scholarly journals Cross Sectional Area of the Achilles Tendon in a Prospective Cohort of an Elite Military Population

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Kevin Martin ◽  
Laura Dawson ◽  
Jeffrey Wake
Keyword(s):  
Achilles Tendon ◽  
Prospective Cohort ◽  
Military Training ◽  
Cross Sectional Area ◽  
Service Members ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean ◽  
Multiple Levels ◽  
The Cross

Category: Ankle, Hindfoot Introduction/Purpose: The prevalence of Achilles tendon pathology is common in many sports and daily activities. From ruptures to overuse injuries resulting in tendonopathies, AT dysfunction can result in disability and reduced productively. Continued research that increases our knowledge base of normal Achilles tendon properties can improve our ability to reduce and prevent future AT injuries. In this study, we examined the cross-sectional area (CSA) of the Achilles tendon (AT) at multiple levels in an asymptomatic population of elite American military service members that participate in greater than 20 hours of intense training per week. Methods: We conducted a prospective cohort study composed of 41 active duty United States Army Rangers. The Rangers are a specialized infantry organization that participates in extensive military training and rigorous combat missions. The service members were voluntarily recruited to participate while deployed in a combat theater. All subjects were members of the Ranger Regiment participating in greater than 20 hours of intense bipedal non-sport weekly training with no history of AT pathology. In a standing position, each subject had bilateral Achilles insertion marked along with additional skin markings made at 2 cm, 4 cm, and 6 cm above the AT insertion. At all four levels, the AT was measured in the coronal and sagittal plains using ultrasound. Results: In 41 subjects, a total of 82 Achilles tendons were examined. The mean age of the cohort was 26 years, 70 inches tall, with a mean weight of 187 pounds. The mean sagittal thickness of the AT at the insertion was 4.3 mm, 2 cm above the insertion is was 4.3 mm, 4 cm above the insertion is was 4.2 mm, and at 6 cm above the insertion it was 4 mm. In the coronal plain was 19.1 mm, 14.3 mm, 13.5 mm, and 14.4 mm respectively. The cross-sectional area was calculated at each respective level: 0.65 cm2, 0.48 cm2, 0.44 cm2 and 0.45 cm2. The non-dominant ankle was slightly larger at each level but was not found to be statistically significant. Conclusion: These results provide the mean sagittal and coronal diameters of the Achilles tendon as measured by ultrasound throughout the watershed area of a young active adult male population. Our data also suggest that increased non-sport activity may not increase the cross-sectional area of the Achilles tendon. Identifying the normal diameter at multiple levels throughout the most commonly injured area can potentially improve the provider’s ability to identify early disease processes and apply targeted interventions to help slow or prevent progression and possible rupture.

scholarly journals Atrophy patterns in isolated subscapularis lesions

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Andreas Voss ◽  
Daniel J. H. Henderson ◽  
Simone Waldt ◽  
Bernhard Haller ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Area Ratio ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Subscapularis Muscle ◽  
Mri Scans ◽  
The Mean ◽  
The Cross

Abstract Background While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon. Methods Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Calculation of the ratio between the upper half of the cross sectional area (CSA) and the total CSA was performed. Eleven MRI scans of patients with subscapularis atrophy following isolated subscapularis tendon tears were analysed and cross sectional area ratio (upper half /total) determined. To guarantee reliable measurement of the CSA and its ratio, bony landmarks were also defined. All parameters were statistically compared for inter-rater reliability, reproducibility and capacity to quantify subscapularis atrophy. Results The mean age in the control group was 49.7 years (± 15.0). The mean cross sectional area (CSA) was 2367.0 mm2 (± 741.4) for the complete subscapularis muscle and 1048.2 mm2 (± 313.3) for the upper half, giving a mean ratio of 0.446 (± 0.046). In the subscapularis repair group the mean age was 56.7 years (± 9.3). With a mean cross sectional area of 1554.7 mm2 (± 419.9) for the complete and of 422.9 mm2 (± 173.6) for the upper half of the subscapularis muscle, giving a mean CSA ratio of 0.269 (± 0.065) which was seen to be significantly lower than that of the control group (p < 0.05). Conclusion Analysis of typical atrophy patterns of the subscapularis muscle demonstrates that the CSA ratio represents a reliable and reproducible assessment tool in quantifying subscapularis atrophy. We propose the classification of subscapularis atrophy as Stage I (mild atrophy) in case of reduction of the cross sectional area ratio < 0.4, Stage II (moderate atrophy) in case of < 0.35 and Stage III (severe atrophy) if < 0.3.

