Presentation
Sudden pain in the posterior aspect of the leg.
Patient Data
Full thickness tear of the achilles tendon with retraction and significant fluid-filled gap between the proximal fibers and distal tendon fibers. Background tendopathy seen evident by thickened tendon and loss of the normal anterior tendon concavity. Notice the presence of plantaris tendon.
Case Discussion
Achilles tendon tear classically occurs 3 to 5 cm proximal to the calcaneal insertion site because this is a relatively hypovascular watershed region. Acute tendon rupture is usually clinically evident, however, MRI is usually obtained to assess the gap for pre-op planning. Intact plantaris tendon can sometimes preserve the ability to plantar flex.