Achilles Tears

Fig. 3.39a,b. Chronic nonoperated Achilles tendon tear, a Long-axis extended field-of-view 17-5 MHz US image over the posterior ankle in a patient who suffered an acute Achilles tendon rupture 1 year previously as a result of a bicycling injury with b sagittal Tl-weighted MR imaging correlation demonstrates a gap of approximately 6 cm between the proximal (star) and distal (asterisk) blunt tendon ends. There is debris between the torn tendon ends and posterior herniation of the pre-Achilles fat (curved arrow) within the defect created by the tear. Note the fusiform, blunt contraction of the distal tendon segment. PM, posterior malleolus C, calcaneus... 

Grass W, Filippucci E, Farina A et al (2000) Sonographic imaging of tendons. Arthritis Rheum 43 969-976 Hartgerink P, Fessell DP, Jacobson JA et al (2001) Full- versus partial-thickness Achilles tendon tears sonographic accu-... 

Compared with Achilles tendon and rotator cuff tears, rupture of the quadriceps tendon is a rare condition which mostly occurs in association with systemic disorders such as gout, rheumatoid arthritis, systemic lupus erythematosus, hyperparathyroidism, diabetes mellitus and chronic renal fail-... 

The differential diagnosis list for a tear of the medial head of the gastrocnemius includes leg thrombophlebitis, recent rupture of a Baker cyst and, occasionally, Achilles tendon tear (Liu et Chen. 1989 JAMADAR et al. 2002). As described elsewhere, these conditions can be accurately distinguished with US from a tear of the medial head. Soleus tears can occasionally mimic a tennis leg lesion (Fig. 15.26). Similar to lateral head ruptures, these latter injuries are relatively rare, probably because the soleus is mainly composed of type 1 fibers which are devoted to slow contraction. On the other hand, there is no clear explanation as to why lateral head... 

Degenerative changes in the Achilles tendon substance, and especially hypoxic and myxoid types of tendon degeneration, may lead to the development of microscopic tears, progressing through multiple symptomatic episodes to interstitial tears (which are usually parallel to the long axis of the tendon), up to partial tears and eventually to complete tears. The rupture of the Achilles tendon has a prevalence of approximately 7x10 new cases per year (Schweitzer and Karasick 2000). It is more common in males, with the left side predominantly involved for unknown reasons. The... 

Fig. 16.76. Complete rupture of the Achilles tendon. Long-axis extended field-of-view 12-5 MHz US image demonstrates with difficulty the separation of the torn tendon ends because of an ill-defined hypoechoic hematoma (asterisks). Note the anterior orientation of the distal tendon end (arrow) this is a common finding in Achilles tendon tears. C, calcaneus...

In full-thickness tears of the Achilles tendon, the plantaris tendon frequently remains intact. In the context of a complete Achilles tendon tear, an intact... 

Fig. 16.79 a-c. Partial rupture of the Achilles tendon. Longitudinal 12-5 MHz US images demonstrate a spectrum of appearances of partial-thickness tears of the Achilles tendon in three different cases, all surgically proven, a The echotexture of the posterior half of the Achilles tendon is abnormally hypoechoic (asterisks) with loss of the fibrillar pattern, b A hypoechoic interstitial defect (asterisks) in the longitudinal direction is visible within the tendon substance. C, calcaneus c The anterior border of the Achilles tendon is wavy (arrows) and the echotexture appears diffusely hypoechoic. In this case, there wis discontinuity of the anterior fibers from the soleus muscle... 

Fig. 16.81 a,b. Recurrent rupture of the Achilles tendon after surgical repair in a patient with sudden onset of pain while walking upstairs, a Long-axis and b short-axis 12-5 MHz US images of the operated Achilles tendon (arrows) reveal an intratendinous fluid collection (asterisks) reflecting recurrence of a partial tendon tear. A suture (arrowheads) is visible in close relationship with the hematoma... 

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