Standardized pain mapping for diagnosing Achilles tendinopathy

Tjerk S O Sleeswijk Visser, Eline M van Es, Duncan E Meuffels, Jan A N Verhaar, Robert-Jan de Vos*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
59 Downloads (Pure)

Abstract

OBJECTIVES: To assess the level of agreement between patient-reported pain using a standardized pain map and the physician-determined clinical diagnosis of Achilles tendinopathy.

DESIGN: Cross-sectional study.

METHODS: Eligible patients were adults visiting a sports physician for symptoms in the Achilles tendon region. Patients completed a digital questionnaire and indicated one location on a pain map where they experienced their pain. The primary outcome measure was level of agreement (% and Kappa coefficient) between patient-reported pain on the pain map and the physician-determined clinical diagnosis (defined as localized pain associated with tendon-loading activities and pain on palpation with or without tendon thickening). The secondary outcome measure was the agreement between the location on the pain map (midportion/insertional region) with the clinical diagnosis of midportion/insertional Achilles tendinopathy.

RESULTS: 110 patients (mean (SD) age 48 (13), 61% men) with pain in the Achilles region were included. In 102 (93%, Kappa = 0.86, CI 0.78-0.95) patients who indicated pain in the Achilles tendon region on the pain map, the clinical diagnosis of Achilles tendinopathy was made by the sports physician. 82% of the patients had the clinical diagnosis of tendinopathy in the specific region of the tendon they marked on the pain map (Kappa = 0.67, CI 0.54-0.79).

CONCLUSIONS: There is almost perfect agreement between patient-reported pain on a pain map and a physician-established clinical diagnosis of Achilles tendinopathy. There was substantial agreement between the localization of the pain that was selected by the patient and the diagnosis of insertional/midportion Achilles tendinopathy by the physician. This tool could potentially aid in adequate triage for specialized care and for researchers performing large epidemiological studies.

Original languageEnglish
Pages (from-to)204-208
Number of pages5
JournalJournal of Science and Medicine in Sport
Volume25
Issue number3
Early online date21 Oct 2021
DOIs
Publication statusPublished - 1 Mar 2022

Bibliographical note

Funding Information:
The authors would like to thank all patients that participated in this study. The authors declare there is no conflict of interest. The authors received no specific funding for this work. All authors contributed equally to this manuscript.

Publisher Copyright:
© 2021 The Author(s)

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