Achilles Tendon Thickness and Stiffness Evaluation with Shear-Wave Elastography in Hemodialysis Patients

Abstract

Background: Changes in tendon structure are expected in chronic renal failure (CRF) due to metabolic alterations. Shear-wave elastography (SWE) is a new elastography technique that determines soft tissue elasticity noninvasively. SWE may determine early tendon degeneration due to CRF. Objectives: We aim to determine Achilles tendon thickness and elasticity in CRF patients undergoing hemodialysis with B-mode and SWE ultrasonography (US). Patients and Methods: Thirty-four (23 male, 11 female) patients with CRF and 32 healthy individuals (24 male, eight female) were included in the study. Initially both Achilles tendons of patients were evaluated for structural abnormalities or focal lesions then tendon thickness was measured with B-mode US. Tendon stiffness was measured by SWE in kilopascal (kPa) units. Results: Mean Achilles tendon thickness in the patient group was significantly lower than the control group (4.16 ± 0.59 mm vs. 4.78 ± 0.61 mm, P < 0.001). The mean elasticity scores in the patient group was 26.00 ± 9.74 kPa and 24.64 ± 6.64 kPa in the control group which was not statistically significant. Conclusion: Achilles tendon is thinner in chronic renal failure patients compared to the control group. However, there was no significant difference between the groups in stiffness values of tendons measured by SWE.