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Prevalence of Coexistent Plantaris Tendon Pathology in Patients with Mid-Portion Achilles Pathology: A Retrospective MRI Study

Australasian College of Sports and Exercise Medicine, Melbourne 3000, Australia
MP Sports Physicians, Victoria 3199, Australia
Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), School of Medical and Health Sciences, Edith Cowan University, Joondalup 6027, Australia
Department of Physiotherapy, Monash University, Melbourne 3199, Australia
Imaging @ Olympic Park, Melbourne 3004, Australia
Tan Tock Seng Hospital, Singapore 308433, Singapore
Department of Radiology, Monash University, Melbourne 3800, Australia
Author to whom correspondence should be addressed.
Sports 2019, 7(5), 124;
Received: 15 April 2019 / Revised: 17 May 2019 / Accepted: 17 May 2019 / Published: 22 May 2019
Co-existence of Plantaris tendinopathy (PT) in patients with mid-Achilles tendinopathy (Mid-AT) is of clinical significance. This study aims to describe the MRI-based pathological characteristics of co-existing PT and Mid-AT. One-hundred MRI studies of patients diagnosed with Mid-AT were retrospectively analysed by an experienced musculoskeletal radiologist. Presence or absence of a Plantaris tendon, co-existing PT with Mid-AT, insertional characteristics of Plantaris tendon, and maximum anteroposterior thickness of the tendon in Mid-AT (axial images) were evaluated. When PT co-existed with Mid-AT, the location of the tendon pathologies in relation to calcaneal insertion was assessed (sagittal images) and their association was analysed using the coefficient of variation (CV) and Pearson’s correlation coefficient. Plantaris was present in 84 cases (84%), and Mid-AT and PT co-existed in 10 cases (10%). A greater variability in the location of Plantaris pathology (CV = 42%) than Achilles tendinopathy (CV = 42%) was observed. The correlation coefficient also revealed a low and non-significant association between the location of two pathologies when they exist together (r = +0.06; p = 0.88). Clinical evaluation of Achilles tendon pain needs careful consideration into the possible co-existence of Plantaris pathology. The considerable difference observed in the location of PT and Mid-AT suggest possible isolated pathologies and differentials for Achilles tendon pain. View Full-Text
Keywords: Achilles; mid-portion; tendinopathy; Plantaris Achilles; mid-portion; tendinopathy; Plantaris
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Khullar, S.; Gamage, P.; Malliaras, P.; Huguenin, L.; Prakash, A.; Connell, D. Prevalence of Coexistent Plantaris Tendon Pathology in Patients with Mid-Portion Achilles Pathology: A Retrospective MRI Study. Sports 2019, 7, 124.

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