title: Endofibrosis in athletes: is a simple bedside exercise helpful or sufficient for the diagnosis?
abstract: OBJECTIVE
  Ankle-to-brachial index (ABI) can be easily performed by all physicians. The Ruffier-Dickson (RD) test is an easy procedure to attain moderate exercise at the bedside for physicians who do not have an ergometer.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Tertiary care, institutional practice.
  
  
  METHODS
  Fifty-three asymptomatic athletes and 22 patients suffering from unilateral pain due to histologically proven exercise-induced arterial endofibrosis (EIAE).
  
  
  METHODS
  Brachial and ankle systolic blood pressures were measured in the supine position on the suspected leg in EIAE or left leg in controls, at rest (rest) and at the first minute of the recovery from incremental maximal cycle ergometer exercise (maxCE) and Ruffier-Dickson (RD) exercise tests.
  
  
  METHODS
  Comparison of ABI(rest), ABI(maxCE), and ABI(RD) in discriminating patients from normal subjects, using receiver operating characteristics (ROC) curves.
  
  
  RESULTS
  Area (+/-SE of area) of ROC curve was 0.76 +/- 0.06 for ABI(rest), 0.83 +/- 0.05 for ABI(RD) (nonsignificant from rest), and 0.99 +/- 0.01 for ABI(maxCE) (P < 0.01 from ABI(RD) and P < 0.001 from ABI(rest)). An ABI(maxCE) below 0.48 was 100% specific and 80% sensitive for EIAE. For the RD test, a 100% negative predictive value was only attained for postexercise ABI values higher than 0.92.
  
  
  CONCLUSIONS
  ABI after maximal cycle ergometer exercise is more accurate than ABI after an RD test to search for unilateral EIAE in athletes.
authors.affiliation: CNRS 6214-INSERM 771, Faculty of Medicine, University of Angers, Angers, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Bruneau
authors.forename: Alexis
authors.initials: A
authors.lastname: Le Faucheur
authors.forename: Guillaume
authors.initials: G
authors.lastname: Mahe
authors.forename: Bruno
authors.initials: B
authors.lastname: Vielle
authors.forename: Georges
authors.initials: G
authors.lastname: Leftheriotis
authors.forename: Pierre
authors.initials: P
authors.lastname: Abraham
mesh_terms: D000328:Adult; D000842:Ankle / Q000098:blood supply*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000473:pathology; D001265:Athletic Injuries / Q000175:diagnosis*; D001795:Blood Pressure Determination / Q000379:methods*; D001916:Brachial Artery / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000592:standards*; D012189:Retrospective Studies