Evaluation of the Achilles Tendon Using B‐Mode Ultrasound and Strain Elastography in Patients With Chronic Kidney Disease

• Published in: Journal of ultrasound in medicine Vol. 40; no. 4; pp. 771 - 778
• Main Authors: Mutlu, Samet, Erdem Toslak, Iclal, Inci, Ayca, Cekic, Bulent, Yavuz, Alpaslan
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.04.2021
• Subjects: Achilles tendon; Achilles Tendon - diagnostic imaging; Adult; Aged; chronic kidney disease; Elasticity Imaging Techniques; Humans; Middle Aged; real‐time elastography; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnostic imaging; strain ratio; Tendinopathy; Ultrasonography; ultrasound; strain ratio; Achilles tendon; chronic kidney disease; real-time elastography; ultrasound; tendinopathy
• ISSN: 0278-4297; 1550-9613
• DOI: 10.1002/jum.15453

Objectives To investigate the B‐mode ultrasound (US) features and elasticity of the Achilles tendon in patients with chronic kidney disease (CKD) using US elastography and to compare them with those of healthy individuals. Methods From March 2019 through May 2019, 30 consecutive patients with variable stages of CKD and 30 healthy individuals were prospectively included in this study. Ultrasound and strain elastographic examinations were performed on both Achilles tendons of all individuals. Degrees of tendinopathy, if existed, were classified as defined by Archambault et al (J Clin Ultrasound 1998; 26:335–339), and thicknesses were documented with US. Strain ratios (SRs) were calculated by measuring the strain values from the Achilles tendon and Kager fat pad. Statistical differences in the SRs of Achilles tendons between the control group and patients with CKD were calculated. Results The 30 patients with CKD ranged in age from 24 to 73 years, and the 30 healthy individuals ranged in age from 25 to 78 years. Both distal and left middle thirds of the Achilles tendons were thicker in patients with CKD than in healthy individuals (P < .05). The mean SRs ± SDs in the patient group (4.71 ± 0.95 and 4.85 ± 1.47 on the right and left, respectively) were significantly higher (P < .05) than in healthy individuals (2.31 ± 0.42 and 2.65 ± 0.55 on the right and left), which indicated an increased stiffness of Achilles tendons in the patient group. Conclusions As a semiquantitative and noninvasive imaging modality, strain elastography has the potential to detect the morphologic and elasticity changes of Achilles tendons in patients with CKD, which may give an opportunity to help physicians predict possible leading partial or complete tears.