Department of Radiology, Leeds Teaching Hospitals, Musculoskeletal Centre, Chapel Allerton Hospital, Leeds LS7 4SA, UK.
National Institute for Health Research Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, UK.
AJR Am J Roentgenol. 2022 Sep;219(3):355-368. doi: 10.2214/AJR.22.27632. Epub 2022 May 4.
The Achilles tendon is commonly affected by both chronic repetitive overuse and traumatic injuries. Achilles tendon injuries can potentially affect any individual but have a particularly high incidence in professional athletes. Appropriate imaging evaluation and diagnosis are paramount to guiding appropriate management. In this Expert Panel Narrative Review, we discuss the role of various imaging modalities (particularly ultrasound and MRI) in the assessment of Achilles tendon pathology, focusing on the modalities' relative advantages and technical considerations. We describe the most common diagnoses affecting the Achilles tendon and adjacent structures, highlighting key imaging findings and providing representative examples. Various image-guided interventions that may be used in the management of Achilles tendon pathology are also reviewed, including high-volume injection, tendon fenestration, prolotherapy, and corticosteroid injection. The limited evidence supporting such interventions are summarized, noting an overall paucity of large-scale studies showing benefit. Finally, a series of consensus statements by the panel on imaging and image-guided intervention for Achilles tendon pathology are provided.
跟腱常见于慢性反复过度使用和创伤性损伤。跟腱损伤可能影响任何个体，但在专业运动员中发病率特别高。适当的影像学评估和诊断对于指导适当的管理至关重要。在本专家小组叙事性综述中，我们讨论了各种成像方式（特别是超声和 MRI）在评估跟腱病变中的作用，重点介绍了这些方式的相对优势和技术注意事项。我们描述了影响跟腱和相邻结构的最常见诊断，强调了关键的影像学发现并提供了代表性的示例。还回顾了各种可能用于管理跟腱病变的图像引导介入，包括大容量注射、肌腱开窗术、富血小板血浆疗法和皮质类固醇注射。总结了支持这些介入的有限证据，指出缺乏显示益处的大规模研究。最后，专家组就跟腱病变的影像学和图像引导介入提供了一系列共识声明。
