Otwarty dostęp

Achilles tendon degeneration on ultrasound in type 2 diabetic patients

Babalola Ishamel Afolabi
Babalola Ishamel Afolabi
, 
Bukunmi Michael Idowu
Bukunmi Michael Idowu
 oraz 
Stephen Olaoluwa Onigbinde
Stephen Olaoluwa Onigbinde
   | 18 gru 2020
Journal of Ultrasonography's Cover Image
O artykule
Poprzedni artykuł
Następny artykuł
Zacytuj
Article Category: research-article
Data publikacji: 18 gru 2020
Zakres stron: 291 - 299
Otrzymano: 11 maj 2020
Przyjęty: 21 sie 2020
DOI: https://doi.org/10.15557/jou.2020.0051
Słowa kluczowe
© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Ultrasonography of a normal Achilles tendon (arrows) showing the transducer position and equivalent sonographic image in longitudinal/long-axis view ( A, B ) and transverse/short-axis view ( C, D )
Ultrasonography of a normal Achilles tendon (arrows) showing the transducer position and equivalent sonographic image in longitudinal/long-axis view ( A, B ) and transverse/short-axis view ( C, D )

Fig. 2.

B-mode ultrasound image of the Achilles tendon (longitudinal view) showing hypoechoic foci (arrows) within the tendon fibers (arrows)
B-mode ultrasound image of the Achilles tendon (longitudinal view) showing hypoechoic foci (arrows) within the tendon fibers (arrows)

Fig. 3.

B-mode ultrasound image of the Achilles tendon (longitudinal view) showing disorganization of the Achilles tendon fibers (arrows)
B-mode ultrasound image of the Achilles tendon (longitudinal view) showing disorganization of the Achilles tendon fibers (arrows)

Fig. 4.

B-mode ultrasound image of the Achilles tendon (transverse view) showing the presence of calcific focus (arrow) within the Achilles tendon fibers
B-mode ultrasound image of the Achilles tendon (transverse view) showing the presence of calcific focus (arrow) within the Achilles tendon fibers

Comparison of disorganized fibers of AT with characteristics of diabetics

Variables Diabetics’ χ 2 df p-value
AT disorganized fibr
Present Absent Total
Age (years)
40–49 3 (20.0) 12 (80.0) 16 (100) 12.315 3 0.006
50–59 11 (68.8) 5 (31.3) 16 (100)
60–69 20 (69.0) 9 (31.0) 29 (100)
70–79 14 (70.0) 6 (30.0) 20 (100)
Gender
Male 24 (80.0) 6 (20.0) 30 (100) 8.000 1 0.005
Female 24 (48.0) 26 (52.0) 50 (100)
BMI (kg/m2)
Normal 19 (51.4) 18 (48.6) 37 (100) 2.233 2 0.327
Overweight 18 (69.2) 8 (30.8) 26 (100)
Obese 11 (64.7) 6 (35.3) 17 (100)
DM Duration (months)
<5 years 20 (46.5) 23 (53.5) 43 (100) 7.715 2 0.021
5–10 years 17 (70.8) 7 (29.2) 24 (100)
>10 years 11 (84.6) 2 (15.4) 13 (100)
Any peripheral neuropathy
Present 41 (71.9) 16 (28.1) 57 (100) 11.757 1 0.001
Absent 7 (30.4) 16 (69.6) 23 (100)
FBG
<5.6 (mmol/L) 10 (62.5) 6 (37.5) 16 (100) 0.059 2 0.971
5.6–6.9 (mmol/L) 15 (60.0) 10 (40.0) 25 (100)
≥7.0 (mmol/L) 23 (59.0) 16 (41.0) 39 (100)
HbA1c
Poor (HbA1c ≥7.0%) 32 (62.7) 19 (37.3) 51 (100) 0.442 1 0.506
Good (HbA1c <7.0%) 16 (55.2) 13 (44.8) 29 (100)

Comparison of the degenerative changes in the AT of T2DM and controls

Variables Study group, n (%) χ 2 df p-value
Diabetics (n = 80) Controls (n = 80)
Right AT calcifications
Present 4 (5.0) 0 (0.0) 0.120*
Absent 76 (95.0) 80 (100.0)
Left AT calcifications
Present 5 (6.3) 2 (2.5) 0.443*
Absent 75 (93.8) 78 (97.5)
Right AT disorganized fibres
Present 43 (53.8) 14 (17.5) 22.919 1 <0.001
Absent 37 (46.3) 66 (82.5)
Left AT disorganized fibres
Present 41 (51.3) 12 (15.0) 23.728 1 <0.001
Absent 39 (48.8) 68 (85.0)
Right AT hypoechoic foci
Present 16 (20.0) 4 (5.0) 8.229 1 0.004
Absent 64 (80.0) 76 (95.0)
Left AT hypoechoic foci
Present 15 (18.8) 6 (7.5) 4.440 1 0.035
Absent 65 (81.2) 74 (92.5)
Right AT calcification, disorganized fibres or hypoechoic foci
Present 44 (55.0) 15 (18.8) 22.581 1 <0.001
Absent 36 (45.0) 65 (81.2)
Left AT calcification, disorganized fibres or hypoechoic foci
Present 42 (52.5) 15 (18.8) 19.867 1 <0.001
Absent 38 (47.5) 65 (81.2)

