Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation

Chronic Achilles tendinosis is a condition with unknown aetiology and patho genesis, most often, but not always, associated with painful nodular thicke ning of the tendon. In this investigation, 28 tendons (21 patients) with a painful nodule located at the 2-6 cm level in the tendon, and 20 normal (pa in-free) tendons, were examined with grey-scale ultrasonography combined wi th colour Doppler examination. In all tendons with a painful nodule, but no t in any of the normal pain-free tendons, neovascularisation was seen in th e area with tendon changes (localised widening of the tendon with focal hyp o-echoic areas). In tendons with advanced changes, vessels were seen throug h the entire widened part of the tendons, and both arterial and venous bloo d flows were registered. The neovascularisation found in this investigation might have implications on the pathogenesis of chronic Achilles tendinosis .