DIAGNOSIS OF THE ACHILLES INSERTIONAL TENDINOPATHIES BY ALGOMETRY.

Introduction Diagnosis of Achilles insertional tendinopathies (AIT) is based on pain by tendon palpation. However, there is no consensus or standard regarding the amount of force to be used during the evaluation. The algometry is a method of measuring the pressure applied in a specific region and can be a method for determining diagnosis values. Goal To determine a cut-off value for Pain Threshold (PT) in the assessment of AIT. Design This is a prospective case-control study of diagnostic accuracy, to develop a diagnostic criterion. Methods Forty asymptomatic individuals and forty patients with insertional Achilles tendinopathy, matched by age and sex, were evaluated, and submitted to algometry for PT and for Visual Analogical Scale (VAS) levels with 3 kg/f at the insertion of the calcaneal tendon by two different evaluators. Inter-observer reproducibility was accessed through the interclass correlation index (ICC). Sensitivity and specificity calculation of PT and of VAS ​​were calculated and plotted on a ROC (Receiver Operator Characteristic) curve. Results The lowest ICC found was 0.788. Regarding the diagnosis through TP, the 4.08 kg/f mark showed the best relation between sensitivity and specificity (92.5% and 92.5%, respectively). Algometry values lower than 4.08 were considered positive for disease. For the diagnosis of TIA through VAS with 3 kg/f, the value of 2.98 was determined (sensitivity of 92.5% and specificity of 97.5%). Conclusion The algometry showed to be a simple and reliable method for diagnosing AIT. Values for PT under 4.08 kg/f were found predictors of the disease.