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Quantitative ultrasound mapping of regional variations in shear wave speeds of the aging Achilles tendon



Evaluate the effects of aging on healthy Achilles tendon and aponeurosis shear wave speed (SWS), a quantitative metric which reflects tissue elasticity.


Shear wave elastography was used to measure spatial variations in Achilles tendon SWS in healthy young (n = 15, 25 ± 4 years), middle-aged (n = 10, 49 ± 4 years) and older (n = 10, 68 ± 5 years) adults. SWS was separately measured in the free Achilles tendon, soleus aponeurosis and gastrocnemius aponeurosis in resting (R), stretched (dorsiflexed 15° from R) and slack (plantarflexed 15° from R) postures.


SWS significantly increased with stretch and varied with age in all tendon regions. Slack free tendon SWS was significantly higher in older adults than young adults (p = 0.025). However, stretched soleus aponeurosis SWS was significantly lower in older adults than young adults (p = 0.01). Stretched gastrocnemius aponeurosis SWS was significantly lower in both middle-aged (p = 0.003) and older (p = 0.001) adults, relative to younger adults.


These results suggest that aging alters spatial variations in Achilles tendon elasticity, which could alter deformations within the triceps surae muscle–tendon units, thus affecting injury potential. The observed location- and posture-dependent variations highlight the importance of controlling ankle posture and imaging location when using shear wave approaches clinically to evaluate tendon disorders.

Key Points

Shear wave elastography shows promise as a clinical quantitative ultrasound-based technique.

Aging induces location-dependent changes in Achilles tendon shear wave speed.

Spatial and postural dependence necessitates careful integration of this approach clinically.

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The scientific guarantor of this publication is Dr. Kenneth Lee. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study received funding from the Radiological Society of North America (Scholar Grant), the University of Wisconsin-Madison Radiology Department Research and Development Fund (#1204-001), and the Clinical and Translational Science Award (CTSA) program, previously through the National Center for Research Resources (NCRR) grant 1UL1RR025011, and now by the National Center for Advancing Translational Sciences (NCATS), grant 9U54TR000021. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported in Physiological Measurement (12) and the Journal of Biomechanics (11). The study was prospective, cross-sectional and performed at one institution.

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Correspondence to Laura Chernak Slane.

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Slane, L.C., Martin, J., DeWall, R. et al. Quantitative ultrasound mapping of regional variations in shear wave speeds of the aging Achilles tendon. Eur Radiol 27, 474–482 (2017).

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  • Ultrasound
  • Elastography
  • Tendon
  • Aging
  • Compliance