Achilles Tendon Arthritis Research

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reflecting progressive scar maturation at the repair site.

Despite the acknowledged benefits and widespread use of MR imaging in the assessment of the Achilles tendon, there is some debate as to the utility of MRI in examination in this regard. Karjalainen et al. examined 117 Achilles tendons with MRI and documented the overall sensitivity of MR imaging in the detection of abnormalities in cases of painful Achilles tendon to be 94%, with a specificity of 81%, and overall accuracy of 89%. The interobserver agreement for the MR imaging findings evaluated was good in all categories.50 However, several authors demonstrated an overlap of imaging findings in symptomatic and asymptomatic individuals.41,53 Signal heterogeneity and subtle focal increases in intrasubstance signal with distal longitudinal striations or small punctate foci of increased T1 weighted signal may represent normal fascial anatomy or possibly small vessels in normal Achilles tendons.41 This fascicular signal should be less apparent on STIR/T2 weighted images and the tendon should maintain a normal morphologic appearance with a concave anterior surface on axial imaging.54 Areas of mild increased T2 weighted signal visualized within the Achilles tendon in asymptomatic patients have been described and postulated by Haims and co-workers to represent areas of subclinical tendi-nopathy/mucoid degeneration. In contrast, areas of intense T2 weighted signal and thickened tendons were associated with chronic symptoms and tendon tears.53 Unlike ultrasound, Khan et al. did show that graded MRI did correlate with 12-month clinical outcome in patients with tendinopathy.33

In conclusion, the Achilles tendon is the most commonly injured tendon in the foot and ankle, with injuries commonly related to sports/athletic activities. Imaging modalities most commonly employed in the diagnostic assessment of the Achilles include conventional radiography, ultra-sonography, and magnetic resonance imaging. Cross-sectional imaging, including ultrasound and MR imaging, plays an important role in the documentation and staging of disease of the Achilles, and provides a noninvasive means of assessing the tendon's response to therapy or progression of disease.


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  • Lily Clayhanger
    Does ossification of achilles tendon at the ankle imply arthritis?
    9 months ago

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