title: Achilles tendon pain and related pathologies: diagnosis by ultrasonography.
abstract: BACKGROUND
  When encountering complaints of pain in the area of the Achilles tendon, the clinician seldom reaches a correct and precise diagnosis based solely on the grounds of physical examination and standard X-rays.
  
  
  OBJECTIVE
  To assess the usefulness of ultrasound in diagnosing pathologies of the Achilles tendon.
  
  
  METHODS
  We conducted a retrospective review of patients presenting at our orthopedic clinics.
  
  
  RESULTS
  Sonography was used to evaluate 41 patients with achillodynia. This modality enabled the diagnoses of 19 abnormal tendons (46%), peritendinous and other lesions; a complete rupture in two patients (5%); a partial rupture of the Achilles tendon in 3 (7%); various degrees of calcification of the tendon in 7 (17%); and peritendinous lesions discerned by the tendon's hypoechoic regions with disorganized arrangement of collagen fibrils in 4 patients (10%). Other lesions included tendonitis (3 patients, 7%), retrocalcaneal bursitis (3 patients, 7%), lipoma (1 patient, 2%), and foreign bodies (2 patients, 5%). The mean diameter of the pathological tendons was 10.4 +/- 2.7 mm, while normal tendons measured 5.2 +/- 0.8 mm (P < 0.001).
  
  
  CONCLUSIONS
  As in many other soft tissue lesions, ultrasonography is a useful tool in the evaluation of the underlying pathology in patients presenting with achillodynia.
authors.affiliation: Departments of Orthopedic Surgery and Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Blankstein
authors.forename: I
authors.initials: I
authors.lastname: Cohen
authors.forename: L
authors.initials: L
authors.lastname: Diamant
authors.forename: M
authors.initials: M
authors.lastname: Heim
authors.forename: I
authors.initials: I
authors.lastname: Dudkiewicz
authors.forename: A
authors.initials: A
authors.lastname: Israeli
authors.forename: A
authors.initials: A
authors.lastname: Ganel
authors.forename: A
authors.initials: A
authors.lastname: Chechick
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002062:Bursitis / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D012189:Retrospective Studies; D012421:Rupture; D017678:Sex Distribution; D052256:Tendinopathy / Q000000981:diagnostic imaging* / Q000209:etiology; D014463:Ultrasonography