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Ultrasound Int Open 2016; 02(01): E13-E18
DOI: 10.1055/s-0035-1569286
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Is Sonographic Assessment of Intratendinous Blood Flow in Achilles Tendinopathy Patients Reliable?

Consistency of Doppler Ultrasound Modes and Intra- and Inter-observer Reliability
L. Risch
1   University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany
,
M. Cassel
1   University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany
,
J. Messerschmidt
1   University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany
,
K. Intziegianni
1   University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany
,
K. Fröhlich
1   University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany
,
S. Kopinski
1   University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany
,
F. Mayer
1   University Outpatient Clinic, Sports Medicine and Sports Orthopaedics, University of Potsdam, Potsdam, Germany
› Author Affiliations
Further Information

Publication History

received 16 May 2015

accepted 08 November 2015

Publication Date:
04 February 2016 (online)

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Abstract

Purpose:

The purpose of this study was to investigate the consistency between different Doppler ultrasound (DU) modes as well as the intra- and inter-observer reliability of investigators with different experience level in assessing intratendinous blood flow (IBF) in Achilles tendinopathy patients.

Material and Methods:

18 participants (36 Achilles tendons, AT) with Achilles tendinopathy (24 AT) were examined with power Doppler ultrasound (PDU), colour Doppler ultrasound (CDU) and “Advanced Dynamic Flow” (ADF) (Toshiba Xario SSA-660 A; 14MHz transducer) by 2 investigators (experienced, EI; inexperienced, II) in a test-retest design (M1/M2). A modified Öhberg score was used to quantify IBF. Data was analysed descriptively (absolute and relative). Consistency of the 3 modes was presented by Kendall’s Coefficient of Concordance (Kendall’s W). Intra- and inter-observer reliability were calculated by use of Kendall’s tau b correlation coefficient.

Results:

IBF was detected in 79–92% of symptomatic AT and in 33–50% of contralateral asymptomatic AT. Comparing the 3 modes, Kendall’s W ranged from 0.97–0.98. Analysis of intra-observer reliability resulted in Kendall’s tau 0.90–0.92 for EI and 0.84–0.87 for II. Inter-observer reliability resulted in Kendall’s tau 0.64–0.69 in M1 and 0.68–0.70 in M2.

Conclusion:

The very good consistency between PDU, CDU and ADF indicates a comparable applicability for assessing IBF in ATs. Intra-observer reliability was high for both investigators, independent of experience. The moderate inter-observer reliability reflects the challenge in sonographic detection of intratendinous blood flow (IBF) amount.

Key words

ultrasound-power doppler - ultrasound-color doppler - advanced dynamic flow - achilles tendon - reliability
 

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