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Achilles tendon ossification

Dr Henry Knipe and Dr Frank Gaillard et al.

Achilles tendon ossification (ATO) is an uncommon condition and has characteristic bone formation within the Achilles tendon itself. 


ATO is more common in males 4


The aetiology is unknown but Achilles tendon ossification is seen both with previous macrotrauma of the tendon (e.g Achilles tendon rupture, previous surgery) as well as repetitive microtrauma 1. There may be a familial or genetic genetic component 3

It is somewhat more common than dystrophic calcification of the Achilles tendon, and may represent a separate entity rather than progression. 

Radiographic features

It is characterised by mature bone (i.e. cortex, trabeculae, marrow).

Treatment and prognosis


An ossified Achilles tendon may fracture. 

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