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E2045. Evaluation of Tendo Achilles Tears Using Ultrasound and Magnetic Resonance Imaging
Authors
  1. Anish Mondal; Institute of Post Graduate Medical Education and Research
  2. Shubham Saha; Institute of Post Graduate Medical Education and Research
Background
Tendo Achilles tears are the most common tendon injuries seen in everyday practice, occurring in patients with penetrating and sports related trauma or in case of systemic diseases like Rheumatoid arthritis, Diabetes mellitus. Ultrasound is the primary imaging modality in Tendo Achilles tears which are followed up by Magnetic Resonance Imaging in case of diagnostic difficulty or for confirmation. In this exhibit, we have attempted to showcase the different types of Tendo Achilles tears and their imaging findings.

Educational Goals / Teaching Points
By the end of the exhibit, the reader should understand 1) Normal Ultrasound and MR anatomy of Achilles Tendon 2) Ultrasound imaging technique and MRI parameters 3) Various grades of Tendo Achilles tears

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The Achilles tendon is the common tendon of gastrocnemius and soleus. It is the thickest and strongest tendon in the human body. Approximately 15 cm long, it begins near the middle of the calf and becomes attached to the midpoint of the posterior surface of the calcaneus. There are three main vascular territories: a proximal section, a hypovascular midsection (2-6 cm from insertion site) and a distal section. The posterior tibial artery primarily supplies the proximal and distal sections, and the midsection receives a relatively poor blood supply from the fibular artery, thus making it prone to rupture. Most tears occur in the avascular zone of the tendon. Partial thickness tears are defined as incomplete disruption of the tendon fibres, often extending to the tendon surface. Full thickness tears involve the entire cross section of the tendon with a gap between the retracted torn tendon ends. Atypical distal insertional tears can be iatrogenic or detected in patients with systemic disease like diabetes. Proximal tears are also atypical and represents a musculotendinous junction injury. A high frequency linear (3-12 MHz) probe of Philips HD7 ultrasound scanner was used to perform ultrasound of Tendo Achilles in longitudinal and transverse sections. The Magnetic Resonance Imaging was performed using 3.0 TESLA MRI machine (GE HEALTHCARE) SIGNA 3T hdxt. The sequences obtained were Sagittal PDFS, Sagittal GRE, Sagittal T2, Axial PDFS.

Conclusion
Prompt and correct diagnosis of Tendo Achilles tears will lead to proper treatment and thus quick recovery of the patient.