{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:05:16Z","timestamp":1780031116593,"version":"3.53.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,28]]},"DOI":"10.7759\/cureus.109845","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:50:58Z","timestamp":1780030258000},"source":"Crossref","is-referenced-by-count":0,"title":["Relationship Between Ankle Plantar Flexion Angle and Tendon Gap in Achilles Tendon Rupture: A Prospective Study Using Portable Handheld Ultrasonography"],"prefix":"10.7759","author":[{"given":"Gregory","family":"Waryasz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atta","family":"Taseh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Nassour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noopur","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Kattady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Bejarano-Pineda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W","family":"DiGiovanni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soheil","family":"Ashkani-Esfahani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Guss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2020.12.1.1","article-title":"Treatment of acute Achilles tendon rupture","volume":"12","author":"Park SH","year":"2020","unstructured":"Park SH, Lee HS, Young KW, Seo SG. Treatment of acute Achilles tendon rupture. Clin Orthop Surg. 2020, 12:1-8. 10.4055\/cios.2020.12.1.1","journal-title":"Clin Orthop Surg"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12253","article-title":"Epidemiology of Achilles tendon ruptures: increasing incidence over a 33-year period","volume":"25","author":"Lantto I","year":"2015","unstructured":"Lantto I, Heikkinen J, Flinkkil\u00e4 T, Ohtonen P, Leppilahti J. Epidemiology of Achilles tendon ruptures: increasing incidence over a 33-year period. Scand J Med Sci Sports. 2015, 25:e133-8. 10.1111\/sms.12253","journal-title":"Scand J Med Sci Sports"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-018-0912-5","article-title":"Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis","volume":"7","author":"Meulenkamp B","year":"2018","unstructured":"Meulenkamp B, Stacey D, Fergusson D, Hutton B, Mlis RS, Graham ID. Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis. Syst Rev. 2018, 7:247. 10.1186\/s13643-018-0912-5","journal-title":"Syst Rev"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514531014","article-title":"Rehabilitation regimen after surgical treatment of acute Achilles tendon ruptures: a systematic review with meta-analysis","volume":"43","author":"Huang J","year":"2015","unstructured":"Huang J, Wang C, Ma X, Wang X, Zhang C, Chen L. Rehabilitation regimen after surgical treatment of acute Achilles tendon ruptures: a systematic review with meta-analysis. Am J Sports Med. 2015, 43:1008-16. 10.1177\/0363546514531014","journal-title":"Am J Sports Med"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510376052","article-title":"Acute Achilles tendon rupture: a randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures","volume":"38","author":"Nilsson-Helander K","year":"2010","unstructured":"Nilsson-Helander K, Silbernagel KG, Thome\u00e9 R, Fax\u00e9n E, Olsson N, Eriksson BI, Karlsson J. Acute Achilles tendon rupture: a randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures. Am J Sports Med. 2010, 38:2186-93. 10.1177\/0363546510376052","journal-title":"Am J Sports Med"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01401","article-title":"Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation","volume":"92","author":"Willits K","year":"2010","unstructured":"Willits K, Amendola A, Bryant D, et al.. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am. 2010, 92:2767-75. 10.2106\/JBJS.I.01401","journal-title":"J Bone Joint Surg Am"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-201008000-00007","article-title":"Diagnosis and treatment of acute Achilles tendon rupture","volume":"18","author":"Chiodo CP","year":"2010","unstructured":"Chiodo CP, Glazebrook M, Bluman EM, et al.. Diagnosis and treatment of acute Achilles tendon rupture. J Am Acad Orthop Surg. 2010, 18:503-10. 