Prevalence of various degenerative changes by characteristics of controls

Variables Present Absent Total χ 2 p-value
Disorganized AT fibers
Age (years)
40–49 0 (0.0) 16 (100.0) 16 (100.0) 0.044*
50–59 2 (13.3) 13 (86.7) 15 (100.0)
60–69 7 (25.0) 21 (75.0) 28 (100.0)
70–79 7 (33.3) 14 (66.7) 21 (100.0)
Gender
Male 8 (23.5) 26 (76.5) 34 (100.0) 0.460 0.497
Female 8 (17.4) 38 (82.6) 36 (100.0)
BMI (kg/m2)
Normal 7 (17.5) 33 (82.5) 40 (100.0) 1.615 0.446
Overweight 8 (26.7) 22 (73.3) 30 (100.0)
Obese 1 (10.0) 9 (90.0) 10 (100.0)
AT hypoechoic foci
Age (years)
40–49 0 (0.0) 16 (100.0) 16 (100.0) 0.035*
50–59 0 (0.0) 15 (100.0) 15 (100.0)
60–69 2 (7.1) 26 (92.9) 28 (100.0)
70–79 5 (23.8) 16 (76.2) 21 (100.0)
Gender
Male 3 (8.8) 31 (91.2) 34 (100.0) 1.000*
Female 4 (8.7) 42 (91.3) 46 (100.0)
BMI (kg/m2)
Normal 3 (7.5) 37 (92.5) 40 (100.0) 0.327*
Overweight 2 (6.7) 28 (93.3) 30 (100.0)
Obese 2 (20.0) 8 (80.0) 10 (100.0)
AT calcifications
Age (years)
40–49 0 (0.0) 16 (100.0) 16 (100.0) 1.000*
50–59 0 (0.0) 15 (100.0) 15 (100.0)
60–69 1 (3.6) 27 (96.4) 28 (100.0)
70–79 1 (4.8) 20 (95.2) 21 (100.0)
Gender
Male 0 (0.0) 34 (100.0) 34 (100.0) 0.505*
Female 2 (4.3) 44 (95.7) 46 (100.0)
BMI (kg/m2)
Normal 1 (2.5) 39 (97.5) 40 (100.0) 1.000*
Overweight 1 (3.3) 29 (96.7) 30 (100.0)
Obese 0 (0.0) 10 (100.0) 10 (100.0)

Comparison of hypoechoic foci of AT with characteristics of T2DM subjects

Variables Diabetics’ χ 2 df p-value
AT hypoechoic foci
Present Absent Total
Age (years)
40–49 0 (0.0) 15 (100.0) 15 (100.0)     0.060*
50–59 2 (12.5) 14 (87.5) 16 (100.0)
60–69 9 (31.0) 20 (69.0) 29 (100.0)
70–79 5 (25.0) 15 (75.0) 20 (100.0)
Gender
Male 9 (30.0) 21 (70.0) 30 (100.0) 3.000 1 0.083
Female 7 (14.0) 43 (86.0) 50 (100.0)
BMI (kg/m2)
Normal 7 (18.9) 30 (81.1) 37 (100.0) 1.526 2 0.466
Overweight 7 (26.9) 19 (73.1) 26 (100.0)
Obese 2 (11.8) 15 (88.2) 17 (100.0)
Duration of DM (months)
<5 years 6 (14.0) 37 (86.0) 43 (100.0) 2.320 1 0.314
5–10 years 7 (29.2) 17 (70.8) 24 (100.0)
>10 years 3 (23.1) 10 (76.9) 13 (100.0)
Any peripheral neuropathy
Present 15 (26.3) 42 (73.7) 57 (100.0)     0.031*
Absent 1 (4.3) 22 (95.7) 23 (100.0)
FBS
<5.6 (mmol/L) 4 (25.0) 12 (75.0) 16 (100.0) 0.506 2 0.776
5.6–6.9 (mmol/L) 4 (16.0) 21 (84.0) 25 (100.0)
≥7.0 (mmol/L) 8 (20.5) 31 (79.5) 39 (100.0)
Glycaemic control
Poor (HbA1c ≥7.0%) 11 (21.6) 40 (78.4) 51 (100.0) 0.216 1 0.642
Good (HbA1c <7.0%) 5 (17.2) 24 (82.8) 29 (100.0)