scholarly journals Patients with Achilles Tendon Rupture Have a Degenerated Contralateral Achilles Tendon: An Elastography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Qianru Li ◽  
Qi Zhang ◽  
Yehua Cai ◽  
Yinghui Hua
Keyword(s):  
Achilles Tendon ◽  
Axial Strain ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Computer Assisted ◽  
Study Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.

scholarly journals Erect Position as the Alternative Technique in Achilles Tendon US: Comparison with Prone Position

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Lailatul Muqmiroh ◽  
Safinah Fajarini Yusfadhiyah ◽  
Paulus Rahardjo
Keyword(s):  
Achilles Tendon ◽  
Prone Position ◽  
Longitudinal Axis ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Erect Position ◽  
Tendon Thickness ◽  
Alternative Position ◽  
The Mean

Background : Ultrasonography (US) is the cheaper and non invasive modality to determine Achilles tendon. Prone position is the standart position of Achilles tendon US. However, it is a discomfort for an uncooperative patient and a difficult technique too. The erect position is an alternative technique of Achilles tendon US. The goal of this study is to compare the erection as an alternative position with prone as a standart position.Material and Methode: The patient who had an injury or any inflamation process of Achilles tendon were excluded. The patient underwent two positions of Achilles tendon US, 900 and dorsoflexi. Longitudinal axis measured tendon thickness and a transversal axis which covered a cross-sectional area of the tendon.Result: From all the 21 patients coming, 13 patients were males (61,9%), and eight patients were females (38,1%). The mean of tendon thickness and cross-sectional area in 900 prone positions were 4,24±0,24 mm, 30,08±2,86 mm, respectively. The mean of tendon thickness and cross-sectional area in 900 erect positions were 4,27±0,23 mm, 31,36±2,19 mm, respectively. There was no anisotropy effect during longitudinal axis examination. Conclusion: We found that there were no significant differences between a prone and erect position (p<0.05). The erect postion could be an alternative position, uncooperative patient in particular, without reducing the diagnostic value. Keywords: Achilles tendon the US, erect position, prone position, tendon thickness, cross-sectional area

Cross-sectional area of the ulnar nerve after decompression at the cubital tunnel

2016 ◽  
Vol 41 (8) ◽  
pp. 838-842 ◽  
Author(s):  
S. Duetzmann ◽  
K. G. Krishnan ◽  
F. Staub ◽  
J.-S. Kang ◽  
V. Seifert ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Cross Sectional Area ◽  
Cubital Tunnel ◽  
Slight Reduction ◽  
Sectional Area ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
The Mean ◽  
The Cross

A total of 48 patients undergoing surgical decompression of the ulnar nerve at the cubital tunnel between February 2010 and May 2013 were retrospectively studied to determine changes in the cross-sectional area of the nerve by the technique of neurosonography. The mean follow-up was 46 months. Post-operative follow-up examination of the cross-sectional area of the ulnar nerve showed a slight reduction in the mean value from 13.8 mm2 (pre-operative) to 12.9 mm2 (post-operative). Of the 48 patients, 36 showed a reduction in the cross-sectional area. No correlation was detected between the clinical and sonographic outcomes. Ultrasound seems to be of limited value in the post-operative assessment of patients with entrapment neuropathy of the ulnar nerve. Level of Evidence: IV

scholarly journals Correction with thiocetam of lead nanoparticles influence on morpho-functional status of rat liver

2020 ◽  
Vol 33 (3) ◽  
pp. 149-154
Author(s):  
Sergii Omelchuk ◽  
Vasyl Aleksiichuk ◽  
Yuri Chaikovsky ◽  
Liudmyla Sokurenko
Keyword(s):  
Body Weight ◽  
Morphological Changes ◽  
Liver Weight ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Relative Liver Weight ◽  
The Mean ◽  
Pharmacological Correction ◽  
The Cross

