无症状腓骨肌腱超声检查异常结果的患病率
Prevalence of Abnormal Ultrasonographic Findings in Asymptomatic Peroneal Tendons.
作者信息
Smoker Brice A, Giakas Alec M, Mills F Baker, Williams Kevin A, Bornemann Paul H, Benjamin Jackson J
机构信息
Department of Orthopedic Surgery, Prisma Health-USC Medical Center, Columbia, SC, USA.
Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC, USA.
出版信息
Foot Ankle Orthop. 2023 Mar 27;8(1):24730114231164146. doi: 10.1177/24730114231164146. eCollection 2023 Jan.
BACKGROUND
The peroneus longus (PL) and peroneus brevis (PB) tendons comprise the lateral compartment of the leg and stabilize the foot during weightbearing. Peroneal tendinopathy can precipitate lateral ankle pain and induce functional disability. The progression of peroneal pathology to lateral ankle dysfunction is thought to stem from asymptomatic, subclinical peroneal tendinopathy. There may be clinical benefit to identifying asymptomatic patients with this condition before progression to disability. Various ultrasonographic characteristics have been observed in peroneal tendinopathy. The purpose of this study is to identify the frequency of subclinical tendinopathic characteristics in asymptomatic peroneal tendons.
METHODS
One hundred seventy participants underwent bilateral foot and ankle ultrasonographic examination. Images were assessed for abnormalities of the PL and PB tendons by a group of physicians who recorded frequencies of abnormalities. This team consisted of an orthopaedic surgeon specializing in foot and ankle surgery, a fifth-year orthopaedic surgery resident, and a family medicine physician with musculoskeletal sonographer certification.
RESULTS
A total of 340 PL and 340 PB tendons were assessed. Sixty-eight (20%) PL and 41 (12.1%) PB tendons had abnormal traits. Twenty-four PLs and 22 PBs had circumferential fluid, 16 PLs and 9 PBs had noncircumferential fluid, 27 PLs and 6 PBs had thickening, 36 PLs and 12 PBs had heterogenicity, 10 PLs and 2 PBs had hyperemia, and 1 PL had calcification. In Caucasian participants, male gender was associated with increased frequency of abnormal findings, but there were no other significant differences based on age, body mass index, or ethnicity.
CONCLUSION
In our studied population of 170 patients who had no complaints of associated symptoms, we found that 20% of PLs and 12% of PBs displayed ultrasonographic abnormalities. When we included all unusual findings within and around the tendons, prevalence rates of ultrasonographic abnormalities were 34% for PLs and 22% for PBs.
LEVEL OF EVIDENCE
Level II, prospective cohort study.
背景
腓骨长肌（PL）和腓骨短肌（PB）肌腱构成小腿外侧肌间隔，并在负重时稳定足部。腓骨肌腱病可导致外踝疼痛并引起功能障碍。腓骨病变发展为外踝功能障碍被认为源于无症状的亚临床腓骨肌腱病。在病情发展至功能障碍之前识别出患有这种疾病的无症状患者可能具有临床益处。在腓骨肌腱病中已观察到各种超声特征。本研究的目的是确定无症状腓骨肌腱中亚临床肌腱病特征的出现频率。
方法
170名参与者接受了双侧足踝超声检查。一组医生对图像进行评估，以检查PL和PB肌腱的异常情况，并记录异常频率。该团队由一名专门从事足踝外科手术的骨科医生、一名骨科手术五年级住院医师以及一名具有肌肉骨骼超声检查认证的家庭医学医生组成。
结果
共评估了340条PL肌腱和340条PB肌腱。68条（20%）PL肌腱和41条（12.1%）PB肌腱具有异常特征。24条PL肌腱和22条PB肌腱有环形积液，16条PL肌腱和9条PB肌腱有非环形积液，27条PL肌腱和6条PB肌腱有增厚，36条PL肌腱和12条PB肌腱有不均匀回声，10条PL肌腱和2条PB肌腱有充血，1条PL肌腱有钙化。在白种人参与者中，男性的异常发现频率较高，但在年龄、体重指数或种族方面没有其他显著差异。
结论
在我们研究的170名无相关症状主诉的患者群体中，我们发现20%的PL肌腱和12%的PB肌腱显示出超声异常。当我们将肌腱内部和周围的所有异常发现都包括在内时，PL肌腱的超声异常患病率为34%，PB肌腱为22%。
证据级别
二级，前瞻性队列研究。
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