title: What is the best clinical test for Achilles tendinopathy?
abstract: BACKGROUND
  Differential diagnosis of Achilles pathology is demanding. This study evaluates the diagnostic accuracy of clinical tests identified for a chronic mid body Achilles tendinopathy. Ultrasound scanning provides the reference standard.
  
  
  METHODS
  Twenty-one participants with, and without, an Achilles tendinopathy, had an ultrasound scan followed immediately by the application of ten clinical tests. The accuracy and reproducibility of each test was determined.
  
  
  RESULTS
  The most valid tests are; pain on palpation of the tendon (sensitivity 84%, specificity 73%, kappa 0.74-0.96) and the subjective reporting of pain 2-6 cm above the insertion into the calcaneum (sensitivity 78%, specificity 77%, kappa 0.75-0.81).
  
  
  CONCLUSIONS
  Only location of pain and pain on palpation were found to be sufficiently reliable and accurate, to be recommended for use.
authors.affiliation: Department of Physiotherapy, Trauma and Orthopaedics, Morriston Hospital, Abertawe Bro Morgannwg University Health Board and College of Medicine, Swansea University, Wales, United Kingdom. Anne-Marie.Hutchison@wales.nhs.uk
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hutchison
authors.forename: Rhodri
authors.initials: R
authors.lastname: Evans
authors.forename: Owen
authors.initials: O
authors.lastname: Bodger
authors.forename: Ian
authors.initials: I
authors.lastname: Pallister
authors.forename: Claire
authors.initials: C
authors.lastname: Topliss
authors.forename: Paul
authors.initials: P
authors.lastname: Williams
authors.forename: Nicola
authors.initials: N
authors.lastname: Vannet
authors.forename: Victoria
authors.initials: V
authors.lastname: Morris
authors.forename: David
authors.initials: D
authors.lastname: Beard
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D052256:Tendinopathy / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography