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DOI: 10.1055/s-0035-1569286
Is Sonographic Assessment of Intratendinous Blood Flow in Achilles Tendinopathy Patients Reliable?
Consistency of Doppler Ultrasound Modes and Intra- and Inter-observer ReliabilityPublication History
received 16 May 2015
accepted 08 November 2015
Publication Date:
04 February 2016 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00028422/201601/lookinside/thumbnails/05-2015-0017_10-1055-s-0035-1569286-1.jpg)
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.
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