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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.
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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