诊断领域、鉴别诊断和需要进一步医疗关注的条件被认为是评估跟腱病的重要因素:德尔菲共识研究

IF 11.6 1区 医学 Q1 SPORT SCIENCES
Peter Malliaras, Karin Gravare Silbernagel, Robert-Jan de Vos, Jaryd Bourke, Igor Sancho, Shawn L Hanlon, Anne-Sofie Agergaard, Roald Bahr, Natália Franco Netto Bittencourt, Marcelo Bordalo, Annelie Brorsson, Victoria Tzortziou Brown, Tanusha Cardoso, Sally Child, Ruth L Chimenti, Emma Cowley, Pieter D’Hooghe, Wayne Derman, Jonathan T Finnoff, Siu Ngor Fu, Jill Halstead, Bruce Hamilton, Katarina Maria Nilsson-Helander, Per Hölmich, Jonathan Houghton, Alicia M James, Kornelia Kulig, Amanda Lau, Samuel Ling, Nicola Maffulli, Lorenzo Masci, Sue Mayes, Sean Mc Auliffe, Carol McCrum, Dylan Morrissey, Shannon E Munteanu, Myles Calder Murphy, Richard Newsham-West, Seth O’Neill, Nat Padhiar, Theodora Papadopoulou, Jonathan D Rees, Ebonie Kendra Rio, Diego Ruffino, Alex Scott, Suzy Speirs, Yang Sun, Kristian Thorborg, Larissa Trease, Jan A N Verhaar, Evi Wezenbeek, Sue White, Jennifer A Zellers, S Zhang, Vasileios Korakakis, Bill Vicenzino
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引用次数: 0

摘要

缺乏一致的方法来诊断跟腱病阻碍了研究和临床实践。这种差距导致异质性和/或描述不佳的研究样本,使其在临床实践中应用研究结果具有挑战性。本德尔菲研究的目的是确定以下共识:(1)诊断领域;(2)鉴别诊断;(3)在评估跟腱病变时需要进一步医疗护理的情况。我们进行了一个连续的三个阶段的过程,其中包括:(1)根据现有的范围审查和临床实践指南确定诊断领域、鉴别诊断和需要进一步医疗关注的病症;(2)开发德尔菲调查问题;(3)进行五轮德尔菲在线调查。共识定义为≥70%的同意。52名参与者完成了调查。四个诊断领域被认为是必不可少的,并达成了共识(疼痛位置(93%);活动时疼痛(97%);引起疼痛的检查(87%);触诊评估疼痛(83%)。15例鉴别诊断达成共识:2例为中段和插入性撕裂(部分撕裂)(80%);踝关节后部撞击(78%),中部跖腱病(84%);胫骨后肌或拇长屈肌肌腱病/腱鞘炎(72%);指长屈肌腱病变(77%);副比目鱼肌(74%);paratendinopathy (86%);腓肠神经病变(81%),插入性(浅表性(88%)和跟骨后滑囊炎(86%);Haglund’s/跟骨外生(80%),肌腱内钙化(73%);严重疾病(78%);跟骨应力反应/骨折(80%);距下/踝关节疼痛(71%)。需要进一步就医的六种情况达成共识:(跟腱断裂(83%);全身性炎性关节病(86%);代谢综合征(75%);家族性高胆固醇血症(77%);内分泌和激素紊乱(80%);药物反应(77%)。这一共识确定了评估跟腱病时应考虑的基本诊断领域、鉴别诊断和需要进一步医疗关注的条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic domains, differential diagnosis and conditions requiring further medical attention that are considered important in the assessment for Achilles tendinopathy: a Delphi consensus study
The absence of agreed methods to diagnose Achilles tendinopathy impedes research and clinical practice. This gap results in heterogeneous and/or poorly described study samples, making it challenging to apply findings in clinical practice. The aim of this Delphi study was to define consensus on (1) diagnostic domains; (2) differential diagnoses; and (3) conditions requiring further medical attention, when assessing for Achilles tendinopathy. We conducted a sequential three-stage process which included: (1) identifying diagnostic domains, differential diagnoses and conditions requiring further medical attention based on existing scoping reviews and clinical practice guidelines; (2) developing Delphi survey questions; and (3) administering a five-round Delphi online survey. Consensus was defined as ≥70% agreement. 52 participants completed the surveys. Four diagnostic domains were deemed essential and reached consensus (pain location (93%); pain during activity (97%); tests that provoke pain (87%); palpation to assess pain (83%)). 15 differential diagnoses reached consensus: 2 for both midportion and insertional (partial tear (80%); posterior ankle impingement (78%)), 6 for midportion (plantaris tendinopathy (84%); tibialis posterior or flexor hallucis longus tendinopathy/tenosynovitis (72%); flexor digitorum longus tendinopathy (77%); accessory soleus muscle (74%); paratendinopathy (86%); sural nerve neuropathy (81%)) and 7 for insertional (superficial (88%) and retrocalcaneal bursitis (86%); Haglund’s/calcaneal exostosis (80%), intratendinous calcifications (73%); Sever’s disease (78%); calcaneal stress reaction/fracture (80%); subtalar/ankle pain (71%)). Six conditions requiring further medical attention reached consensus: (Achilles tendon rupture (83%); systemic inflammatory joint disease (86%); metabolic syndrome (75%); familial hypercholesterolaemia (77%); endocrine and hormonal disorders (80%); drug reactions (77%)). This consensus identified essential diagnostic domains, differential diagnoses and conditions requiring further medical attention that should be considered when assessing for Achilles tendinopathy.
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来源期刊
CiteScore
27.10
自引率
4.90%
发文量
217
审稿时长
3-8 weeks
期刊介绍: The British Journal of Sports Medicine (BJSM) is a dynamic platform that presents groundbreaking research, thought-provoking reviews, and meaningful discussions on sport and exercise medicine. Our focus encompasses various clinically-relevant aspects such as physiotherapy, physical therapy, and rehabilitation. With an aim to foster innovation, education, and knowledge translation, we strive to bridge the gap between research and practical implementation in the field. Our multi-media approach, including web, print, video, and audio resources, along with our active presence on social media, connects a global community of healthcare professionals dedicated to treating active individuals.
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