NEW! We're excited to announce two new radiology learning pathways by Andrew Dixon and Frank Gaillard LEARN MORE

Achilles tendinosis and tear

Case contributed by Dr Maulik S Patel

Presentation

Initially bilateral pain in the Achilles tendon region. Then 10 weeks later, an acute exacerbation in the right Achilles tendon region.

Patient Data

Age: 55 years
Gender: Male
X-ray

1st study. Pain in both Achilles regions.

There is a thickening of soft tissue shadow of distal Achilles tendon on both sides along with the presence of enthesophyte. Kager fat pad is normal bilaterally.

Ultrasound

1st study. Pain in both Achilles regions.

There is a thickening of bilateral distal Achilles tendons with the presence of enthesophytes. There is no tendon tear on either side.

X-ray

2nd study 10 weeks later - sudden increase in right Achilles region pain

X-ray with plantarflexed foot shows loss of normal outline of the distal Achilles tendon. There is an avulsed enthesophyte. Kager fat pad shows areas of loss of normal fat density.

X-ray with dorsiflexed foot shows thinning of the distal Achilles tendon. The avulsed enthesophyte shows increased distance from the calcaneum.

Ultrasound

2nd study 10 weeks later - sudden increase in right Achilles region pain

There is a complete tear of the right Achilles tendon. A gap between the two edges of the torn tendon is 30 mm. A bone flake in the proximally retracted tendon is a part of the avulsed enthesophyte.

X-ray

Postoperative 1 week x-ray

A plaster cast is present. There is an anchor in the calcaneum.

X-ray

Postoperative 2 months x-ray

The repaired Achilles tendon soft tissue shadow shows thickening. Kager fat pad shows irregularity. The anchor is in position in the calcaneum.

Case Discussion

The case shows bilateral Achilles tendinosis and progression to a tear in case of the right tendon.  Right Achilles tendon tear which was repaired, fixed with anchor placement.

PlayAdd to Share

Case information

rID: 13999
Published: 3rd May 2020
Last edited: 25th Jun 2020
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.