden on the health care systems worldwide. Tendinopathy is a common problem in the adult population that especially affects elite athletes and amateurs. 22%, with differences related to sport and to the level [1]. One of the commonest tendinopathy, afflicts the 45% of elite volleyball players and the 32% of elite basketball players [2], in elite soccer players, cumulative trauma disorder and re-injuries constituted 37% and 22% of all injuries [3], while among non-elite players of all the different sports, the incidence is lower, only 14%, but still remarkable [4]. While the prevalence in elite athletes of the Achilles tendinopathy is 5%, and rises till 9% in recreational runners [5]. Quadriceps tendinopathy prevalence is about 14.2% of elite athletes, especially in sports that require repetitive jumps [2]. Proximal Hamstring Tendinopathy and Medicina 2020, 56, 378; doi:10.3390/medicina56080378 www.mdpi.com/journal/medicina

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