Achilles tendon pain and related pathologies: diagnosis by ultrasonography.
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.
Blankstein
A
A
Departments of Orthopedic Surgery and Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel.
Cohen
I
I
Diamant
L
L
Heim
M
M
Dudkiewicz
I
I
Israeli
A
A
Ganel
A
A
Chechick
A
A
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