Citation, DOI, disclosures and article data
Citation:
Feger J, Walizai T, Lee K, Paratenon. Reference article, Radiopaedia.org (Accessed on 23 Mar 2025) https://doi.org/10.53347/rID-89241
The paratenon is a membrane-like areolar structure consisting of loose connective tissue found around extraarticular tendons without a synovial sheath including Achilles tendon, quadriceps tendon, patella tendon, the distal biceps tendon, or the distal 1-2cm of the posterior tibial tendon. It allows the tendon to move more freely acting as a gliding mechanism towards the adjacent tissues and supplies the tendon with blood from neighbouring vessels at several levels 1-3.
Radiographic features
Ultrasound
The paratenon can be sometimes seen as a delicate hyperechoic lining that encircles the tendon 4.
MRI
The paratenon might be visualised as a delicate hyperintense lining on fat-saturated sequences with a high in-plane resolution e.g. mDixon sequences.
Related pathology
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1. Gott M, Ast M, Lane L et al. Tendon Phenotype Should Dictate Tissue Engineering Modality in Tendon Repair: A Review. Discov Med. 2011;12(62):75-84. - Pubmed
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2. Steinmann S, Pfeifer C, Brochhausen C, Docheva D. Spectrum of Tendon Pathologies: Triggers, Trails and End-State. IJMS. 2020;21(3):844. doi:10.3390/ijms21030844 - Pubmed
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3. Tadros A, Huang B, Pathria M. Muscle-Tendon-Enthesis Unit. Semin Musculoskelet Radiol. 2018;22(3):263-74. doi:10.1055/s-0038-1641570 - Pubmed
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4. Tamborrini G, UZR, Ultrasound Center and Institute for Rheumatology, EULAR Network of Imaging Center, Basel, Switzerland, Müller-Gerbl M et al. Ultrasound of the Elbow with Emphasis on the Sonoanatomy of the Distal Biceps Tendon and Its Importance for the Surgical Treatment of Tendon Lesions. J Ultrason. 2020;20(81):e129-34. doi:10.15557/jou.2020.0021 - Pubmed
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5. Hodgson R, O'Connor P, Grainger A. Tendon and Ligament Imaging. BJR. 2012;85(1016):1157-72. doi:10.1259/bjr/34786470 - Pubmed
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6. Syha R, Springer F, Ketelsen D et al. Achillodynia - Radiological Imaging of Acute and Chronic Overuse Injuries of the Achilles Tendon. Fortschr Röntgenstr. 2013;185(11):1041-55. doi:10.1055/s-0033-1335170 - Pubmed
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7. Lee S, Oliveira I, Li Y, Welck M, Saifuddin A. Fluid Around the Distal Tibialis Posterior Tendon on Ankle MRI: Prevalence and Clinical Relevance. BJR. 2019;92(1104):20190722. doi:10.1259/bjr.20190722 - Pubmed
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