Leung John L Y, Griffith James F
Department of Radiology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Hong Kong.
J Clin Ultrasound. 2008 Jan;36(1):27-32. doi: 10.1002/jcu.20388.
To describe the sonographic appearance of Achilles tendon in normal subjects and patients with chronic Achilles tendinopathy with the aim of establishing diagnostic sonographic criteria for Achilles tendinopathy.
A prospective, cross-sectional, case-control sonographic study of the Achilles tendon was undertaken. Thirty tendons in 21 patients and 100 tendons in 50 control subjects were selected. Sonographic assessment included tendon thickness, echogenicity, fibrillar pattern, and presence of calcifications. Power Doppler imaging was used to assess tendon vascularity. Paratendinous structures and plantar fascia were also examined.
Tendinopathic tendons were larger than normal tendons in both cross-sectional area and antero-posterior diameter. Hypoechoic areas within the tendon were more commonly seen in patients. Disruption of fibrillar pattern, increase in tendon vascularity, increased Kager's fat pad echogenicity, and paratenon thickening were solely seen in patients. Fluid in the retrocalcaneal bursa and calcaneal bony abnormalities were seen in both groups without a significant difference.
Achilles tendinopathy results in enlargement, particularly of the mid- and distal portions of the tendon, disruption of fibrillar pattern, and increase in tendon vascularity. Additional signs are increased Kager's fat pad echogenicity and paratenon thickening. Tendon calcification, changes in retrocalcaneal bursae, and calcaneal contour are not specific for Achilles tendinopathy.
描述正常受试者及慢性跟腱病患者跟腱的超声表现，旨在建立跟腱病的超声诊断标准。
对跟腱进行一项前瞻性、横断面、病例对照超声研究。选取21例患者的30条跟腱以及50名对照受试者的100条跟腱。超声评估包括跟腱厚度、回声、纤维结构及钙化情况。采用能量多普勒成像评估跟腱血管情况。同时也检查腱旁结构及跖筋膜。
跟腱病患者跟腱的横截面积和前后径均大于正常跟腱。患者跟腱内低回声区更为常见。仅在患者中观察到纤维结构破坏、跟腱血管增多、Kager脂肪垫回声增强及腱旁组织增厚。两组均可见跟腱后滑囊内积液及跟骨骨质异常，且差异无统计学意义。
跟腱病会导致跟腱增粗，尤其是肌腱的中、远端，纤维结构破坏，跟腱血管增多。其他征象包括Kager脂肪垫回声增强及腱旁组织增厚。肌腱钙化、跟腱后滑囊改变及跟骨轮廓对跟腱病并无特异性。