Achilles tendon calcifications compared by characteristics of T2DM subjects

Variables Diabetics’ Total p-value*
AT calcifications
Present Absent
Age (years)
40–49 0 (0.0) 15 (100.0) 15 (100.0) 0.512
50–59 1 (6.3) 15 (93.8) 16 (100.0)
60–69 4 (13.8) 25 (86.2) 29 (100.0)
70–79 1 (5.0) 19 (95.0) 20 (100.0)
Gender
Male 3 (10.0) 27 (90.0) 30 (100.0) 0.667
Female 3 (6.0) 47 (94.0) 50 (100.0)
BMI
Normal 3 (8.1) 34 (91.9) 37 (100.0) 0.564
Overweight 1 (3.8) 25 (96.2) 26 (100.0)
Obese 2 (11.8) 15 (88.2) 17 (100.0)
DM Duration (months)
<5 years 2 (4.7) 41 (95.3) 41 (100.0) 0.295
5–10 years 2 (8.3) 22 (91.7) 24 (100.0)
>10 years 2 (15.4) 11 (84.6) 13 (100.0)
Any PN
Present 5 (8.8) 52 (91.2) 57 (100.0) 0.667
Absent 1 (4.3) 22 (95.7) 23 (100.0)
FBG
<5.6 (mmol/L) 2 (12.5) 14 (87.5) 16 (100.0) 0.203
5.6–6.9 (mmol/L) 0 (0.0) 25 (100.0) 25 (100.0)
≥7.0 (mmol/L) 4 (10.3) 35 (89.7) 39 (100.0)
HbA1c
Poor (HbA1c ≥7.0%) 3 (5.9) 48 (94.1) 51 (100.0) 0.662
Good (HbA1c <7.0%) 3 (10.3) 26 (89.7) 29 (100.0)

Association between the degenerative changes and characteristics of T2DM subjects

Variables Degeneration t p-value
Present Absent
AT disorganized fibers
Age (mean ± SD) (years) 63.8 ± 8.7 56.6 ± 11.0 3.132 0.003
BMI (mean ± SD) (kg/m2) 26.44 ± 4.36 25.14 ± 4.67 1.272 0.207
FBG (mean ± SD) (mmol/L) 8.7 ± 5.4 7.4 ± 2.4 1.409 0.163
HbA1 (mean ± SD) (%) 8.7 ± 2.8 8.2 ± 2.4 0.853 0.396
DM duration Median (IQR) months 67.0 (16.0–116.8) 24.0 (6.0–61.8) -2.294 0.022**
AT hypoechoic foci
Age (mean ± SD) (years) 65.9 ± 7.2 59.7 ± 10.6 2.773 0.009
BMI (mean ± SD) (kg/m2) 25.86 ± 4.72 25.94 ± 4.49 -0.068 0.946
FBG (mean ± SD) (mmol/L) 9.7 ± 7.3 7.8 ± 3.4 1.004 0.330
HbA1 (mean ± SD) (%) 9.5 ± 3.0 8.3 ± 2.5 1.757 0.083
DM duration Median (IQR) months 64.5 (28.5–103.0) 37.5 (8.8–96.8) -0.848 0.396**
AT calcifications
Age (mean ± SD) (years) 65.5 ± 7.2 60.6 ± 10.5 1.134 0.260
BMI (mean ± SD) (kg/m2) 27.87 ± 5.52 25.77 ± 4.42 1.100 0.275
FBG (mean ± SD) (mmol/L) 7.9 ± 3.0 8.2 ± 4.6 -0.144 0.886
HbA1 (mean ± SD) (%) 9.3 ± 3.8 8.5 ± 2.5 0.508 0.632
DM duration Median (IQR) months 65.0 (21.5–206.3) 38.5 (7.5–96.3) -1.042 0.298**
AT degenerative changes*
Age (mean ± SD) (years) 63.8 ± 8.7 56.5 ± 11.2 3.094 0.003
BMI (mean ± SD) (kg/m2) 26.41 ± 4.32 25.15 ± 4.74 1.219 0.227
FBG (mean ± SD) (mmol/L) 8.8 ± 5.4 7.3 ± 2.2 1.740 0.086
HbA1 (mean ± SD) (%) 8.8 ± 2.8 8.0 ± 2.2 1.395 0.167
DM duration Median (IQR) months 66.0 (17.0–116.5) 23.0 (6.0–62.0) -2.218 0.027**
eISSN:
2451-070X
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Basic Medical Science, other
Kanał RSS czasopisma