Normal MR. of the Achilles tendon demonstrates this to be a well defined hypotenuse (dark) structure (arrow) inserting onto the cleanses, thereafter becoming continuous with the plantar fascia (arrow). Figure 2: Ultrasound of a normal Achilles tendon depicts the multiple small fibrils hat make up the tendon as alternating bright and dark lines (arrow). Note the cleaned insertion.
Achilles Tendonitis Risk factors: Chronic overuse of calf muscle (runners, dancers, gymnasts, tennis players injury) Ornithological conditions (e. G. Psychopathology, rheumatoid arthritis) Clinical Presentation Sharp heel pain and stiffness at the mid-Achilles tendon to insertion (scaremongering) Clinical examination Inflammation – pain, local tenderness, swelling (from cleaned insertion [insertion tendonitis] to 3-CM above cleaned insertion [true Achilles tendonitis]) Dry creepiest
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Achilles peritonitis’s (involves inflammation of tendon sheath) Radiology Ankle Cray may show spurring at the Achilles tendon insertion US: tendon thickening MR.: Figure 4: MR. Of severe Achilles tendonitis is characterizes by marked thickening, increased signal intensity (brightness) and areas of intransigence tearing of the tendon, placing the tendon at risk of full thickness rupture. Management Unsaid for Ion RICE, limit}avoid running, walk on flat surfaces, cross-training e. G. Swimming or riding Rehab: gentle stretching and strengthening Podiatry referral: orthodontics Achilles Tendon Rupture
Incidence : 18 per 100,000/year Male, 30-40 years, episodic athletes, feloniousness antibiotics, steroid injections (e. G. For Achilles tendonitis) Clinical presentation: Often misdiagnosed as an ankle sprain (up to 25%) Traumatic injury: during a sporting event (sudden forced dereliction) “Pop”, weakness, difficulty walking, pain in heel Clinical examination: Inspection: increased resting ankle dereliction, calf atrophy may be apparent if chronic Palpation: palpable gap Motion: weakness to ankle plantar flexing Provocative test: Thompson test: lack of plantar flexing when calf is squeezed sensitivity 0. 6 and specificity 0. 93) Radiology: CRUX: exclude Other pathology LIES: complete vs.. Partial ruptures MR.: (if equivocal physical exam findings) Figure S: MR. Of a patient suffering from severe pain following a jumping injury demonstrates a full thickness tear of the Achilles tendon.