Evaluation of Elastic Stiffness and Tendon Thickness in the Quadriceps Tendon in Patients Undergoing Chronic Hemodialysis

Objective: Spontaneous rupture of the quadriceps tendon is more common in patients with chronic renal failure than in the healthy population.Recurrent microtrauma, hypoxia, hyperparathyroidism, and chronic acidosis are some predisposing factors for spontaneous rupture.This study aimed to evaluate tendon thickness and sonoelastography findings of the quadriceps tendon in patients with chronic renal failure undergoing a dialysis program.Methods: Forty randomly allocated patients [24 male, 16 female; mean [± standard deviation (SD)] age: 58.18±14.41years [range: 24-75] with chronic renal failure undergoing dialysis program, and 32 healthy volunteers 10 males, 22 females; mean age (± SD): 54.72±13.84(range: 31-74)] were included.Measurements of quadriceps tendon thickness and strain elastography were performed in the right knees of all subjects.For the measurement of a strain ratio, two ROIs were placed on the tendon that was 1 cm proximal to the patellar insertion area (ROI A) and the prefemoral fat area (ROI B). Results:The mean quadriceps tendon thickness values were 6.55±1.77mm (range: 3.8-9.4mm) in the chronic renal failure group and 5.81±0.93mm (range: 4.3-8.3mm) in the control group.The quadriceps tendons were significantly thicker in the patient group (p=0.03).The mean elasticity scores were 6.88±15.82 in patients with chronic renal failure group and 8.49±15.07 in the control group.Mean strain elastography values showed no statistically significant difference (p=0.66). Conclusion:Compared with the control cases, the increase in the thickness of quadriceps tendons was found to be significant,but there was no significant difference in sonoelastography findings between the two groups.