10.5435\/00124635-201008000-00007","journal-title":"J Am Acad Orthop Surg"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.22.27632","article-title":"The Achilles tendon: imaging diagnoses and image-guided interventions - AJR expert panel narrative review","volume":"219","author":"Pass B","year":"2022","unstructured":"Pass B, Robinson P, Ha A, Levine B, Yablon CM, Rowbotham E. The Achilles tendon: imaging diagnoses and image-guided interventions - AJR expert panel narrative review. AJR Am J Roentgenol. 2022, 219:355-68. 10.2214\/AJR.22.27632","journal-title":"AJR Am J Roentgenol"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.09.013","article-title":"Imaging modalities in the diagnosis and monitoring of Achilles tendon ruptures: a systematic review","volume":"48","author":"Dams OC","year":"2017","unstructured":"Dams OC, Reininga IH, Gielen JL, van den Akker-Scheek I, Zwerver J. Imaging modalities in the diagnosis and monitoring of Achilles tendon ruptures: a systematic review. Injury. 2017, 48:2383-99. 10.1016\/j.injury.2017.09.013","journal-title":"Injury"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2355-y","article-title":"MRI is unnecessary for diagnosing acute Achilles tendon ruptures: clinical diagnostic criteria","volume":"470","author":"Garras DN","year":"2012","unstructured":"Garras DN, Raikin SM, Bhat SB, Taweel N, Karanjia H. MRI is unnecessary for diagnosing acute Achilles tendon ruptures: clinical diagnostic criteria. Clin Orthop Relat Res. 2012, 470:2268-73. 10.1007\/s11999-012-2355-y","journal-title":"Clin Orthop Relat Res"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.15557\/JoU.2017.0027","article-title":"Standards for musculoskeletal ultrasound","volume":"17","author":"Czyrny Z","year":"2017","unstructured":"Czyrny Z. Standards for musculoskeletal ultrasound. J Ultrason. 2017, 17:182-7. 10.15557\/JoU.2017.0027","journal-title":"J Ultrason"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2018.01.001","article-title":"Pocket-size point-of-care ultrasound in rural Uganda - a unique opportunity \"to see\", where no imaging facilities are available","volume":"23","author":"Epstein D","year":"2018","unstructured":"Epstein D, Petersiel N, Klein E, et al.. Pocket-size point-of-care ultrasound in rural Uganda - a unique opportunity \"to see\", where no imaging facilities are available. Travel Med Infect Dis. 2018, 23:87-93. 10.1016\/j.tmaid.2018.01.001","journal-title":"Travel Med Infect Dis"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.26603\/001c.68184","article-title":"MSK ultrasound - an IJSPT perspective","volume":"18","author":"Page P","year":"2023","unstructured":"Page P, Manske RC, Voight M, Wolfe C. MSK ultrasound - an IJSPT perspective. Int J Sports Phys Ther. 2023, 18:1-10. 10.26603\/001c.68184","journal-title":"Int J Sports Phys Ther"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1177\/08850666221076041","article-title":"Handheld point-of-care ultrasound: safety considerations for creating guidelines","volume":"37","author":"Hsieh A","year":"2022","unstructured":"Hsieh A, Baker MB, Phalen JM, Mejias-Garcia J, Hsieh A, Hsieh A, Canelli R. Handheld point-of-care ultrasound: safety considerations for creating guidelines. J Intensive Care Med. 2022, 37:1146-51. 10.1177\/08850666221076041","journal-title":"J Intensive Care Med"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-04625-y","article-title":"Modified gastro-soleus turn-down flap for chronic or neglected Achilles tendon ruptures","volume":"19","author":"Ibrahim MA","year":"2024","unstructured":"Ibrahim MA, Abdelkader MG, Nematallah SA, Elsawy GA, Alghandour SA, Shwitter LM. Modified gastro-soleus turn-down flap for chronic or neglected Achilles tendon ruptures. J Orthop Surg Res. 2024, 19:168. 