Ultrasound findings are not associated with tendon pain in recreational athletes with chronic Achilles tendinopathy

Abstract

Achilles tendinopathy (AT) is associated with pain and altered ultrasound (US) and color Doppler (CD) findings. However, the relationship between them is equivocal, perhaps because previous studies have only used the VISA-A scale as the measure of tendon pain. To determine the relationship between tendon US and CD findings and self-reported pain using the VISA-A, Short-form McGill Pain Questionnaire (sf-MPQ), and Short-form Brief Pain Inventory (sf-BPI). Recreational athletes with AT rated their tendon pain on the VISA-A, sf-MPQ, and sf-BPI. The Achilles tendons of runners with (TEN, n = 127) and without tendinopathy (CON, n = 103) were examined using conventional grayscale ultrasound and CD settings. Participants with AT had thicker tendons (mm) (median [IQR]) [TEN- 6.2 (5.3-7.9) vs CON 5.5 (4.8; 6.0)] (P < 0,001); abnormal tendon ultrasound appearances (P = .001); and more neovessels than healthy controls (P < .001). No differences were noted between tendon pain scores and US or CD abnormalities (P > .05). Tendinopathy is associated with US and CD changes that may be of some prognostic value. The mismatch between patient-reported symptoms and US and CD findings could be indicative of the need to standardize US and CD protocols in order to enhance comparisons across the studies.