The clinical diagnosis of Achilles tendinopathy: a scoping review
Background Achilles tendinopathy describes the clinical presentation of pain localised to the Achilles tendon and associated loss of function with tendon loading activities. However, clinicians display differing approaches to the diagnosis of Achilles tendinopathy due to inconsistency in the clinica...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PeerJ Inc.
2021-09-01
|
| Series: | PeerJ |
| Subjects: | |
| Online Access: | https://peerj.com/articles/12166.pdf |
| _version_ | 1797418466941075456 |
|---|---|
| author | Wesley Matthews Richard Ellis James Furness Wayne A. Hing |
| author_facet | Wesley Matthews Richard Ellis James Furness Wayne A. Hing |
| author_sort | Wesley Matthews |
| collection | DOAJ |
| description | Background Achilles tendinopathy describes the clinical presentation of pain localised to the Achilles tendon and associated loss of function with tendon loading activities. However, clinicians display differing approaches to the diagnosis of Achilles tendinopathy due to inconsistency in the clinical terminology, an evolving understanding of the pathophysiology, and the lack of consensus on clinical tests which could be considered the gold standard for diagnosing Achilles tendinopathy. The primary aim of this scoping review is to provide a method for clinically diagnosing Achilles tendinopathy that aligns with the nine core health domains. Methodology A scoping review was conducted to synthesise available evidence on the clinical diagnosis and clinical outcome measures of Achilles tendinopathy. Extracted data included author, year of publication, participant characteristics, methods for diagnosing Achilles tendinopathy and outcome measures. Results A total of 159 articles were included in this scoping review. The most commonly used subjective measure was self-reported location of pain, while additional measures included pain with tendon loading activity, duration of symptoms and tendon stiffness. The most commonly identified objective clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). Further objective tests used to assess Achilles tendinopathy included tendon pain during loading activities (single-leg heel raises and hopping) and the Royal London Hospital Test and the Painful Arc Sign. The VISA-A questionnaire as the most commonly used outcome measure to monitor Achilles tendinopathy. However, psychological factors (PES, TKS and PCS) and overall quality of life (SF-12, SF-36 and EQ-5D-5L) were less frequently measured. Conclusions There is significant variation in the methodology and outcome measures used to diagnose Achilles tendinopathy. A method for diagnosing Achilles tendinopathy is proposed, that includes both results from the scoping review and recent recommendations for reporting results in tendinopathy. |
| first_indexed | 2024-03-09T06:33:03Z |
| format | Article |
| id | doaj.art-7b0724a2947c42cfbe548574c7614844 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T06:33:03Z |
| publishDate | 2021-09-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-7b0724a2947c42cfbe548574c76148442023-12-03T11:02:03ZengPeerJ Inc.PeerJ2167-83592021-09-019e1216610.7717/peerj.12166The clinical diagnosis of Achilles tendinopathy: a scoping reviewWesley Matthews0Richard Ellis1James Furness2Wayne A. Hing3Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, AustraliaActive Living and Rehabilitation: Aotearoa New Zealand, Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New ZealandBond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, AustraliaBond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, AustraliaBackground Achilles tendinopathy describes the clinical presentation of pain localised to the Achilles tendon and associated loss of function with tendon loading activities. However, clinicians display differing approaches to the diagnosis of Achilles tendinopathy due to inconsistency in the clinical terminology, an evolving understanding of the pathophysiology, and the lack of consensus on clinical tests which could be considered the gold standard for diagnosing Achilles tendinopathy. The primary aim of this scoping review is to provide a method for clinically diagnosing Achilles tendinopathy that aligns with the nine core health domains. Methodology A scoping review was conducted to synthesise available evidence on the clinical diagnosis and clinical outcome measures of Achilles tendinopathy. Extracted data included author, year of publication, participant characteristics, methods for diagnosing Achilles tendinopathy and outcome measures. Results A total of 159 articles were included in this scoping review. The most commonly used subjective measure was self-reported location of pain, while additional measures included pain with tendon loading activity, duration of symptoms and tendon stiffness. The most commonly identified objective clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). Further objective tests used to assess Achilles tendinopathy included tendon pain during loading activities (single-leg heel raises and hopping) and the Royal London Hospital Test and the Painful Arc Sign. The VISA-A questionnaire as the most commonly used outcome measure to monitor Achilles tendinopathy. However, psychological factors (PES, TKS and PCS) and overall quality of life (SF-12, SF-36 and EQ-5D-5L) were less frequently measured. Conclusions There is significant variation in the methodology and outcome measures used to diagnose Achilles tendinopathy. A method for diagnosing Achilles tendinopathy is proposed, that includes both results from the scoping review and recent recommendations for reporting results in tendinopathy.https://peerj.com/articles/12166.pdfTendinopathyDiagnosisAchillesTendonTendinosisTendinitis |
| spellingShingle | Wesley Matthews Richard Ellis James Furness Wayne A. Hing The clinical diagnosis of Achilles tendinopathy: a scoping review PeerJ Tendinopathy Diagnosis Achilles Tendon Tendinosis Tendinitis |
| title | The clinical diagnosis of Achilles tendinopathy: a scoping review |
| title_full | The clinical diagnosis of Achilles tendinopathy: a scoping review |
| title_fullStr | The clinical diagnosis of Achilles tendinopathy: a scoping review |
| title_full_unstemmed | The clinical diagnosis of Achilles tendinopathy: a scoping review |
| title_short | The clinical diagnosis of Achilles tendinopathy: a scoping review |
| title_sort | clinical diagnosis of achilles tendinopathy a scoping review |
| topic | Tendinopathy Diagnosis Achilles Tendon Tendinosis Tendinitis |
| url | https://peerj.com/articles/12166.pdf |
| work_keys_str_mv | AT wesleymatthews theclinicaldiagnosisofachillestendinopathyascopingreview AT richardellis theclinicaldiagnosisofachillestendinopathyascopingreview AT jamesfurness theclinicaldiagnosisofachillestendinopathyascopingreview AT wayneahing theclinicaldiagnosisofachillestendinopathyascopingreview AT wesleymatthews clinicaldiagnosisofachillestendinopathyascopingreview AT richardellis clinicaldiagnosisofachillestendinopathyascopingreview AT jamesfurness clinicaldiagnosisofachillestendinopathyascopingreview AT wayneahing clinicaldiagnosisofachillestendinopathyascopingreview |