Sport and exercise medicine consultants are reliable in assessing tendon neovascularity using ultrasound Doppler

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Author
Watson, James
Barker-Davies, Robert
Bennett, Alexander
Fong, Daniel
Wheeler, Patrick
Lewis, Mark
Ranson, Craig
Date
2018-02-07Acceptance date
2017-12-13
Type
Article
Publisher
BMJ Publishing Group
ISSN
2055-7647
Metadata
Show full item recordAbstract
Objective: Several lower limb tendinopathy treatment modalities involve identification of pathological paratendinous or intratendinous neovascularisation to target proposed co-location of painful neoneuralisation. The ability to reliably locate and assess the degree of neovascularity is therefore clinically important. The Modified Ohberg Score (MOS) is frequently used to determine degree of neovascularity, but reliability has yet to be established among Sport and Exercise Medicine (SEM) consultants. This study aims to determine inter-rater and intra-rater reliability of an SEM consultant cohort when assessing neovascularity using the 5-point MOS.
Method: Eleven participants (7 male and 4 female) provided 16 symptomatic Achilles and patella tendons. These were sequentially examined using power Doppler (PD) enabled ultrasound (US) imaging by 6 SEM consultants who rated neovascular changes seen using the MOS. Representative digital scan images were saved for rescoring 3 weeks later. Inter-rater and intra-rater reliability of the MOS was examined using intraclass correlation coefficient (ICC) and Kappa Agreement scores.
Results: Neovascular changes were reported in 65.6% of 96 scans undertaken. ICC for inter-rater reliability was 0.86 and Fleiss Kappa 0.52. ICC for intra-rater reliability was 0.95 and Weighted Kappa 0.91.
Conclusions: Neovascular changes were present in two-thirds of symptomatic tendons. Excellent SEM consultant inter-rater and intra-rater reliability was demonstrated. These findings support the use of PD-enabled US to assess neovascularity by appropriately experienced SEM consultants. Furthermore, future interventional research using a similarly experienced SEM consultant cohort can be undertaken with assurance that assessment of neovascularity will be reliable.
Journal/conference proceeding
BMJ Open Sport and Exercise Medicine;
Citation
Watson, J., Barker-Davies, R.M., Bennett, A.N., Fong, D.T., Wheeler, P.C., Lewis, M. and Ranson, C. (2018) 'Sport and exercise medicine consultants are reliable in assessing tendon neovascularity using ultrasound Doppler', BMJ Open Sport and Exercise Medicine, 4(1), p.e000298. DOI: 10.1136/bmjsem-2017-000298.
Description
Article published in BMJ Open Sport and Exercise Medicine (online) on 07 February 2018, available open access at: http://dx.doi.org/10.1136/bmjsem-2017-000298.
Sponsorship
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
Higher Education Funding Council for England and PhD Studentship
Collections
- Sport Research Groups [1089]
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