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Achilles Tendon Tear and Tendinopathy
Julia R. Crim, MD; Donna G. Blankenbaker, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Paratenon: Loose connective tissue surrounding tendon
              • Found in tendons, such as Achilles tendon, which lack true tendon sheath
            • Paratenonitis: Inflammation of paratenon
              • a.k.a. peritendinitis, paratendinitis, peritendinopathy
            • Tendinitis: Inflammatory change in tendon
              • Occurs at Achilles tendon insertion on calcaneus
            • Tendinopathy: Tendon degeneration without inflammation
              • Occurs in midsubstance of Achilles tendon

          IMAGING

          • General Features

            • Radiographic Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          • Reporting Tips

                                            Selected References

                                            1. Fernández-Sarmiento JA et al: Histological study of the influence of plasma rich in growth factors (PRGF) on the healing of divided Achilles tendons in sheep. J Bone Joint Surg Am. 95(3):246-55, 2013
                                            2. Thevendran G et al: The ruptured Achilles tendon: a current overview from biology of rupture to treatment. Musculoskelet Surg. 97(1):9-20, 2013
                                            3. Soroceanu A et al: Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a meta-analysis of randomized trials. J Bone Joint Surg Am. 94(23):2136-43, 2012
                                            4. Calleja M et al: The Achilles tendon. Semin Musculoskelet Radiol. 14(3):307-22, 2010
                                            5. Courville XF et al: Current concepts review: noninsertional Achilles tendinopathy. Foot Ankle Int. 30(11):1132-42, 2009
                                            6. Luck MD et al: High association between accessory soleus muscle and Achilles tendonopathy. Skeletal Radiol. 37(12):1129-33, 2008
                                            7. Richards PJ et al: Achilles tendon ossification: pathology, imaging and aetiology. Disabil Rehabil. 30(20-22):1651-65, 2008
                                            8. Sode J et al: Use of fluroquinolone and risk of Achilles tendon rupture: a population-based cohort study. Eur J Clin Pharmacol. 63(5):499-503, 2007
                                            9. Chiodo CP et al: Current concepts review: acute ruptures of the achilles tendon. Foot Ankle Int. 27(4):305-13, 2006
                                            10. Dobson MH et al: Treatment of acute Achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am. 88(5):1160; author reply 1160, 2006
                                            11. Hartgerink P et al: Full- versus partial-thickness Achilles tendon tears: sonographic accuracy and characterization in 26 cases with surgical correlation. Radiology. 220(2):406-12, 2001
                                            12. Schweitzer ME et al: MR imaging of disorders of the Achilles tendon. AJR Am J Roentgenol. 175(3):613-25, 2000
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Paratenon: Loose connective tissue surrounding tendon
                                                        • Found in tendons, such as Achilles tendon, which lack true tendon sheath
                                                      • Paratenonitis: Inflammation of paratenon
                                                        • a.k.a. peritendinitis, paratendinitis, peritendinopathy
                                                      • Tendinitis: Inflammatory change in tendon
                                                        • Occurs at Achilles tendon insertion on calcaneus
                                                      • Tendinopathy: Tendon degeneration without inflammation
                                                        • Occurs in midsubstance of Achilles tendon

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  • Image Interpretation Pearls

                                                                                    • Reporting Tips

                                                                                      Selected References

                                                                                      1. Fernández-Sarmiento JA et al: Histological study of the influence of plasma rich in growth factors (PRGF) on the healing of divided Achilles tendons in sheep. J Bone Joint Surg Am. 95(3):246-55, 2013
                                                                                      2. Thevendran G et al: The ruptured Achilles tendon: a current overview from biology of rupture to treatment. Musculoskelet Surg. 97(1):9-20, 2013
                                                                                      3. Soroceanu A et al: Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a meta-analysis of randomized trials. J Bone Joint Surg Am. 94(23):2136-43, 2012
                                                                                      4. Calleja M et al: The Achilles tendon. Semin Musculoskelet Radiol. 14(3):307-22, 2010
                                                                                      5. Courville XF et al: Current concepts review: noninsertional Achilles tendinopathy. Foot Ankle Int. 30(11):1132-42, 2009
                                                                                      6. Luck MD et al: High association between accessory soleus muscle and Achilles tendonopathy. Skeletal Radiol. 37(12):1129-33, 2008
                                                                                      7. Richards PJ et al: Achilles tendon ossification: pathology, imaging and aetiology. Disabil Rehabil. 30(20-22):1651-65, 2008
                                                                                      8. Sode J et al: Use of fluroquinolone and risk of Achilles tendon rupture: a population-based cohort study. Eur J Clin Pharmacol. 63(5):499-503, 2007
                                                                                      9. Chiodo CP et al: Current concepts review: acute ruptures of the achilles tendon. Foot Ankle Int. 27(4):305-13, 2006
                                                                                      10. Dobson MH et al: Treatment of acute Achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am. 88(5):1160; author reply 1160, 2006
                                                                                      11. Hartgerink P et al: Full- versus partial-thickness Achilles tendon tears: sonographic accuracy and characterization in 26 cases with surgical correlation. Radiology. 220(2):406-12, 2001
                                                                                      12. Schweitzer ME et al: MR imaging of disorders of the Achilles tendon. AJR Am J Roentgenol. 175(3):613-25, 2000