Ultrasound echogenicity is associated with fatigue damage of achilles tendon in a cadaveric loading model

Achilles tendinopathy is an overuse injury that is associated with increased risk of tendon rupture. There is an urgent clinical need to identify predicting risk of injury. Using a combined biomechanical loading and ultrasound imaging model, we mechanically fatigued cadaveric Achilles tendons and found that changes in mean echogenicity measurements increase under tendon tension with increased tendon damage. These findings suggest that ultrasound imaging is sensitive to changes in Achilles tendon fatigue damage, which may serve as such a predictor of Achilles tendon failure.