Cushman Daniel M, Vomer Rock, Teramoto Masaru, O'Sullivan Maddie, Mulvey Jade, Eby Sarah F, McAuliffe Sean
Department of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah.
Department of Orthopaedics, University of Utah, Salt Lake City, Utah.
Clin J Sport Med. 2025 Jan 1;35(1):13-22. doi: 10.1097/JSM.0000000000001236. Epub 2024 Jun 11.
Patients with clinical tendinopathy often demonstrate significant abnormalities with ultrasound (US) imaging. Tendon abnormalities likely precede pain in these patients. The purpose of this review was to systematically evaluate the available literature regarding the utility of US imaging as a method to predict Achilles and patellar tendon pain.
Systematic review and meta-analysis. Inclusion criteria were as follows: prospective studies of Achilles and patellar tendon pain development with baseline US measurements, follow-up clinical measurements, and English-language studies published after 2000. Exclusion criteria were prior rupture or surgery and presence of rheumatologic disorder.
N/A.
Athletes without Achilles or patellar tendon pain at baseline.
N/A.
Risk ratios (RRs) were identified for the development of pain in those with Achilles or patellar tendon sonographic abnormalities.
This review of 16 studies included 810 Achilles and 1156 patellar tendons from a variety of sports and demonstrated that the RR for pain development from abnormal Patellar and Achilles tendons was 6.07 [95% confidence interval (CI), 2.88-12.81; P < 0.001] and 3.96 [95% CI, 2.21-7.09; P < 0.001], respectively. The positive and negative predictive values of an abnormal US finding were 27.2% and 92.0% for the Achilles tendon and 27.2% and 93.5% for the patellar tendon, respectively.
This systematic review and meta-analysis identified that the use of asymptomatic US scanning of the Achilles or patellar tendon has a low positive predictive value but a high negative predictive value for the future development of pain.
临床肌腱病患者的超声（US）成像常显示出明显异常。这些患者的肌腱异常可能先于疼痛出现。本综述的目的是系统评价有关US成像作为预测跟腱和髌腱疼痛方法的实用性的现有文献。
系统评价和荟萃分析。纳入标准如下：关于跟腱和髌腱疼痛发展的前瞻性研究，包括基线US测量、随访临床测量，以及2000年后发表的英文研究。排除标准为既往有肌腱断裂或手术史以及存在风湿性疾病。
无。
基线时无跟腱或髌腱疼痛的运动员。
无。
确定跟腱或髌腱超声检查异常者发生疼痛的风险比（RRs）。
对16项研究的综述纳入了来自各种运动项目的810条跟腱和1156条髌腱，结果表明，髌腱和跟腱异常导致疼痛的RR分别为6.07[95%置信区间（CI），2.88 - 12.81；P < 0.001]和3.96[95%CI，2.21 - 7.09；P < 0.001]。超声检查异常的阳性和阴性预测值，跟腱分别为27.2%和92.0%，髌腱分别为27.2%和93.5%。
本系统评价和荟萃分析表明，对跟腱或髌腱进行无症状US扫描，对未来疼痛发展的阳性预测值较低，但阴性预测值较高。
