Insertional Achilles Tendinosis With Associated Retrocalcaneal Bursitis And Evidence Of A Haglund Deformity

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Insertional Achilles Tendinosis With Associated Retrocalcaneal Bursitis And Evidence Of A Haglund Deformity

Authors, Editors, Case Information Author: Swetha Sundaram, MS Affiliation: Rowan-Virtua School of Osteopathic Medicine Co Author(s): Cameron Taylor, DO Altamash Raja, DO, RMSK, CSCS Senior Editor: Michael Krill, MD, ATC Clinical Vignette: 69 year old active male presents with left ankle pain that has persisted for the past month due to excessive walking in dress shoes. Physical examination revealed tenderness at posterior heel/calcaneus. Type of Probe Used: 15-4 MHz Linear Transducer Labeled Long Axis View of the Midportion Achilles Tendonwith Doppler of Achilles Tendon Labeled long axis view of the midportion Achilles tendon with Doppler imaging. The thickness of the tendon is outlined as well as the areas of hyperemia noted in red by Doppler. #2 - Video View Video Unlabelled short axis video of the insertional Achilles Tendon and Calcaneus with the proximal part of the ankle at the top and the distal part at the bottom. The left side is lateral, and the right side is medial. Labeled Short Axis View of the Insertional Achilles Tendon and Calcaneus Labeled short axis view of the insertional Achilles tendon and calcaneus. A yellow circle is around hyperechoic structures which are calcifications creating shadowing (white arrow). Labeled Long Axis View of the Insertional Achilles Tendon and Calcaneus Unlabeled Short Axis Insertional Achilles Tendon Unlabeled short axis view of the insertional Achilles Tendon and calcaneus. Unlabeled Long Axis Midsubstance Achilles Tendon with Doppler Unlabeled long axis view of the midportion Achilles tendon with doppler imaging. Unlabeled Long Axis Insertional Achilles Tendon Unlabeled long axis view of the insertional Achilles tendon and calcaneus. Interpretation Image Interpretation: The Achilles tendon is thickened and hypoechoic, with marked hyperemia, most notable along the mid-tendinous portion. The retrocalcaneal bursa is distended, without hyperemia, but sonopalpatory pain is appreciated here. At the distal Achilles insertion, several small, hyperechoic foci are noted with posterior acoustic shadowing, consistent with calcifications and bony changes. The constellation of these clinical and sonographic findings suggests both midportion and insertional achilles tendinosis with associated retrocalcaneal bursitis and evidence of a Haglund deformity.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Authors, Editors, Case Information

Labeled Long Axis View of the Midportion Achilles Tendonwith Doppler of Achilles Tendon

#2 - Video

Labeled Short Axis View of the Insertional Achilles Tendon and Calcaneus

Labeled Long Axis View of the Insertional Achilles Tendon and Calcaneus

Unlabeled Short Axis Insertional Achilles Tendon

Unlabeled Long Axis Midsubstance Achilles Tendon with Doppler

Unlabeled Long Axis Insertional Achilles Tendon

Interpretation

UPCOMING EVENTS

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