Case 2 Partial Rupture
A young man felt a 'tearing' feeling while playing sport.
The achilles tendon is thickened. There are hypoechoic areas seen in both the longitudinal and transverse views. Edge shadowing from these areas are suggestive of partial tears. Movement of the ankle demonstrates movement of the proximal tendon without widening of the hypoechoic areas, suggesting a partial tear.
In tears where the tendon is severly tendinopathic or with echogenic fibrin between the ends, the tendon ends may not be clearly seen. Edge shadowing artefact may be the easiest ultrasound sign to detect a tear.