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Achilles Tendinopathy
Achilles Tendinopathy
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Video Transcription
This is Barry Belosis, one of the musculoskeletal radiology fellows at Stanford University. 30 year old male with bilateral posterior ankle pain, concerned for Achilles tendinopathy. When evaluating Achilles tendon on ultrasound, we look and evaluate at its thickness, its contour, its echogenicity, and the surroundings of tissue, including the Cagre's fat pad and the paratenon region. The patient in this case presented with this ultrasound. The upper images demonstrate the right Achilles tendon, which shows mild thickening and hypoechoic region in the central portion of the mid-substance of the Achilles tendon, and with associated rounding of the anterior margin here, and also seen under transverse imaging. There is also associated echogenicity of the adjacent Cagre's fat pad. On the left-hand side, we can see here the left Achilles tendon demonstrating thickening, mild hypoechoic centrally, and rounding of the anterior contour, also seen here under transverse imaging. And here we can also see the echogenic or bright Cagre's fat pad. Color adopter is also used in evaluation of Achilles tendon. In the setting of Achilles tendinopathy, color flow as seen here on the anterior margin of the Achilles tendon in the sagittal color adopter images and transverse images suggest neovascularization, although increased flow can also be seen in the setting of inflammation in granulation tissue, but normal Achilles tendon does not demonstrate any vascularity.
Video Summary
Barry Belosis, a musculoskeletal radiology fellow at Stanford, discusses the ultrasound evaluation of a 30-year-old male with bilateral posterior ankle pain, suspected of having Achilles tendinopathy. Ultrasound assesses the thickness, contour, echogenicity, and surrounding tissue of the Achilles tendon. The patient's ultrasound shows mild thickening, hypoechoic regions, and contour changes in both Achilles tendons, along with echogenicity in the Cagre's fat pad. Color Doppler imaging indicates potential neovascularization, despite normal Achilles tendons showing no vascularity, suggesting tendinopathy or inflammation.
Meta Tag
Edition
2nd Edition
Related Case
2nd Edition, CASE 11
Topic
Foot and Ankle
Keywords
2nd Edition, CASE 11
2nd Edition
Foot and Ankle
Achilles tendinopathy
ultrasound evaluation
neovascularization
musculoskeletal radiology
Stanford
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