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Achilles Tendon's Tear

Author(s): F. Shahandeh

Journal: Iranian Journal of Radiology
ISSN 1735-1065

Volume: 5;
Issue: S1;
Start page: 25;
Date: 2008;
Original page

Introduction: The achilles and plantaris tendons to-gether makeup the posterior grouptendons of ankle. Their seldom confusion in interpreting MR images of the achilles tendon. The achilles tendon should ap-pear informally straight and black on sagital T1 weighted images and on fluid sensitive images."nCase Presentation: After a heavy sport, a 55 year-old woman cannot walk with right foot."nDiscussion: The classic achilles tendon rupture occurs with forced dorsiflexion of planted foot, such as oc-curs in basketball or other jumping sports. The classic patent is a middle aged "weekend warrior" who leads a sedentary life and then attempts to participate in sports (perhaps with younger players) without an adequate warm-up. Of all the tendons of the foot and ankle, the Achilles is the only one for which disor-ders have a malepredominance. Partial tears and the degree of healing of prior injures of the Achillesten-don can be more difficult to assess by physical exami-nation, thus rendering MRI particularly valuable. There are three types of Achilles tears: Type I: with this partial, intra substance tear the Achilles tendon isabnormally rounded in axial cross section and T2 weighed images revalincreased internal signal inten-sity.Type II: the Achilles tendon is attached with a few remaining intact fibers. Type III: with this com-plete tear no intact fibers can be identified in sagital or axial plan classically, complete Achilles ruptures occur 3-5 cm proximal to the calcaneal insertion site because this is a relatively hypovascular watershed region. On occasion the Achilles tendon rapture at the muscle tendon junction. These unusual proximal tears sometimes require that the imaging coil be repo-sitioned around the lower calf rather than around the ankles so that the torn and retracted proximal end can be visualised. An Achilles tendon that has under-gone internal healing and scar formationfrom a prior tear tends to retain. The thichend fusiform shape similar to that seen in a type I intra sub stands here. Unlike a recent type I tear, however a heeled Achilles tendon does not contain increased internal signal in-tensity.

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