2210: Sonographic assessment of Achilles tendon diseases and injuries

Abstract

Objectives: To assess the pathomechanics of Achilles tendon injury using high-resolution ultrasound and to correlate sonographic findings and nosologic entities of the Achilles tendon with respect to a new understanding of etiology and pathogenesis. Methods: In a retrospective crossectional study the sonographic findings of 52 patients with achillodynia, swelling of the heel, or a suspected rupture were analyzed and correlated with the final diagnoses. Tendon lesions due to lipid storage diseases or rheumatic diseases were analyzed on the base of reports in the literature. The symptomatic patients had an age range of 20 to 72 years (mean 45.3 years) and a 21 male predominance. Images were obtained using a Siemens Sonoline with a 7.5 MHz frequency linear transducer. Results: Only 15% of patients exhibited distal third Achilles tendonitis of whom 97% had associated retrocalcaneal bursitis (cf. bursitis in only 2% of patients with proximal tendon disease); 31.5% of patients exhibited focal medial degenerative changes consistent with hyperpronation injury and a further 13.6% superficial mid-tendon disease suggesting posterior heel-tab impingement or tight heel cord. Conclusions: Achilles tendon microtears accumulation is present at site of tendon degeneration and rupture.