Imaging findings in the Achilles region (a) Calcification is a common finding in pathological tendons. It should not influence management and a bone spicule.

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Presentation transcript:

Imaging findings in the Achilles region (a) Calcification is a common finding in pathological tendons. It should not influence management and a bone spicule (circle) is very difficult to find in surgery. The take-home message is to manage according to symptoms and function; do not manage the radiograph (b) Greyscale ultrasound of a normal Achilles tendon (arrows). The superior calcaneum (arrowhead) prevents sound waves from penetrating, hence the acoustic ‘shadow’ deep to the calcaneal margins (c) Greyscale ultrasound of an Achilles tendon with mild morphological abnormality (arrows)—thickening of the tendon and less echodensity (because of increased matrix ground substance and associated fluid) (d) Colour Doppler ultrasound showing abnormal vessels in symptomatic tendinopathy. Appearances do not mirror symptoms enough to provide definitive clinical support (e) MRI appearance of increased signal in the distal Achilles tendon extending into the insertion (blue oval) (f) Ultrasound tissue characterisation (UTC). This ultrasound modality has been most used in Achilles tendinopathy as the subcutaneous tendon anatomy is well suited to the linear probe. Whether the instrument will have widespread clinical utility remains to be seen Source: Pain in the Achilles region, Brukner & Khan’s Clinical Sports Medicine: Injuries, Volume 1, 5e Citation: Brukner P, Clarsen B, Cook J, Cools A, Crossley K, Hutchinson M, McCrory P, Bahr R, Khan K. Brukner & Khan’s Clinical Sports Medicine: Injuries, Volume 1, 5e; 2017 Available at: https://csm.mhmedical.com/DownloadImage.aspx?image=/data/books/1970/bru61384_4004_new.png&sec=168695962&BookID=1970&ChapterSecID=168695915&imagename= Accessed: October 22, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved