Shear Wave Elastography Findings of Achilles Tendons in Patients on Chronic Hemodialysis and Patients with renal Transplantation

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Abstract

Introduction

Achilles tendon which was comprised of tendinous parts of gastrocnemius and soleus muscles is the strongest and the largest tendon in the human body. Chronic renal disease is related to reduced physical activity, exercise capacity. Spontaneous rupture of achilles tendon have been reported in patients with chronic renal disease and degeneratif changes, recurrent microtraumas, hypoxia, chronic acidosis are predisposing factors. The aim of the study is to assess the degeneration of achilles tendon by shear wave elastography to compare the elastographic findings of Achilles tendons in patients on chronic hemodialysis, patients with renal transplantation and healthy adults.

Materials and Methods

Twenty-five patients who were on chronic hemodialysis at least 5 years, twenty-five renal transplant patients and twenty-five healthy controls were included in this study. The thickness and shear wave velocity (SWV) of the middle thirds of the achilles tendons were measured bilaterally.

Results

The mean SWV of right achilles was 3,67 cm/sn left achilles was 3,64 cm/sn in hemodialysis group. The mean SWV of right achilles was 4,29 cm/sn left achilles was 4,25 cm/sn in renal transplant group. The mean SWV of right achilles was 6,68 cm/sn left achilles was 6,59 cm/sn in control group. There was a statistically significant difference between the SWVs of hemodialysis group, renal transplant group and control group (p<0,005).

Conclusion

The achilles tendons in patients with chronic renal failure were softer than in patients with renal transplantation and control group. Chronic tendinopathy cause softening and weakening of the tendon. In the renal transplant group stiffness of the achilles tendon was increased with respect to hemodialysis group but still softer than the control group which could be explained by the positive clinical effect of renal transplantation. In conclusion shear wave elastography is an objective, easy, noninvasive, method that can asssess tendinopathy.

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