Final diagnosis: full thickness tear of tendo Achilles.
( Images of tendo Achilles tear, courtesy of Dr Golam).
Ultrasound findings of a full thickness tear of the Achilles tendon:1. Complete disruption of the tendon fibers: This is the most characteristic finding of a full thickness tear. The tendon fibers will appear to be completely separated from each other.
2. Swelling:There may be swelling around the area of the tear.
3. Fluid collection: There may be a fluid collection around the area of the tear.
4.Thickening of the tendon: The tendon may appear thickened.
These findings are usually seen in the longitudinal plane. In the transverse plane, the tendon may appear to be absent or to have a gap in it.
The ultrasound findings of a full thickness tear of the Achilles tendon are usually very specific and can be used to make a definitive diagnosis. However, it is important to remember that ultrasound is not always 100% accurate and other conditions, such as tendinosis or a partial tear, can sometimes mimic the findings of a full thickness tear.
What are the main differential diagnoses?
The main differential diagnoses for a full thickness tear of the Achilles tendon include:
1. Achilles tendinosis: This is a condition that causes inflammation and degeneration of the Achilles tendon. It can cause pain, swelling, and stiffness in the tendon.
2. Partial tear of the Achilles tendon: This is a less severe injury than a full thickness tear. The tendon is only partially torn, and there is still some continuity between the two ends of the tendon.
3. Retrocalcaneal bursitis: This is a condition that causes inflammation of the bursa, which is a small sac of fluid that sits behind the Achilles tendon. It can cause pain, swelling, and tenderness in the area behind the heel.
4. Ankle sprain: This is an injury to the ligaments that support the ankle joint. It can cause pain, swelling, and bruising in the ankle.
5. Calf muscle strain: This is an injury to the calf muscles. It can cause pain, swelling, and tenderness in the calf.
General information about full Thickness Tear of Tendo Achilles:
The Achilles tendon is the thickest and strongest tendon in the human body. It connects the calf muscles to the heel bone and allows us to stand on our toes and walk. A full thickness tear of the Achilles tendon is a serious injury that can be very painful and debilitating.
Ultrasound Findings briefly:
Ultrasound is the most common imaging test used to diagnose a full thickness tear of the Achilles tendon. It can show a complete disruption of the tendon fibers. Other findings on ultrasound may include swelling, fluid collection, and thickening of the tendon.
Prognosis:
The prognosis for a full thickness tear of the Achilles tendon is generally good. Most people will make a full recovery with surgery and rehabilitation. However, some people may have persistent pain and weakness, and may not be able to return to their previous level of activity.
Management:
The treatment for a full thickness tear of the Achilles tendon is surgical repair. The surgery is usually done within 10 days of the injury. The goal of surgery is to reattach the torn tendon to the heel bone.
After surgery, most people will need to wear a cast or brace for 6-8 weeks. They will also need to undergo physical therapy to regain strength and range of motion.
Risk Factors:
The risk factors for a full thickness tear of the Achilles tendon include:
* Age: The risk of a tear increases with age.
* Injury: A tear can be caused by a sudden forceful contraction of the calf muscles, such as when jumping or landing from a height.
* Degeneration: The Achilles tendon can become degenerate with age, making it more susceptible to tears.
* Occupation: People who are on their feet for long periods of time, such as athletes and construction workers, are at an increased risk of a tear.
Prevention:
There is no sure way to prevent a full thickness tear of the Achilles tendon. However, there are some things you can do to reduce your risk, such as:
* Warming up before exercise.
* Stretching your calf muscles regularly.
* Wearing proper footwear.
* Avoiding activities that put a lot of stress on your Achilles tendon.
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