The Role of Ultrasound Assessment in Achilles Tendon Pathology

Abstract
Background: Tendons are connective tissues that transmit the force produced by muscle to bone and also prevent muscle damage by acting as shock absorbers. The Achilles tendon is the single largest, thickest and strongest tendon in the human body that transmit the force of powerful calf muscles to foot facilitating walking and running. This has long been known as a site susceptible to disabling injury. Forces up to 12 times bodyweight may arise during sporting activity. US performed with high-resolution linear-array probes has become increas-ingly important in the assessment of ligaments and tendons around the ankle because it is low cost, fast, readily available, and free of ionizing radiation.
Aim of the Work: To provide an overview of clinical applications of ultrasound in assessment of pathological Achilles tendons. And to demonstrate the role of ultrasound in diagnosis of Achilles tendon pathology after clinical diag-nosis.
Patients and Methods: This study is a prospective study, it was conducted in Radiology Department at Ain-Shams University Hospitals (El-Demerdash) from September 2018 till March 2019. It included 20 patients who were referred from the orthopedics, sports medicine and physical medicine outpatients.
Results: In our study US was capable of detecting almost all Achilles tendon abnormalities with high accuracy. The main noticeable limitation was the assessment of the bone marrow. In our study, the sensitivity, specificity and accuracy for US for Achilles tendon were 100%, 75% and 95% respec-tively. Both US and MRI are used in the evaluation of super-ficial structures, such as tendons and ligaments. The choice between US and MRI in such evaluations is determined by availability, referring physician preference, and the experience of the radiologist because in many settings accuracies can be similar.
Conclusion: Ultrasonography is an accurate and sensitive modality in evaluation of the Achilles tendon, it and can be used either as primary tool of investigation or as complemen-tary tool with MRI and even in some cases may be used as a final method of diagnosis without need for further correlation with any other imaging techniques.