AbstractThe aim of this paper is to investigate the influence of Thiocetam on morphological changes in the liver of rats and on biochemical changes in their blood after exposure to lead nanoparticles and compounds. The liver is an organ that performs a number of functions, such as the synthesis of enzymes, hormones, plasma components and the neutralization of toxins. It is involved in many metabolic processes in the body.In undertaking this, colloidal solutions of lead sulphide nanoparticles at dosages 10 nm and 30 nm were injected into two groups of rats, PbSnano1 and PbSnano2, respectively, while group Pb(NO3) received subcutaneously a solution of lead nitrate in ion form in a dose of 1.5 mg/kg (0.94 mg/kg lead, in lead equivalent). After 60 administrations (12 weeks) of the studied substances, the exposure was discontinued and the animals were observed for 18 weeks. Subsequently, half of each group received Thiocetam by injection (for 6 weeks at a dose of 250 mg/kg) while the other half did not. We then assessed the mean body weight, absolute and relative liver weight, blood biochemistry values (total protein, albumin, glucose, total lipids, cholesterol, triglycerides levels in blood serum) and morphological changes in hepatocytes (morphological slides, nuclei cross-sectional area and cytoplasm cross-sectional area).The outcome of this work showed that the mean body weight of animals exposed to nanoparticles with Tiocetam did not differ from that of animals exposed to nanoparticles without pharmacological correction, but relative liver weight was statistically significantly higher than the corresponding values in rats without pharmacological correction. The morphological picture in all study group animals was characterized by the normalization of microvessel blood filling, structure of hepatic plates, disappearance of infiltration with lymphocytes and histiocytes. No dystrophic changes in hepatocytes were found. All this indicates the feasibility of preventive measures during exposure to lead nanoparticles, by administering Thiocetam.In both series of animals exposed to lead nanoparticles (PbSnano1 and PbSnano2), the cross-sectional area of the hepatocytes cytoplasm and the cross-sectional area of the hepatocytes nuclei were smaller than just after exposure, but in the series with Thiocetam adminstration, all the values did not differ from those in the control.

Treatment of Partial Tendon Lacerations

HAND ◽  
1980 ◽  
Vol os-12 (2) ◽  
pp. 163-166 ◽  
Author(s):  
R. Christie Wray ◽  
Paul M. Weeks
Keyword(s):  
Early Mobilization ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Active Motion ◽  
Interrupted Suture ◽  
The Mean ◽  
The Cross ◽  
Lost To Follow Up

We treated twenty six patients with thirty four partial tendon lacerations by not suturing the tendons and by early mobilization of the digit. These partial tendon lacerations varied from 25 to 95 per cent of the cross sectional area. The mean and median cross-sectional area lacerated was 60 per cent. Twenty three of these patients obtained excellent function, one patient obtained good to excellent function and one patient obtained fair function. One patient was lost to follow-up. No tendon ruptured but one patient did develop trigger finger which spontaneously resolved. Partial flexor tendon lacerations should not be repaired and early active motion should be used if bevelling of the laceration is not present. Bevelled partial tendon lacerations of less than twenty five per cent of the cross sectional area can be either excised or repaired with a simple interrupted suture. If greater than twenty five per cent of the cross-sectional area is lacerated and bevelled, the laceration should be repaired with a few simple sutures. Regardless of the treatment of the tendon early active motion is necessary.

scholarly journals Reference values for the cross-sectional area of the normal sciatic nerve using high-resolution ultrasonography

2021 ◽  
Vol 21 (85) ◽  
pp. e95-e104
Author(s):  
Kunwar Pal Singh ◽  
◽  
Prabhjot Singh ◽  
Kamlesh Gupta
Keyword(s):  
High Resolution ◽  
Sciatic Nerve ◽  
Reference Values ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean ◽  
Sciatic Nerves ◽  
The Cross ◽  
High Resolution Ultrasonography

