The Ability of Ultrasonography, Magnetic Resonance Imaging and Bone Mineral Densitometry to Predict the Strength of Human Achilles' Tendons

Abstract Devitt D, Koike Y, Doherty GP, Ramachandran N, Dinh L, Uhthoff HK, Lecompte M, Trudel G. The ability of ultrasonography, magnetic resonance imaging and bone mineral densitometry to predict the strength of human Achilles' tendons. Objective To assess the value of ultrasonography (US), magnetic resonance imaging (MRI), and bone mineral densitometry (BMD) in evaluating human Achilles' tendon strength. Design Cross-sectional observational study. Setting Tertiary care hospital. Participants Ninety-eight Achilles' tendons from 49 consecutive cadavers (26 men and 23 women with a mean age of 66.6 years) undergoing hospital autopsy were assessed. Interventions Not applicable. Main Outcome Measures Tendon dimensions on US and MRI, and T1-weighted optical density were measured. Areas of hypodensity, hyperdensity, calcification, and heterogeneity were identified on US. The BMD of each calcaneus was recorded. The tendons were mechanically tested to determine peak load at failure. Results Sixteen patients (32.7%, 27 tendons) had abnormalities in 1 or both tendons on US and/or MRI (17 on US, 17 on MRI). Fifty-seven tendons (58%) ruptured in their midsubstance, at an average peak load of 4722±990N. Tendons with and without abnormalities on imaging had similar strengths ( P >.05). Calcaneal BMD correlated weakly with peak load at failure ( r =.21, P