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Retroperiton

 

Goubaa Mohamed MD Djerba Tunisia

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--- Arabic
A 60-year-old male presents with a 3-day history of acute pain in the Achilles region. Un homme de 60 ans se présente se plaint depuis trois jours de douleur aiguë dans la région du tendon d' Achille.

Achilles tendon ultrasound ultrasonography tendon

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In this patient, clinical examination findings suggested rupture of the Achilles tendon. Longitudinal sonogram shows a full-thickness tear, confirmed with surgical findings in a 60-year-old men with acute pain in the Achilles tendon. Image demonstrates a markedly thickened and hypoechoic Achilles tendon (arrows) that was 13 mm anterior to posterior. Chez ce patients l'examen clinique a suggéré la rupture du tendon d'Achille. Le coupe échographique longitudinale montre une rupture complète, confirmée par les résultats chirurgicaux chez cet homme de 60 ans, avec une douleur aiguë dans le tendon d'Achille. L'image démontre un tendon d'Achille nettement épaissi et hypoéchogène et qui était de 13 millimètres d'épaisseur en antéro- postérieur.

Rupture of the Achilles Tendon Rupture du tendon d'Achille

 


Rupture of the Achilles Tendon

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Arabic

The patient describes a sudden onset of acute pain in the Achilles region immediately followed by grossly diminished function.
Rupture of Achilles tendon is an uncommon complication of treatment with fluoroquinolones and Corticosteroids.
The patient will often describe a feeling 'as if I was hit or kicked in the back of the leg'. A snap or tear may be audible.

Ultrasonography:
Ultrasonography of the Achilles tendon with linear probes produces a dynamic and panoramic image of the tendon The Achilles tendon is composed of longitudinally arranged collagen bundles, which reflect the ultrasound beam.
A normal Achilles tendon (scan 1 > right) appears as a hypoechogenic, ribbon-like image that is contained within two hyperechogenic bands. Tendon fascicles appear as alternate hypoechogenic and hyperechogenic bands that are separated when the tendon is relaxed and are more compact when the tendon is strained.
If there is a rupture of the achilles tendon, an increase in the volume and thickness of the tendon and its heterogeneous appearance was the most frequently observed feature. The most characteristic sign of ruptured AT is a break in continuity.
Rupture of the Achilles tendon is seen on ultrasonography scans as an acoustic vacuum with thick, irregular edges.
Ultrasonography also can be used to study the elastic properties of the tendon; this is done by measuring the distance between an intratendinous hypoechogenic or hyperechogenic point and the calcaneus and by assessing how this distance changes with different forces exerted by the gastrocnemius-soleus complex.
Also, Sonography can be used to differentiate full- from partial-thickness tears or tendinosis of the Achilles tendon.

Treatment :
If there is a complete rupture of the achilles tendon then surgery will be often necessary.

 


 
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