Lesions of the Achilles tendon: Evaluation with ultrasonography and magnetic resonance imaging

Purpose: This work aims at evaluating the role of ultrasonography and magnetic resonance imaging in the diagnosis of the lesions affecting Achilles tendon of the ankle joint. Patients and methods: The study is a prospective study of 28 patients. Some of them are complaining of a posterior heel pain, stiffness & a limitation of movements, soft tissue thickness and swollen and ecchymotic ankle. Plain X-ray (anteroposterior and lateral views), ultrasound examination were performed for both ankles of all patients with the patients in a prone position, the Achilles tendon was examined from its musculotendinous junction to its calcaneal insertion in both longitudinal and transverse views. Finally, MRI was performed with the patients in supine position, the foot is dorsiflexed, axial and sagittal T1, T2-weighted images, STIR & proton density were done for all patients. Results: Out of 28 patients that were examined, the final diagnosis included; eight cases of tendinopathy (five cases peritendinosis, and three cases tendinosis), 16 cases of partial thickness tear (as compared to arthroscope), and four cases of full thickness tear. Conclusion: Ultrasound is an important complementary diagnostic tool in the diagnosis of lesions of Achilles tendon, it is as good as MRI in the diagnosis of tendinopathy and full thickness tear, however MRI is more superior in the diagnosis of partial thickness tear, and in the differentiation of the different types of tendinopathy. (C) 2013 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Radiology and Nuclear Medicine.