Aim: High-resolution ultrasonography is a new and promising technique to evaluate peripheral and spinal nerves. Its validity as a diagnostic tool in neurological diseases has been demonstrated in adults. The aims of study were to establish the reference values for the cross-sectional area of the normal sciatic nerve on high-resolution ultrasonography, and to determine the relationship between the cross-sectional area of the normal sciatic nerve and the subjects’ age, gender, height (in cm), weight (in kg), and body mass index. Material and methods: Two hundred subjects of both genders and above 18 years of age were studied with high-resolution ultrasonography. The subjects had no history of peripheral neuropathy or trauma to the lower limb. The cross-sectional areas of the normal sciatic nerves were obtained at two different levels in both lower limbs. The mean cross-sectional areas of the sciatic nerves were measured at two different levels, one located at 1 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves, and the other 4 cm above the bifurcation of the sciatic nerve into the tibial and common peroneal nerves. Results: A positive correlation of the mean cross-sectional area was established with height, weight, and body mass index. Women had smaller cross-sectional areas of the normal sciatic nerves than men at both measuring sites. No significant relationship was established with the age of the subjects. Conclusions: The established reference values of the cross-sectional area of the sciatic nerve can facilitate the analysis of pathological nerve conditions.

Ultrasound-Based Mechanical Adaptation of Achilles Tendon After 12-Week Running with Minimalist Shoes

2020 ◽  
Vol 10 (5) ◽  
pp. 1205-1209
Author(s):  
Xini Zhang ◽  
Zhen Luo ◽  
Junqing Wang ◽  
Yang Yang ◽  
Weijie Fu
Keyword(s):  
Achilles Tendon ◽  
Isometric Contraction ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Mechanical Adaptation ◽  
Intraclass Correlation Coefficients ◽  
The Cross

This study aimed to investigate the effect of a 12-week running program using minimalist shoes on ultrasoundbased mechanical adaptation of Achilles tendon (AT). Fifteen male recreational runners accustomed to run in standard cushioned shoes with rearfoot strike pattern were recruited. They were required to wear minimalist shoes without a compulsory transition in foot strike pattern, and be involved in a 12-week running program. Before and after the intervention, the cross-sectional area of AT was collected in the prone position via an ultrasound device. The ankle plantarflexion moment, recorded on an isokinetic dynamometer, was synchronized to the image changes in vivo AT length. Intraclass correlation coefficient was determined to evaluate the intraand interobserver variabilities. Paired t-test was used to quantify the effects of training program (pre- and posttraining) on each variable of the cross-sectional area, AT force, AT stress, and AT strain during an isometric contraction. Seven participants dropped out after the intervention. The results showed that the intraclass correlation coefficients for the intra- and interobserver reliabilities were good to excellent (intraclass correlation coefficients = 0.895–0.996) for the cross-sectional area and elongation. After 12-week running with minimalist shoes, plantarflexion moment, AT force, AT stress, and AT strain significantly increased during an isometric contraction (P < 0.05). The mechanical adaptation of AT improved after 12-week running with minimalist shoes by more efficient energy storage and release, which could prevent or reduce the risk of injury potentially.

Ultrasonographic Measurements of the Achilles Tendon in Elderly Athletes and Sedentary Men

1994 ◽  
Vol 35 (6) ◽  
pp. 560-563 ◽  
Author(s):  
M. Kallinen ◽  
H. Suominen
Keyword(s):  
Achilles Tendon ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Mean Width ◽  
Tendon Thickness ◽  
The Mean ◽  
Elderly Athletes ◽  
Time Linear

Ultrasonography was performed on the Achilles tendon of the dominant limb of 18 male elderly athletes and 11 sedentary men, aged 70 to 80 years. The tendons were examined with a real-time linear array scanner using a 7.5 MHz transducer. Both longitudinal and transverse images were taken. The mean width of the Achilles tendon was significantly larger in the athletes than in the control subjects. The tendon thickness and cross-sectional area did not differ significantly between the groups, but the figures may indicate a tendency for larger cross-sectional area in the athletes. The results suggest tendon hypertrophy following long-term training.

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