Journal article 558 views 77 downloads
Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department
International Journal of Foot and Ankle, Volume: 3, Issue: 2
Swansea University Author:
Owen Bodger
-
PDF | Version of Record
Copyright: © 2019 Bowen L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License
Download (729.21KB)
DOI (Published version): 10.23937/2643-3885/1710033
Abstract
AimsTo investigate the diagnostic validity of four radiological soft tissue signs Kager's sign (K), disruption to the tendon (D), loss of parallelism (P) and fusiform swelling of the tendon (F) on a lateral ankle x-ray to aid Achilles tendon rupture diagnosis.MethodsWe retrospectively identifie...
Published in: | International Journal of Foot and Ankle |
---|---|
ISSN: | 2643-3885 |
Published: |
ClinMed International Library
2019
|
Online Access: |
Check full text
|
URI: | https://cronfa.swan.ac.uk/Record/cronfa61628 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
first_indexed |
2022-11-09T10:49:53Z |
---|---|
last_indexed |
2023-01-13T19:22:29Z |
id |
cronfa61628 |
recordtype |
SURis |
fullrecord |
<?xml version="1.0"?><rfc1807><datestamp>2022-11-09T10:52:41.3884742</datestamp><bib-version>v2</bib-version><id>61628</id><entry>2022-10-20</entry><title>Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department</title><swanseaauthors><author><sid>8096440ab42b60a86e6aba678fe2695a</sid><ORCID>0000-0002-4022-9964</ORCID><firstname>Owen</firstname><surname>Bodger</surname><name>Owen Bodger</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-10-20</date><deptcode>HDAT</deptcode><abstract>AimsTo investigate the diagnostic validity of four radiological soft tissue signs Kager's sign (K), disruption to the tendon (D), loss of parallelism (P) and fusiform swelling of the tendon (F) on a lateral ankle x-ray to aid Achilles tendon rupture diagnosis.MethodsWe retrospectively identified two groups of patients; Group A consisted of patients with an Achilles tendon rupture and Group B included patients with a clinically intact Achilles tendon but with a lateral ankle ligament sprain. Three clinicians independently reviewed all patients' x-rays for each of the radiological features under investigation to determine whether a rupture was present or not. Inter-rater and Intra-rater reliability were calculated using the Kappa coefficient (Kc.) To determine the predicted value of the signs sensitivity, specificity, positive predicted values and negative predicted values were calculated.Results85 patients x-rays were included in this study; Group A n = 47, Group B n = 38. The most valid radiological sign appeared to be loss of parallelism (sensitivity 70%, specificity 97%, kappa 0.55-0.58).ConclusionClinicians reviewing a lateral ankle x-ray of a patient with an acute ankle injury should review the x-ray for loss of parallelism between the tendon and skin; identification of this radiological sign may alert the clinician to the possible diagnosis of a ruptured Achilles tendon. Reviewing this may reduce the number of missed Achilles ruptures.</abstract><type>Journal Article</type><journal>International Journal of Foot and Ankle</journal><volume>3</volume><journalNumber>2</journalNumber><paginationStart/><paginationEnd/><publisher>ClinMed International Library</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2643-3885</issnElectronic><keywords>Achilles tendon, Rupture, Diagnosis, X-ray, Ankle injury</keywords><publishedDay>14</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2019</publishedYear><publishedDate>2019-09-14</publishedDate><doi>10.23937/2643-3885/1710033</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This research received no specific grant from any funding agency in the public, commercial or not-forprofit sectors.</funders><projectreference/><lastEdited>2022-11-09T10:52:41.3884742</lastEdited><Created>2022-10-20T14:58:58.4423424</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Bowen</firstname><surname>Lowri</surname><order>1</order></author><author><firstname>Evans</firstname><surname>Rhodri</surname><order>2</order></author><author><firstname>Owen</firstname><surname>Bodger</surname><orcid>0000-0002-4022-9964</orcid><order>3</order></author><author><firstname>Howard</firstname><surname>Joshua</surname><order>4</order></author><author><firstname>Hutchison</firstname><surname>Anne-Marie</surname><order>5</order></author></authors><documents><document><filename>61628__25707__4d1c629bf9f44394b1cfde8d7f408388.pdf</filename><originalFilename>61628_VoR.pdf</originalFilename><uploaded>2022-11-09T10:50:16.2750925</uploaded><type>Output</type><contentLength>746714</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: © 2019 Bowen L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
spelling |
