Diagnostic Accuracy of Ultrasonography for Detection of AT by Taking Surgical Findings as Gold Standard

Abstract

Objective: To assess the diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy by taking surgical findings as gold standard. Design of the Study: It was a descriptive cross-sectional study. Study Settings: This study was carried out at Department Of Diagnostic Radiology And Diagnostic Imaging Combined Military Hospital, Lahore from 23rd December 2017 to 22nd June 2018. Material and Methods: A total of 70 patients of age 20-70 years, of either gender presenting with severe pain and swelling in area of Achilles tendon were included. Patients with heel pain having concurrent heel ulcer, eczematous changes or calcaneal fractures, muscular dystrophy and previous surgery were excluded. All the patients were then underwent ultrasonography and findings were noted for presence or absence of Achilles tendinopathy. Each Ultrasonographic finding were compared with surgical findings. Results of the Study: Mean age was 41.24 ± 10.34 years. Out of these 70 patients, 46 (65.71%) were male and 24 (34.29%) were females with male to female ratio of 1.9:1. In USG positive patients, 40 (True Positive) had Achilles tendinopathy and 04 (False Positive) had no Achilles tendinopathy on surgical findings. Among, 26 USG negative patients, 03 (False Negative) had Achilles tendinopathy on surgical findings whereas 23 (True Negative) had no Achilles tendinopathy on surgical findings. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy by taking surgical findings as gold standard was 93.02%, 85.19%, 90.91%, 88.46% and 90.0% respectively. Conclusion: This study concluded that diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy is quite high. Keywords: Achilles tendinopathy, ultrasonography, sensitivity.