PMC5449124_01
(A) Achilles tendon swelling with partial tear. (B) Increased blood flow as revealed with orange dots under power Doppler views. Asterisks, tear site; black arrowhead, calcified lesions; white arrowhead, retrocalcaneal bursa; black arrow, spurs; white arrow, Achilles tendon.
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The thickness of the tendon was 12.9 mm, and the locations of multiple partial tears were 1 cm proximal to the calcaneus (Figure 1A). Blood flow was increased along the tendon as revealed under power Doppler view (Figure 1B).
(A) Achilles tendon swelling, partial tear, and retrocalcaneal bursitis. Increased blood flow as revealed under color Doppler view. (B) Achilles tendon swelling and partial tear in a transverse view. Asterisks, tear site; black arrowhead, calcified lesions; white arrowhead, retrocalcaneal bursa; white arrow, Achilles tendon. Increased blood flow is shown with red and blue dots as revealed under color Doppler view.
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Survey of musculoskeletal ultrasound at the second visit was carefully performed in initial with the same machine and 18 MHz linear array transducer to build up the baseline image (Figure 2A and B).
(A) Achilles tendon swelling, partial tear, and retrocalcaneal bursitis. (B) Increased blood flow in longitudinal view. Asterisks, tear site; black arrowhead, calcified lesions; white arrowhead, retrocalcaneal bursa; white arrow, Achilles tendon.
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The Achilles tendon swelling and partial tear were still noted, accompanied with much increased blood flow along the tendon as revealed under color Doppler view (Figure 3A and B).
(A) Achilles tendon swelling and retrocalcaneal bursitis. Healing pattern was noted at tear site. (B) Inflammation was much relieved as revealed under color Doppler view. Black arrowhead, calcified lesions; white arrowhead: retrocalcaneal bursa; white arrow, Achilles tendon.
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The fiber filament was noted in the previous hypoechoic lesions (Figure 4A and B), and the blood flow around the tendon was much relieved.