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Background Partial Achilles tendon ruptures are not always easy to diagnose. A history including a sudden onset of pain and/or relative weakness in plantar flexion force is an indicator. The most loaded side of the Achilles tendon is the dorsal side (skin side). Objective The aim of this study was to evaluate the ultrasound (US) and colour Doppler (CD) findings in patients with a suspected partial rupture in the Achilles tendon. Materials and Methods Seventeen patients (16 men and 1 woman) with a mean age of 36 years (range 23–71 years) were examined clinically and by US+CD because of mid-portion Achilles tendon pain. There was an acute onset in 14 of 17 patients, and all had painful weakness during tendon loading activity. Results In all patients, the US examination showed a partial Achilles tendon rupture, presented as a disrupted dorsal (skin side) tendon line and an irregular tendon structure mainly located in the dorsal and mid-tendon. The size of the rupture varied from 1/3 to 2/3 of the tendon thickness. In the dorsal part of the tendon, corresponding to the region with disrupted tendon line and irregular structure, CD examination showed high blood flow—most often of a longitudinal character. Six of the patients were surgically treated, and macroscopical examination verified the US findings showing disruption on the dorsal side and a partial rupture in the dorsal and mid-tendon. Conclusions US and Doppler examination can be helpful tools to diagnose partial mid-portion Achilles tendon ruptures. The characteristic findings of a disrupted dorsal tendon line and high blood flow in the structurally abnormal dorsal tendon indicate a partial rupture. [ABSTRACT FROM PUBLISHER]

The author talks about the state of tendinopathy research which is burdened with disagreeing pathological pathways, differing views on management, and tenuous evidence supporting the use of treatments in clinical practice. Topics include disagreements on basic principles like the general definition of tendinopathy and treatments such as corticosteroids, the need for diagnostic criteria for tendinopathy and a better understanding of pain generation, and the role of interventional therapy. [ABSTRACT FROM AUTHOR]

To develop a core outcome set for Achilles tendinopathy (COS-AT) for use in clinical trials we performed a five-step process including (1) a systematic review of available outcome measurement instruments, (2) an online survey on truth and feasibility of the available measurement instruments, (3) an assessment of the methodological quality of the selected outcome measurement instruments, (4) an online survey on the outcome measurement instruments as COS and (5) a consensus in-person meeting. Both surveys were completed by healthcare professionals and patients. The Outcome Measures in Rheumatology guidelines with a 70% threshold for consensus were followed. We identified 233 different outcome measurement instruments from 307 included studies; 177 were mapped within the International Scientific Tendinopathy Symposium Consensus core domains. 31 participants (12 patients) completed the first online survey (response rate 94%). 22/177 (12%) outcome measurement instruments were deemed truthful and feasible and their measurement properties were evaluated. 29 participants (12 patients) completed the second online survey (response rate 88%) and three outcome measurement instruments were endorsed: the Victorian Institute of Sports Assessment-Achilles questionnaire, the single-leg heel rise test and evaluating pain after activity using a Visual Analogue Scale (VAS, 0-10). 12 participants (1 patient) attended the final consensus meeting, and 1 additional outcome measurement instrument was endorsed: evaluating pain during activity/loading using a VAS (0-10). It is recommended that the identified COS-AT will be used in future clinical trials evaluating the effectiveness of an intervention. This will facilitate comparing outcomes of intervention strategies, data pooling and further progression of knowledge about AT. As COS-AT is implemented, further evidence on measurement properties of included measures and new outcome measurement instruments should lead to its review and refinement., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)