Calcaneal CT is a useful tool for identifying Achilles tendon disorders: a pilot study
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RESEARCH ARTICLE
Open Access
Calcaneal CT is a useful tool for identifying Achilles tendon disorders: a pilot study Krzysztof Ficek1,2*, Jolanta Filipek2, Joanna Ficek2, Małgorzata Muzalewska3 and Filip Humpa1,4
Abstract Background: In various Achilles tendon disorders, little attention is paid to the bone environment at the tendon insertion sites. The aim of the present study was to assess the calcaneal bone structure in Achilles tendon disorders using computed tomography (CT). Methods: This study included 31 male patients diagnosed with various Achilles disorders, including episodes of tendon rupture (TR), conservatively treated tendinopathy (TP), and critical-stage Achilles TP treated with endoscopic surgery (TS). CT scans of both feet were conducted to assess the calcaneal bone structure in the TP and TS groups, which comprised 23 patients. Bone measurements were calculated, including the bone volume-to-total volume ratio (BV/TV), cross-sectional area (CSA), product moment of area (Ipm), and polar section modulus (Zpol). Results: The results demonstrated increased BV/TV, CSA, Ipm, and Zpol values in patients who underwent tendinoscopy and in patients with insertional TP. Conclusions: CT images are useful for evaluating calcaneal trabecular structural alterations in patients with Achilles pathology and correlate with the TP type. Keywords: Calcaneus, Achilles tendon, Computed tomography
Background Degenerative tendinopathy, i.e., tendinosis [1], refers to intrinsic deformations in the structure of Achilles tendon fibers without self-reported patient symptoms or subjective pain. This condition does not involve inflammation or clinical manifestations but may develop into active tendinopathy (TP) with variable clinical symptoms, which are usually localized in the narrowest crosssectional segments (midportion Achilles TP, 2–7 cm above the calcaneal insertion) [2]. In contrast, 20% of Achilles disorders involve insertional tendinopathy [2], which is defined as a degeneration of the fibers of the Achilles tendon at its insertion into the calcaneus. Undoubtedly, the deterioration of tendinous structures suggests an approach for diagnostic development. Among the well-known imaging techniques, radiography and MRI appear sufficient for detecting soft tissue and bone changes, such as heel spurs or Haglund’s deformity. * Correspondence: [email protected] 1 The Jerzy Kukuczka Academy of Physical Education, Mikolowska 72A, 40-065 Katowice, Poland 2 Galen-Orthopaedics, Jerzego 6, 43-150 Bierun, Poland Full list of author information is available at the end of the article
The use of computed tomography (CT) is uncommon in cases of both tendinopathy and Achilles tendon rupture (TR). However, CT provides an opportunity to precisely evaluate the quality of the calcaneal bone and its simultaneous anatomical relationship with the Achilles tendon. Among various Achilles tendon pathologies and perspectives regarding its structural and functional anatomy, the calcaneal bone environment and tendon insertion sites have receiv
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