DIFFERENTIAL-DIAGNOSIS OF DISEASES OF THE ACHILLES-TENDON - A CLINICAL ULTRASOUND CONCEPT

Ultrasound of the Achilles tendon is a suitable means of differentiati ng various diseases of the tendon and the surrounding tissue. Differen t forms of degenerative disease (tendinitis, peritendinitis bursitis, fibroosteitis, and Haglund's disease) can be discriminated from rheuma tic and metabolic diseases. Congenital and developmental abnormalities can also be detected. Tendon degeneration mainly occurs in the ventra l part of the medial third of the tendon (''critical zone''). Immature tissue in this area leads to temorary instability of the tendon with a high risk of rupture (''vulnerable phase''). With sonography, lesion s of the Achilles tendon are visible early in the course of the diseas e.