Achilles Tendon Rupture

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Achilles Tendon Rupture

Authors, Editors, Case Information Author: Kelsey Bacidore, MD Affiliation: Loyola University Senior Editor: William Berrigan, MD Senior Editor: Michele Lane, ** Clinical Vignette: 38-year-old female unable to bear weight on her left leg after landing on her foot while playing volleyball. She felt a pop with resulting pain in her calf. There was a palpable deformity proximal to the Achilles insertion and minimal plantar flexion on the Thompson test. Type of Probe Used: 13-6 MHz Linear Transducer Achilles Tendon Rupture The linear probe is in the longitudinal position. The distal Achilles is on the right, proximal on the left, and the hematoma caused by the rupture is visualized in the center of the image. #2 - Video View Video The linear probe is in the longitudinal position, scanning distally over the Achilles and then fanning through the tendon. There is an anechoic defect where the distal (right) portion of the tendon ruptured from the proximal (left) portion. Achilles Tendon Rupture Labeled #4 - Video View Video The linear probe is in the longitudinal position, scanning from the proximal tendon, over the hematoma caused by the rupture, to the distal portion. #5 - Video View Video The linear probe is in the longitudinal position; the foot is being plantarflexed and dorsiflexed. Movement of the distal tendon can be seen while the proximal tendon is immobile. Interpretation Image Interpretation: Achilles tendon rupture. The distal part of the tendon is well visualized until the point of discontinuity, at which point a hematoma can be seen. Movement of the distal tendon without concurrent movement of the proximal tendon during plantar and dorsiflexion further confirms the diagnosis. Teaching Pearl:** Scan with the patient prone and the foot hanging off of the bed. Start in the longitudinal orientation at the calcaneus. Scan proximally to the myotendinous junction and then scan distally in the transverse plane. If there is an area of interest, pause and range the foot while looking for discordance.
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Authors, Editors, Case Information

Achilles Tendon Rupture

#2 - Video

Achilles Tendon Rupture Labeled

#4 - Video

#5 - Video

Interpretation

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