The Roentgenographic Findings of Achilles Tendon Rupture

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Purpose : To evaluate the diagnostic value of a lateral view of the ankles in Achilles tendon rupture.Materials and Methods : We performed a retrospective analysis of the roentgenographic findings of 15 patients withsurgically proven Achilles tendon rupture. Four groups of 15 patients(normal, ankle sprain, medial lateralmalleolar fracture, and calcaneal fracture) were analysed as reference groups. Plain radiographs were reviewedwith regard to Kager ’s triangle, Arner ’s sign, Toygar ’s angle, ill defined radiolucent shadow through theAchilles tendon, sharpness of the anterior margin of Achilles tendon, and meniscoid smooth margin of the posteriorskin surface of the ankle. Results : Kager ’s triangle was deformed and disappeared after rupture of theAchilles tendon in nine patients(60%) with operative verification of the rupture, six patients(40%) had a positiveArner ’s sign, while none had a diminished Toygars angle. In 13 patients(87%) with a ruptured Achilles tendon,the thickness of this was nonuniform compared with the reference group. The anterior margin of the Achilles tendonbecame serrated and indistinct in 14 patients(93%) in whom this was ruptured. An abnormal ill defined radiolucentshadow through the Achilles tendon was noted in nine patient(60%), and nonparallelism between the anterior marginof the Achilles tendon and posterior skin surface of the ankle was detected in 11 patients(73%). The posteriorskin surface of the ankle had a nodular surface margin in 13 patients(87%). Conclusion : A deformed Kager ’striangle and Achilles tendon, and an abnormal ill defined radiolucent shadow through the Achilles tendon in alateral view of the ankles are important findings for the diagnesis of in diagnosing achilles tendon rupture.