2022-11-09T10:52:41.3884742 v2 61628 2022-10-20 Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department 8096440ab42b60a86e6aba678fe2695a 0000-0002-4022-9964 Owen Bodger Owen Bodger true false 2022-10-20 HDAT AimsTo investigate the diagnostic validity of four radiological soft tissue signs Kager's sign (K), disruption to the tendon (D), loss of parallelism (P) and fusiform swelling of the tendon (F) on a lateral ankle x-ray to aid Achilles tendon rupture diagnosis.MethodsWe retrospectively identified two groups of patients; Group A consisted of patients with an Achilles tendon rupture and Group B included patients with a clinically intact Achilles tendon but with a lateral ankle ligament sprain. Three clinicians independently reviewed all patients' x-rays for each of the radiological features under investigation to determine whether a rupture was present or not. Inter-rater and Intra-rater reliability were calculated using the Kappa coefficient (Kc.) To determine the predicted value of the signs sensitivity, specificity, positive predicted values and negative predicted values were calculated.Results85 patients x-rays were included in this study; Group A n = 47, Group B n = 38. The most valid radiological sign appeared to be loss of parallelism (sensitivity 70%, specificity 97%, kappa 0.55-0.58).ConclusionClinicians reviewing a lateral ankle x-ray of a patient with an acute ankle injury should review the x-ray for loss of parallelism between the tendon and skin; identification of this radiological sign may alert the clinician to the possible diagnosis of a ruptured Achilles tendon. Reviewing this may reduce the number of missed Achilles ruptures. Journal Article International Journal of Foot and Ankle 3 2 ClinMed International Library 2643-3885 Achilles tendon, Rupture, Diagnosis, X-ray, Ankle injury 14 9 2019 2019-09-14 10.23937/2643-3885/1710033 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University This research received no specific grant from any funding agency in the public, commercial or not-forprofit sectors. 2022-11-09T10:52:41.3884742 2022-10-20T14:58:58.4423424 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Bowen Lowri 1 Evans Rhodri 2 Owen Bodger 0000-0002-4022-9964 3 Howard Joshua 4 Hutchison Anne-Marie 5 61628__25707__4d1c629bf9f44394b1cfde8d7f408388.pdf 61628_VoR.pdf 2022-11-09T10:50:16.2750925 Output 746714 application/pdf Version of Record true Copyright: © 2019 Bowen L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License true eng https://creativecommons.org/licenses/by/4.0/ |
title |
Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department |
spellingShingle |
Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department Owen Bodger |
title_short |
Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department |
title_full |
Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department |
title_fullStr |
Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department |
title_full_unstemmed |
Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department |
title_sort |
Investigating the Validity of Soft Tissue Signs on Lateral Ankle X-Ray to Aid Diagnosis of Achilles Tendon Rupture in the Emergency Department |
author_id_str_mv |
8096440ab42b60a86e6aba678fe2695a |
author_id_fullname_str_mv |
8096440ab42b60a86e6aba678fe2695a_***_Owen Bodger |
author |
Owen Bodger |
author2 |
Bowen Lowri Evans Rhodri Owen Bodger Howard Joshua Hutchison Anne-Marie |
format |
Journal article |
container_title |
International Journal of Foot and Ankle |
container_volume |
3 |
container_issue |
2 |
publishDate |
2019 |
institution |
Swansea University |
issn |
2643-3885 |
doi_str_mv |
10.23937/2643-3885/1710033 |
publisher |
ClinMed International Library |
college_str |
Faculty of Medicine, Health and Life Sciences |
hierarchytype |
|
hierarchy_top_id |
facultyofmedicinehealthandlifesciences |
hierarchy_top_title |
Faculty of Medicine, Health and Life Sciences |
hierarchy_parent_id |
facultyofmedicinehealthandlifesciences |
hierarchy_parent_title |
Faculty of Medicine, Health and Life Sciences |
department_str |
Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
document_store_str |
1 |
active_str |
0 |
description |
AimsTo investigate the diagnostic validity of four radiological soft tissue signs Kager's sign (K), disruption to the tendon (D), loss of parallelism (P) and fusiform swelling of the tendon (F) on a lateral ankle x-ray to aid Achilles tendon rupture diagnosis.MethodsWe retrospectively identified two groups of patients; Group A consisted of patients with an Achilles tendon rupture and Group B included patients with a clinically intact Achilles tendon but with a lateral ankle ligament sprain. Three clinicians independently reviewed all patients' x-rays for each of the radiological features under investigation to determine whether a rupture was present or not. Inter-rater and Intra-rater reliability were calculated using the Kappa coefficient (Kc.) To determine the predicted value of the signs sensitivity, specificity, positive predicted values and negative predicted values were calculated.Results85 patients x-rays were included in this study; Group A n = 47, Group B n = 38. The most valid radiological sign appeared to be loss of parallelism (sensitivity 70%, specificity 97%, kappa 0.55-0.58).ConclusionClinicians reviewing a lateral ankle x-ray of a patient with an acute ankle injury should review the x-ray for loss of parallelism between the tendon and skin; identification of this radiological sign may alert the clinician to the possible diagnosis of a ruptured Achilles tendon. Reviewing this may reduce the number of missed Achilles ruptures. |
published_date |
2019-09-14T04:20:35Z |
_version_ |
1763754361731678208 |
score |
11.021648 |