Role of ultrasonography in the evaluation of Achilles tendon disorders

Abstract

Background This study was conducted to highlight the role of ultrasonography as an initial imaging modality for evaluation of symptomatic Achilles tendon disorders. Patient and Methods 60 patients (33 men and 27 women) had symptomatic Achilles tendons disorders and confirmed clinically as all patients were referred from orthopedic surgery department. 20 patients had history of blunt trauma followed by pain which may be associated with lost plantar flexion. 40 patients had chronic pain either associated or not associated with swelling at the site of Achilles tendon. US examination (13 MHz probe, GE logic P5 machine) using real time with color and power Doppler examination was performed while the patient in prone position. Results US depicted full-thickness tears in 11 (18.5%) tendons where tendon gaps were not significant (less than 5 mm) in 6 tendons and significant (more than 5 mm) in 5 tendons. De novo partial tears were detected in 15 (25%) tendons. Tendinopathy were seen in 18 (30%) tendons. US depicted paratenonopathy in 3 tendons (5%). 13 (21.7%) tendons appeared normal by ultrasonography. Conclusion Ultrasonography is an initial imaging of choice for evaluation of symptomatic Achilles tendon disorders. Diagnostic accuracy reaches 85%. However, Tendons that appeared normal by US should be followed by MRI for more diagnostic accuracy, detailed regional evaluation and subsequently can exclude other etiologies giving similar clinical manifestations.