Presentation
Tenderness, pain, and swelling in the Achilles area that are usually worse during activity in decathlete.
Patient Data
Fusiform thickening of the midportion of the Achilles tendon with increased signal, while the insertion is regular. There’s also paratenonitis with high signal and thickening of paratenon, accompanying Achilles tendinosis.
Case Discussion
The most common cause is training overload causing microtrauma. The tendon swelling associated with inflammation, reduces its gliding within the nerve rich paratenon, stimulating pain. A focal fluid signal indicates microtears, which may progress to partial and complete rupture. Paratenonitis is an inflammatory reaction of the paratenon, as tenosynovitis and tenovaginitis in tendons with a synovial sheath.
Radiographer: TSRM Fabio Imola