Imaging in chronic achilles tendinopathy: a comparison of ultrasonography,magnetic resonance imaging and surgical findings in 27 histologically verified cases |
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Authors: | M Åström Carl-Fredrik Gentz Paul Nilsson A Rausing Staffan Sjöberg Nils Westlin |
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Institution: | Department of Orthopaedics, Malm? University Hospital, S-20502 Malm?, Sweden, SE Department of Radiology, Malm? University Hospital, Malm?, Sweden, SE Department of Pathology, Malm? University Hospital, Malm?, Sweden, SE
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Abstract: | Objective. To compare information gained by ultrasonography and magnetic resonance imaging (MRI) in chronic achilles tendinopathy with
regard to the nature and severity of the lesion. Design. Imaging of both achilles tendons with ultrasonography and MRI was performed prior to unilateral surgery. Operative findings
and histological biopsies together served as a reference. Patients. Twenty-seven patients (22 men, 5 women; mean age 44 years; 21 athletes) suffering from chronic achilles tendinopathy participated
in the study. Eighteen patients had unilateral and 9 had bilateral symptoms. Results and conclusions. Surgical findings included 4 partial ruptures, 21 degenerative lesions and 2 macroscopically normal cases. Microscopy revealed
tendinosis (degeneration) in all tendon biopsies, including cases with a partial rupture, but only slight changes in the paratendinous
tissues (paratenon). Ultrasonography was positive in 21 of 26 and MRI in 26 of 27 cases. Severe intratendinous abnormalities
and a sagittal tendon diameter >10 mm suggested a partial rupture. In tendons with a false negative result histopathological
changes were mild and a tendency towards a better clinical outcome was noted in the sonographic cases. Assessment of the paratenon
was unreliable with both methods. Ultrasonography and MRI give similar information and may have their greatest potential as
prognostic instruments. |
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Keywords: | Magnetic resonance imaging Ultrasonography Achilles tendon Tendinosis Partial rupture |
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