10.1186\/s13018-024-04625-y","journal-title":"J Orthop Surg Res"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1177\/2325967116667920","article-title":"Acute ultrasonography investigation to predict reruptures and outcomes in patients with an Achilles tendon rupture","volume":"4","author":"Westin O","year":"2016","unstructured":"Westin O, Nilsson Helander K, Gr\u00e4vare Silbernagel K, M\u00f6ller M, K\u00e4lebo P, Karlsson J. Acute ultrasonography investigation to predict reruptures and outcomes in patients with an Achilles tendon rupture. Orthop J Sports Med. 2016, 4:2325967116667920. 10.1177\/2325967116667920","journal-title":"Orthop J Sports Med"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.102B11.BJJ-2020-0908.R1","article-title":"Does size of tendon gap affect patient-reported outcome following Achilles tendon rupture treated with functional rehabilitation?","volume":"102-B","author":"Yassin M","year":"2020","unstructured":"Yassin M, Myatt R, Thomas W, Gupta V, Hoque T, Mahadevan D. Does size of tendon gap affect patient-reported outcome following Achilles tendon rupture treated with functional rehabilitation?. Bone Joint J. 2020, 102-B:1535-41. 10.1302\/0301-620X.102B11.BJJ-2020-0908.R1","journal-title":"Bone Joint J"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejro.2021.100342","article-title":"MRI of the Achilles tendon - a comprehensive pictorial review. Part one","volume":"8","author":"Szaro P","year":"2021","unstructured":"Szaro P, Nilsson-Helander K, Carmont M. MRI of the Achilles tendon - a comprehensive pictorial review. Part one. Eur J Radiol Open. 2021, 8:100342. 10.1016\/j.ejro.2021.100342","journal-title":"Eur J Radiol Open"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506294856","article-title":"The Achilles tendon total rupture score (ATRS): development and validation","volume":"35","author":"Nilsson-Helander K","year":"2007","unstructured":"Nilsson-Helander K, Thome\u00e9 R, Silbernagel KG, Thome\u00e9 P, Fax\u00e9n E, Eriksson BI, Karlsson J. The Achilles tendon total rupture score (ATRS): development and validation. Am J Sports Med. 2007, 35:421-6. 10.1177\/0363546506294856","journal-title":"Am J Sports Med"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(74)90884-8","article-title":"Measurement of pain","volume":"9","author":"Huskisson EC","year":"1974","unstructured":"Huskisson EC. Measurement of pain. Lancet. 1974, 9:1127-31. 10.1016\/s0140-6736(74)90884-8","journal-title":"Lancet"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-24-00432","article-title":"Use of patient-reported outcomes measurement information system measures in orthopaedic specialties: results of a scoping review for 2018 to 2022","volume":"33","author":"Cella MS","year":"2025","unstructured":"Cella MS, Baumhauer JF, Rothrock NE, Swantek K, Franklin PD. Use of patient-reported outcomes measurement information system measures in orthopaedic specialties: results of a scoping review for 2018 to 2022. J Am Acad Orthop Surg. 2025, 33:561-8. 10.5435\/JAAOS-D-24-00432","journal-title":"J Am Acad Orthop Surg"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717742372","article-title":"Achilles tendon resting angle relates to tendon length and function","volume":"39","author":"Zellers JA","year":"2018","unstructured":"Zellers JA, Carmont MR, Silbernagel KG. Achilles tendon resting angle relates to tendon length and function. Foot Ankle Int. 2018, 39:343-8. 10.1177\/1071100717742372","journal-title":"Foot Ankle Int"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/s1067-2516(01)80078-8","article-title":"Magnetic resonance and cadaveric findings of the \u201cwatershed band\u201d of the Achilles tendon","volume":"40","author":"Saxena A","year":"2001","unstructured":"Saxena A, Bareither D. Magnetic resonance and cadaveric findings of the \u201cwatershed band\u201d of the Achilles tendon. J Foot Ankle Surg. 2001, 40:132-6. 