Revisiting physical examination: Abadie's sign and Achilles intratendinous changes in subjects with diabetes.
OBJECTIVE
The aim of this study was to evaluate whether or not the positivity of Abadie's sign could be an indicator of asymptomatic Achilles intratendinous changes.


METHODS
A total of 18 patients (36 tendons) suffering from diabetes, with at least 1 Achilles tendon positive to Abadie's sign, were compared to matched subjects with diabetes bilaterally negative to Abadie's sign. Anthropometric measures and the Toronto Clinical Neuropathy Score were registered. Echotexture was evaluated and degenerative features classified as absent, mild, moderate and severe. The frequencies of structural abnormalities, according to both Abadie's sign and the Toronto Clinical Neuropathy Score, were determined.


RESULTS
In the first group 26 out of 36 tendons (72.2%) showed positive Abadie's sign and a significantly higher frequency of moderate and severe (65.3%) structural abnormalities compared to Achilles tendons with negative sign (4.3%; p < 0.0001). This frequency was similar to that observed in the subjects with the highest Toronto Clinical Neuropathy Score (64.2%).


CONCLUSIONS
This study showed that Abadie's sign was a useful tool for assisting in the diagnosis of asymptomatic Achilles intratendinous changes, which, when detected early, could help prevent unexpected tendon rupture. The concordance between Abadie's sign and Achilles sonographic abnormalities needs to be evaluated in a larger sample to consider it useful for practical purposes.
Department of Medicine and Science of Aging, University G. d'Annunzio, Chieti-Pescara, Chieti, Italy.
Michele
M
Abate
Cosima
C
Schiavone
Vincenzo
V
Salini
Isabel
I
Andia
D000125:Achilles Tendon / Q000503:physiopathology*; D000368:Aged; D001837:Body Weights and Measures; D048909:Diabetes Complications / Q000175:diagnosis*; D003929:Diabetic Neuropathies / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000175:diagnosis* / Q000453:epidemiology; D010808:Physical Examination / Q000379:methods*