Achilles tendon pain and related pathologies: Diagnosis by ultrasonography

Background: When encountering complaints of pain in the area of the Achille s tendon, the clinician seldom reaches a correct and precise diagnosis base d solely on the grounds of physical examination and standard X-rays. Objectives: To assess the usefulness of ultrasound in diagnosing pathologie s of the Achilles tendon. Methods: We conducted a retrospective review of patents presenting at our o rthopedic clinics. Results: Sonography was used to evaluate 41 patients with achillodynia. Thi s modality enabled the diagnoses of 19 abnormal tendons (46%), peritendinou s and other lesions; a complete rupture in two patients (5%); a partial rup ture of the Achilles tendon in 3 (7%); various degrees of calcification of the tendon in 7 (17%); and peritendinous lesions discerned by the tendon's hypoechoic regions with disorganized arrangement of collagen fibrils in 4 p atients (10%). Other lesions Included tendonitis (3 patients, 7%), retrocal caneal bursitis (3 patients, 7%), lipoma (1 patient, 2%), and foreign bodie s (2 patients, 5%). The mean diameter of the pathological tendons was 10.4 +/- 2.7 min, while normal tendons measured 5.2 +/- 0.8 mm (P <0.001). Conclusion: As in many other soft tissue lesions, ultrasonography is a usef ul tool in the evaluation of the underlying pathology in patients presentin g With achillodynia.