10.1016\/s1067-2516(01)80078-8","journal-title":"J Foot Ankle Surg"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1177\/03635465980260021801","article-title":"The clinical diagnosis of subcutaneous tear of the Achilles tendon","volume":"26","author":"Maffulli N","year":"1998","unstructured":"Maffulli N. The clinical diagnosis of subcutaneous tear of the Achilles tendon. Am J Sports Med. 1998, 26:266-70. 10.1177\/03635465980260021801","journal-title":"Am J Sports Med"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1177\/1941738119893996","article-title":"Eccentric and isometric exercises in Achilles tendinopathy evaluated by the VISA-A score and shear wave elastography","volume":"12","author":"Gatz M","year":"2020","unstructured":"Gatz M, Betsch M, Dirrichs T, Schrading S, Tingart M, Michalik R, Quack V. Eccentric and isometric exercises in Achilles tendinopathy evaluated by the VISA-A score and shear wave elastography. Sports Health. 2020, 12:373-81. 10.1177\/1941738119893996","journal-title":"Sports Health"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2018.7402","article-title":"Cross-cultural adaptation of the Victorian Institute of Sport assessment-Achilles (VISA-A) questionnaire for Spanish athletes with Achilles tendinopathy","volume":"48","author":"Hern\u00e1ndez-S\u00e1nchez S","year":"2018","unstructured":"Hern\u00e1ndez-S\u00e1nchez S, Poveda-Pag\u00e1n EJ, Alakhdar-Mohmara Y, Hidalgo MD, Fern\u00e1ndez-de-Las-Pe\u00f1as C, Arias-Bur\u00eda JL. Cross-cultural adaptation of the Victorian Institute of Sport assessment-Achilles (VISA-A) questionnaire for Spanish athletes with Achilles tendinopathy. J Orthop Sports Phys Ther. 2018, 48:111-20. 10.2519\/jospt.2018.7402","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-98256-0_21","article-title":"Evolution of sports ultrasound","author":"Smith J","year":"2022","unstructured":"Smith J, Schroeder AN, Lloyd AR, Onishi K. Evolution of sports ultrasound. Musculoskeletal Ultrasound-Guided Regenerative Medicine. El Miedany Y (ed): Springer, Cham, Switzerland; 2022. 437-68. 10.1007\/978-3-030-98256-0_21"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0b013e318272c89b","article-title":"Ultrasound in athletes: emerging techniques in point-of-care practice","volume":"11","author":"Yim ES","year":"2012","unstructured":"Yim ES, Corrado G. Ultrasound in athletes: emerging techniques in point-of-care practice. Curr Sports Med Rep. 2012, 11:298-303. 10.1249\/JSR.0b013e318272c89b","journal-title":"Curr Sports Med Rep"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-97-4202-8_21","article-title":"Emerging technologies in the diagnosis of foot and ankle pathologies","author":"Ghandour S","year":"2024","unstructured":"Ghandour S, Ashkani-Esfahani S. Emerging technologies in the diagnosis of foot and ankle pathologies. Clinical and Radiological Examination of the Foot and Ankle. Sharma S, Karaismailoglu B, Ashkani-Esfahani S (ed): Springer, Gateway East, Singapore; 2024. 361-74. 10.1007\/978-981-97-4202-8_21"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/12-128","article-title":"Use of portable ultrasound machine for outpatient orthopedic diagnosis: an implementation study","volume":"17","author":"Adelman S","year":"2013","unstructured":"Adelman S, Fishman P. Use of portable ultrasound machine for outpatient orthopedic diagnosis: an implementation study. Perm J. 2013, 17:18-22. 10.7812\/TPP\/12-128","journal-title":"Perm J"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/488505-relationship-between-ankle-plantar-flexion-angle-and-tendon-gap-in-achilles-tendon-rupture-a-prospective-study-using-portable-handheld-ultrasonography","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:51:07Z","timestamp":1780030267000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/488505-relationship-between-ankle-plantar-flexion-angle-and-tendon-gap-in-achilles-tendon-rupture-a-prospective-study-using-portable-handheld-ultrasonography"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":30,"URL":"https:\/\/doi.org\/10.7759\/cureus.109845","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5,28]]}}}