Tendon pathology

A number of processes can affect tendons.

Tendinopathy (tendonopathy)

Literally means a disease or disorder of a tendon and typically used to describe any problem involving a tendon. While many define tendinopathy as an umbrella term to describe all tendon pathology, others may use it to describe a chronic tendon condition that fails to resolve. 

Tears and myxoid degeneration

Tears are common and are categorised as:

  • complete or incomplete (partial)
  • full thickness or partial thickenss
  • horizontal or longitudinal (split)
  • hypertrophic or atrophic (more serious)

The MRI characteristics are of change in shape of the tendon (thickened, thinned) as well as increase in signal on both T1WI and T2WI. Unfortunately these features are indistinguishable from myxoid degeneration.

Prediposing factors to tendon rupture

Tendinitis

Used to describe situations where there is inflammation of the tendon.

Tendinosis

Usually implies a non-inflammatory degeneration of a tendon. This degeneration can include changes to the structure or composition of the tendon. 

Tenosynovitis

Should only be called if fluid is seen surrounding the entire tendon. A mesotendon may be seen as a thin low intensity band. If the tendon communicates with a joint, such as the long head of biceps at the shoulder, and flexor hallucis longus at the ankle, then no fluid should be present in the joint to make the call.

If the fluid is loculated the term stenosing tenosynovitis can be applied. This is most commonly seen in

 

Dislocation or subluxation of tendons

  • wrist
    • extensor carpi ulnaris (medial)
  • shoulder
    • long head of biceps (medial +/- into joint if subscapularis torn)
  • ankle
    • peroneal tendons (lateral or medial)
    • tibialis posterior (medial and anterior)
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Article information

rID: 2156
Synonyms or Alternate Spellings:
  • Tendinopathy

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Cases and figures

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    Sagittal T2 FS
    Case 1: patella tendon lateral femoral condyle friction syndrome
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    Case 2: Achilles paratenonitis
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    Case 3: quadriceps tendon rupture
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    Case 4: Achilles tendon rupture
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    Case 5: extensor carpi ulnaris tenosynovitis
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    Case 6: foreign body induced tenosynovitis of finger
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