ArticleSkeletal radiology2026
Ultrasound gap measurement after acute Achilles rupture is reliable overall but uncertain near a 5-mm decision threshold.
Article in Skeletal radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveUltrasound gap distance has been proposed as a supportive triage input within protocol-based pathways after acute Achilles tendon rupture. We assessed intra-/inter-rater reliability of gap measurement and the extent of classification uncertainty around a 5-mm threshold. Retrospective observer-agreement study without a definitive reference standard, using protocol-acquired stored ultrasound cine loops from 30 clinically diagnosed complete acute ruptures in a prospectively collected cohort.
methodsRetrospective observer-agreement study without a definitive reference standard, using protocol-acquired stored ultrasound cine loops from 30 clinically diagnosed complete acute ruptures in a prospectively collected cohort. Two blinded musculoskeletal radiologists re-reviewed stored cine loops and measured tendon-gap distance in two sessions each (≥ 4 weeks apart). We calculated intraclass correlation coefficients (ICC), Bland-Altman mean difference and 95% limits of agreement (LoA), and standard error of measurement (SEM). Agreement at the 5-mm protocol cut-point was assessed using Cohen's κ and Gwet's AC1. Using SEM, we derived 90% confidence zones indicating firm classification versus a grey zone where repeat measurement or second read may be considered.
resultsIntra-rater ICC(2,1) was 0.88 (95% CI 0.83-0.91) and 0.94 (0.82-0.97); SEMs were 1.57 and 1.19 mm. Inter-rater bias was + 1.12 mm with LoA - 3.85 to 6.10 mm. Agreement for study experimental pathway classification at the 5-mm cut-point (operative vs non-operative) was moderate (κ = 0.60; AC1 = 0.61), with 6/30 examinations classified differently. SEM-based 90% zones were ≤ 2.42 and ≥ 7.58 mm (rater 1) and ≤ 3.04 and ≥ 6.96 mm (rater 2); a conservative cross-rater rule suggested ≤ 2.05 or ≥ 7.95 mm.
conclusionGap measurement shows good relative reliability, but uncertainty near 5 mm can alter classification. Reporting LoA/SEM alongside ICC and flagging a grey zone may reduce misclassification in borderline cases.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.