Can sonography predict the outcome in patients with Achillodynia?

PURPOSE: We evaluated whether the grade assigned to the Achilles tendon's appearance on sonograms can be used to predict the outcome of achillodynia. METHODS: A retrospective evaluation was done of a case series of patients with Achilles tendon pain seen at a sports medicine clinic. The study consisted of chart reviews, telephone follow-up interviews, and grading of ultrasound images of the tendon obtained during the initial visit. The grading scheme was as follows: grade 1, normal tendon; grade 2, enlarged tendon; and grade 3, tendon containing a hypoechoic area, regardless of size. The time needed to recover from symptoms was compared between grades using survival analysis. RESULTS: The group consisted of 33 patients, with a mean age of 35.8 years and a mean follow-up time of 24.3 months. There was a statistically significant difference in the time to full recovery between grades (p = 0.02). Patients with grade 1 tendons had a prompter resolution of symptoms than did patients with grade 2 or 3 tendons. CONCLUSIONS: This retrospective study of the outcome of achillodynia demonstrates the possible use of tendon sonography as a prognostic tool to supplement physical examination.