USE OF ANGULATION IN THE DETECTION OF TENDINITIS WITH US

The purpose of the study was to examine the possible benefit of the lo ngitudinal probe angle deviation in the detection of tendinitis. The i nfluence of the ultrasound beam angle in longitudinal view on the echo intensity was studied on a bovine tendon in vitro, and in vivo on sym ptomatic human Achilles tendons, one of which was operated on the foll owing day. Five other consecutive patients with clinically unilateral tendinitis in the Achilles tendon, were treated conservatively. Experi mental tendinitis was induced in the bovine tendon by injecting saline water inside the tendon with subsequent swelling of the tendon and se paration of the collagen bundles, thus disrupting the anisotropic intr atendinous structure. The echogenicity of the intact and injected bovi ne tendons was studied perpendicularly and with slight angulation of 7 -10 degrees. The symptomatic Achilles tendons were studied in a simila r way using the asymptomatic tendon as comparison. For in vivo studies , the asymptomatic tendons were used as comparison in clinical and son ographic studies. When increasing the longitudinal probe angle up to 7 -10 degrees the normal tendons became hypoechoic, but tendinitic tendo ns did not lose their echogenicity as rapidly. Moreover the anterior p eritenon was seen more clearly in tendinitic tendons compared to the n ormal side. The method is very useful especially in diagnosing early s tage tendinitis, where the treatment should be more effective than in more severe and chronic stages.