Achilles tendon tear

Case contributed by Dr Maulik S Patel

Presentation

A few days prior to the presentation, the patient had right ankle trauma resulting in posterior ankle region pain and swelling. Referred for ultrasound to check the Achilles tendon integrity.

Patient Data

Age: 55 years
Gender: Male
Ultrasound

The symptomatic right Achilles tendon shows loss of continuity at its insertion site. There is full thickness and full width defect in the tendon. The defect measures about 14 mm and is filled with hemorrhagic fluid. The retracted tendon shows thickening and presence of an avulsed enthesophyte.

The asymptomatic left Achilles tendon shows continuity. There is normal tendon echo pattern with presence of an enthesophyte. There is no tendon thickening.

Ultrasound

6 weeks postoperative ultrasound

Achilles tendon shows continuity and reaches up to the calcaneum. The distal end of the tendon is thicker and heterogeneous which is a normal finding in the case of a postoperative tendon. There are sutures in and around the tendon substance. Reverberation artifact helps to identify present the anchors in the calcaneum.

Case Discussion

The case shows the post-traumatic rupture of the Achilles tendon in an adult patient. The contralateral asymptomatic Achilles tendon shows an absence of tendinosis.

Surgery revealed a complete tear of the Achilles tendon. The double-raw repair technique was used to repair the tendon.

Postoperative ultrasound shows repaired tendon without re-tear/ dislodged anchors/ local collection.

Ultrasound of the Achilles tendon after complete rupture repair shows hypoechoic thickening and heterogeneous echopattern1.

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Case information

rID: 76024
Published: 13th Apr 2020
Last edited: 2nd May 2020
Inclusion in quiz mode: Included