The value of ultrasonography of the Achilles tendon in traumatology

Abstract

Using high-frequency probes with 10 or more MHz, it is possible to examine even the insertion area of the tendon or the pathology of a subachilleal bursa by tilting the probe. The dynamic examination and the comparison with the contralateral side in two planes should be included in a standardized examination procedure and are of great importance in some cases of fresh tendon ruptures. Knowledge of the physical principles and the possibility of misleading artefacts is crucial.

Frequency and Effects of Intratendinous and Peritendinous Calcifications after Open Achilles Tendon Repair

“…Dederick et al 4 reported a loss of muscle mass in over 40% of their patients, and we also found a loss of 0.2 to 3.5 cm (average 1.6 cm) in calf circumference in the injured leg. We found persistent soft-tissue swelling at both the smallest calf circumference and at the ankle, as described by Rominger et al 23 Using US examination, Grechenig et al 9 found irregularities of the tendon fiber architecture, and other authors 15,18,20 noted the development of a ''spool-shaped'' swelling in the Achilles tendon on US. Both of these findings were confirmed in this study.…”

“…1,5,7,19 Because postoperative Achilles tendon calcification has not been systematically investigated, its effect on the clinical outcome of Achilles tendon repair has not been established. 5,9 The purposes of this retrospective study were to determine the frequency of tendon calcification after operative repair of Achilles tendon rupture, evaluate the effect of calcification on clinical outcome, and identify possible causes of the calcification.…”

Anatomic variations of the musculotendinous junction of the soleus muscle and its clinical implications

“…Chow et al (2000) presented sonographic studies that surveyed gender differences in muscle architecture in relaxed human soleus and gastrocnemius muscles. Neither in anatomical (Hollinshead, 1964;Sarrafian, 1993;Williams et al, 1995) nor in radiological literature (Reimers and Gaulrapp, 1998;Berquist, 2000;Grechenig et al, 2002) could any descriptions be found of the anatomical variations of the soleus musculotendinous junction. Fig.…”

“…The musculotendinous junction and the insertion of the calcaneal tendon on the calcaneus are considered ''problem'' zones that cannot be fully visualized with ultrasonography. Tendon disorders or calcifications make the correct diagnosis more difficult (Grechenig et al, 1997). When evaluating possible calcaneal tendon ruptures by ultrasound, it is important to take notice of the distal insertion of the soleus muscle and its relationship to any tendon defect.…”

Kein Einfluss der Physiotherapie auf das klinische Ergebnis nach operativ behandelter Achillessehnenruptur?

“…Die Sonografie (Siemens Sono line 13,5 MHz linearer Schallkopf) erfolgte in Bauchlage, wobei die Achillessehne vom Kalkaneus bis zum muskulären Übergang des M. trizeps surae in zwei Ebenen auf Ossifikationen und Strukturunregelmäßigkeiten sowie Defekte untersucht wurde. Da kleinere Verkalkungen im Ultraschall sicher zu erkennen sind und die Sonografie mit dieser Fragestellung der Röntgenaufnahme überlegen ist, haben wir primär auf letztere im Rahmen der Nachuntersuchung verzichtet [5,6,8,15,17]. Die Gegenseite wurde zum Vergleich herangezogen, um Ossifikationen der nicht verletzten Sehne zu identifizieren [8,17,21].…”