Intra-Tendinous Ossification with Concomitant Tendonitis and Bursitis - Ultrasound Grey-Scale and Colour Doppler Findings

Abstract

A case report of a 62-year-old man with a 20-year history of tendon problems, who presented with a swollen and tender left Achilles tendon. Ultrasound (US) revealed a 2 x 1 x 0.9 cm intra-tendinous substance with acoustic shadowing. On a radiogram, ossification was found. Colour Doppler activity was present in both the bursa and the tendon. A US-guided injection of 40 mg Depomedrol was applied into the retrocalcaneal bursa. On follow-up two months later, the patient had no symptoms and US showed total regression of Doppler activity. The ossification was unchanged. US colour Doppler may be recommended for guidance and monitoring of treatment.

Disorders of the midfoot and rearfoot

“…Ultrasound is not necessary to confi rm a diagnosis but may reveal signs of Achilles tendinopathy, bursitis and ossifi cation of the insertion of the Achilles tendon. 126,127 Similarly, MRI is rarely used but may assist in differentiating between normal and abnormal retrocalcaneal bursae. A recent case-control study indicated that retrocalcaneal bursae larger than 1 mm anteroposteriorly, 11 mm transversely, or 7 mm dorsoplantarly can be considered abnormal.…”