Sonographic appearance of nonoperatively treated Achilles tendon ruptures

Objective. This report describes the gray-scale and color Doppler sonograph ic appearance of healed Achilles tendon ruptures that have been treated non operatively. Design and patients. Eleven patients with acute Achilles tendon ruptures we re studied with sonography in the acute setting and following nonoperative management of their torn tendon. Results. On sonographic examination, healed tendons treated nonoperatively are characterized by mild residual distortion of the normal fibrillar archi tecture of the tendon, anterior bulging or irregularity of the healed tendo n, and a hypoechoic area about the site of rupture. Less frequent observati ons include mildly increased color flow and calcification at the rupture si te. The previous ly described findings of acute tears, including hematomas, gaps at the rupture site, hyperemic torn tendon ends, and markedly distort ed fibrillar architecture, were seen to have resolved in this series. Conclusion. The Achilles tendon tear treated nonoperatively has a different sonographic appearance from that of a normal or acutely ruptured tendon.