ULTRASONOGRAPHY OF THE ACHILLES-TENDON IN HYPERCHOLESTEROLEMIA

The ultrasonographic (US) appearance of Achilles tendon was examined i n 34 patients with hypercholesterolemia (10 with familial (FH), and 24 with secondary hypercholesterolemia (SH)), and in 22 patients with no rmal tendons. US findings were compared with clinical, laboratory, and radiologic results. In patients with FH, typical xanthomas in the for m of hyperechoic tendinal tumors were found in only 15% while various forms of inhomogeneity of tendon structure without xanthoma formation were found in 75%. The high rate of tendon inhomogeneity may be due to the concomitant occurrence of both xanthomas and degeneration of tend on fibers. Physical examination revealed abnormalities in 60% of these patients. At CT of the tendons, abnormalities were found in 65% of th e FH patients and in 40%, abnormalities were shown by plain radiograph y. In SH, the results did not differ significantly from normal control s. In our opinion US should be used to prove or rule out Achilles tend on abnormalities in patients with FH for prophylaxis and treatment of tendinitis and tendon rupture.