Can Achilles tendon xanthoma be distinguished from Achilles tendinopathy using Dixon method MRI? A cross-sectional exploratory study

Autor: Thomas Michael Zahradnik, Mark Cresswell, Kip Squier, Charlotte Waugh, Liam Brunham, Hazel Screen, Alex Scott
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-9 (2021)
Druh dokumentu: article
ISSN: 1471-2474
DOI: 10.1186/s12891-021-04494-0
Popis: Abstract Background Familial hypercholesterolemia is a genetic condition characterized by life-long elevations of plasma low-density lipoprotein cholesterol. In addition to life-threatening cardiovascular complications, intratendinous cholesterol deposits (xanthomas) can lead to pain and tendon thickening, particularly in the Achilles. Clinical detection of xanthomas currently relies upon visual assessment and palpation, or ultrasound-based measures of tendon thickening or echotexture. Misdiagnosis of xanthoma can delay the commencement of potentially life-saving lipid-lowering therapy. Our primary purpose was to determine whether analysis of separated fat and water magnetic resonance images may be able to differentiate between xanthomatic and nonxanthomatic Achilles tendons through quantification of intratendinous fat content. The main hypothesis was that Achilles tendon xanthomas will demonstrate greater lipid content than Achilles tendinopathy or healthy control tendons. Methods Bilateral MRI scans of Achilles tendons from 30 participants (n = 10 Achilles tendon xanthoma, n = 10 Achilles overuse tendinopathy, n = 10 healthy controls) were analyzed for total lipid content using the Dixon method of fat and water signal separation. Secondary outcome measures included tendon water content, as well as ultrasound characterization of tendon tissue organization and thickness. Results Fat content was greater in Achilles tendon xanthomas compared to the tendinopathy (p
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