Abstract
An 8-year-old intact male German shorthaired pointer was presented for a left pelvic limb lameness. Examination revealed a plantigrade stance with flexed digits in the left pelvic limb, and swelling of the left common calcanean tendon distally. Magnetic resonance imaging revealed a partial rupture of the left common calcanean tendon, involving rupture to the tendons of the biceps femoris, gracilis, and semitendinosus muscles. Surgical repair was performed using a modified 3-loop pulley suture. Postoperatively, the tarsus was immobilized with external coaptation. Destabilization of the external coaptation occurred over 9 weeks followed by physical rehabilitation and complete return to function at 10 months post-operative. This case report illustrates the utility of MRI as a diagnostic tool for evaluation of tendon pathology. MRI provided exceptional detail of the tendons that comprise the common calcaneal tendon and the anatomical relationships to surrounding structures which facilitated appropriate surgical correction.
Highlights
The common calcanean tendon is composed of the tendons of the superficial digital flexor, gastrocnemius, and the common tendons of the biceps femoris, semitendinosus, and gracilis [1, 2]
calcanean tendon (CCT) ruptures are typically diagnosed based on observation of the gait, posture, and palpation, along with imaging studies including radiographs, ultrasound, and magnetic resonance imaging (MRI) [4]
Imaging studies used in the diagnosis of CCT rupture include radiographs, ultrasound, and MRI
Summary
The common calcanean tendon is composed of the tendons of the superficial digital flexor, gastrocnemius, and the common tendons of the biceps femoris, semitendinosus, and gracilis [1, 2]. From the abrupt end distally, heterogenous T2-hyperintense tissue was present that expanded to ∼0.8 cm diameter and resulted in displacement of the fibularis longus muscle cranially and the tendons of the gastrocnemius and superficial digital flexor tendons caudally This tissue had a heterogeneously, intermediate signal intensity on T1W images, and strongly enhanced (Figure 1). There was an increased amount of tissue surrounding and dissecting between the gastrocnemius and superficial digital flexor tendons such that they could be defined as separate structures as compared to the normal right side. This tissue had heterogeneously intermediate signal intensity on T1W, T2W, and STIR sequences, and displayed heterogenous contrast enhancement. Ten months post-operatively, the dog had recovered well-enough to resume his previous hunting activity
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