Test Yourself

Case 1

HISTORY

 An elderly lady felt a 'snap' at the back of her leg while exercising.

ULTRASOUND FINDINGS

There is a discontinuity seen in the achilles tendon with a hypoechoic gap present between the tendon ends. The tendon lacks the usual taut appearance, instead appearing think and 'wavy'. Echogenic fibrin can be seen in the second image. The lack of continuity of the two ends is seen in the loop.

DISCUSSION

If there is prominent fibrin deposits or significant tendinopathy (a risk factor for rupture) then the clear ends and hypoechoic gap may not be seen, instead edge shadowing from the ruptured ends may be more prominent. The lack of continuity of the two ends can be seen while performing the Simmonds (Thompson) test or by gentle plantar and dorsiflexion.

SUBMITTED BY

Adrian Goudie


Achilles tendon long

Achilles tendon long

The two ends of the ruptured tendon are separated by a hypoenchoic gap. The tendon has lost it's taut appearance.
Achilles tendon long Achilles tendon long Achilles tendon long