Can Achilles tendon be affected in patients with intermittent claudication?

Abstract

Objective: To investigate ultrasonographically the frequency of Achilles tendon (AT) involvement in patients with intermittent claudication due to lower extremity arterial ischemia. Materials and Methods: 70 lower extremity in 40 patients with unilateral (n=10) and bilateral (n=30) symptoms of intermittent claudication were studied. 60 age and sex matched asymptomatic lower extremities in 34 subjects served as a control group. Arterial Doppler ultrasonography was done to establish the diagnosis of occlusive arterial disease and the degree of obstruction was recorded. Tendinopathic changes of AT were assessed by ultrasonography (US). Results: Tendon thickness was increased in patient group (7.35+2.91mm) compared to control group (5.39 +1.21 mm). Tendinopathic changes like increased thickness, decreased echogenicity and loss of edge sharpness with intraperitenon fluid collection were seen in 54/70 heels in patient group. Among, tendinopathic changes increased thickness and hypoechogenicity has shown a significant correlation with stenotic changes of popliteal (P=0.027), tibialis posterior (P=0.27) and dorsalis pedis arteries (P=0,006), whereas no correlation was found with those of common and superficial femoral arteries. Conclusion: Tendiopathic changes can be seen in AT in occlusive distal arterial diseases of lower extremity. Ultrasonography may offer a good diagnostic modality in displaying these changes in patients with lower limb ischaemia