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Barry S.1, Atkinson L.1
1Coventry University, Faculty of Health and Life Sciences, Coventry, United Kingdom
Background: Ultrasonographic Tissue Characterisation (UTC) scanning is a novel approach to imaging tendons developed from equine medicine. UTC collects contiguous transverse ultrasound images of the tendon to create a three dimensional image. The stability of pixel brightness over the length of the scan is used to quantify tendon structure. Dedicated algorithms quantify the pixel brightness into four echo-types
(ET I-IV), which reflect the structural integrity of the tendon. There is a growing evidence base investigating UTC imaging but currently the methods used to undertake UTC scanning can vary as there is no standardised approach. One of main discrepancies is the scanning position leading to concerns that scans of the same tendon using different positions can produce conflicting results.
(ET I-IV), which reflect the structural integrity of the tendon. There is a growing evidence base investigating UTC imaging but currently the methods used to undertake UTC scanning can vary as there is no standardised approach. One of main discrepancies is the scanning position leading to concerns that scans of the same tendon using different positions can produce conflicting results.
Purpose: To investigate the degree of agreement and intra-rater reliability between prone lying and standing lunge positions for UTC scanning of the Achilles tendon.
Methods: An exploratory repeated measures cross sectional design was adopted. Twenty healthy participants were recruited via convenience sampling. Achilles tendons were scanned twice in prone lying (P1 and P1) and twice in standing lunge position (S1 and S2). This was completed on the left and right Achilles to create 40 data sets for analysis.
Results: Intra class correlation was lowest when comparing P1 and S1 data for each ET (0.59, 0.62, 0.45, 0.79) but excellent in P1-P2 re- test (0.79, 0.81, 0.65, 0.89) and S1-S2 re test (0.80, 0.85, 0.69, 0.89).
Minimal detectable change (MDC) was significantly higher in the P1-S1 analysis (8.68, 8.13, 0.67 and 0.17 for ET1-4. MDC was similar between P1-P2 re-test (4.87, 4.44, 0.48, 0.09) and S1-S2
(4.11, 3.15, 0.31, 0.17).
Conclusion(s): The current study suggests that scanning position directly affects echo pattern produced from UTC scanning of the Achilles mid-tendon. Therefore scanning position should not be used interchangeably and data sets from studies that utilised different scanning positions should be compared with caution. The results of the current study found high reliability when comparing prone re-test and standing re-test scans.
Implications: There is evidence from the results of this study that a change in scanning position has an effect on the quantification of echo pattern following UTC scanning of Achilles mid-tendons. These results should be considered in the design of future research, clinical UTC scanning interpretation and in any future systematic reviews or meta-analysis. Adopting a standardised scanning position when investigating the Achilles tendon will allow clinicians and researchers to have greater confidence that any change in echo pattern is a true change and not a consequence the scanning position adopted
Funding acknowledgements: This study was unfunded
Topic: Research methodology & knowledge translation
Ethics approval: This study was approved by the Coventry University Ethics Committee, project reference number P41360
All authors, affiliations and abstracts have been published as submitted.
