2021 ISAKOS Biennial Congress ePoster
Diagnosis Of The Achilles Insertional Tendinopathies By Algometry
Nacime Salomao Barbachan Mansur, MD, PhD, Coralville, IA UNITED STATES
Vinicius Felipe Pereira, MD, São Paulo, SP BRAZIL
Andre Fukunishi Fukunishi Yamada, PhD, São Paulo, Sao Paulo BRAZIL
Fabio Teruo Matsunaga, PhD, São Paulo, SP BRAZIL
Marcel J. S. Tamaoki, MD, PhD, São Paulo, SP BRAZIL
Department of Orthopedics and Traumatology, Paulista School of Medicine, Federal University of Sao Paulo, São Paulo, SP, BRAZIL
FDA Status Cleared
Summary
The algometry proved to be a simple and reliable method for diagnosing AIT. Values for PT under 4.08kg/f were found predictors of the disease.
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Abstract
Introduction
Diagnosis of Achilles insertional tendinopathies (AIT) is based on pain by tendon palpation. However, there is no consensus or standard regarding the amount of force to be used during the evaluation. The algometry is a mechanism of measuring the pressure applied in a specific region and can be a technique for determining diagnosis values.
Goal:
To determine a cut-off value for Pain Threshold (PT) in the assessment of AIT.
Design
This is a prospective case-control study of diagnostic accuracy, to develop a diagnostic criterion.
Methods
Forty asymptomatic individuals and forty patients with insertional Achilles tendinopathy, matched by age and sex, were evaluated, and submitted to algometry for PT and for Visual Analogical Scale (VAS) levels with 3kg/f at the insertion of the calcaneal tendon by two different evaluators. Inter-observer reproducibility was accessed through the interclass correlation index (ICC). Sensitivity and specificity calculation of PT and of VAS were calculated and plotted on a ROC (Receiver Operator Characteristic) curve.
Results
The lowest ICC found was 0.788. Regarding the diagnosis through TP, the 4.08 kg/f mark showed the best relation between sensitivity and specificity (92.5% and 92.5%, respectively). Algometry values lower than 4.08 were considered positive for disease. For the diagnosis of TIA through VAS with 3kg/f, the value of 2.98 was determined (sensitivity of 92.5% and specificity of 97.5%).
Discussion
The algometry showed to be a simple and reliable method for diagnosing AIT. Values for PT under 4.08kg/f were found predictors of the disease.