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My Foot Doesn't Work Right
A 35 year-old male felt a painful "pop" in his posterior left lower leg while playing football. Afterwards his "foot didn't work right anymore." X-ray of the left ankle and tib/fib are normal but he is unable to ambulate. You place an ultrasound over the area of maximal tenderness and discover the following:
My Foot Doesn't Work Right
Author: Chris Durkin, DO, Robert "Max" Lystrup, MD, CAQSM
Peer-reviewer: Matthew Negaard, MD
Editor: Alex Tomesch, MD
A 35 year-old male felt a painful "pop" in his posterior left lower leg while playing football. Afterwards his "foot didn't work right anymore." X-ray of the left ankle and tib/fib are normal but he is unable to ambulate. You place an ultrasound over the area of maximal tenderness and discover the following:
Figure 1: Ultrasound of the L posterior ankle 11cm proximal to the calcaneal insertion of the achilles tendon. Robert Lystrup's images.
What imaging confirms the diagnosis?
Imaging is not necessary to make the diagnosis of Achilles tendon rupture. If the diagnosis is in question, ultrasound or MRI can be used on an outpatient basis to confirm the diagnosis.
Figure 2: MRI of the L ankle demonstrating acute tear of the achilles tendon at the myotendinous junction with 2cm retraction 11cm from the calcaneal insertion. Robert Lystrup's images.
References
[1] Khan-Farooqi W, Anderson RB. Achilles tendon evaluation and repair. The Journal of Musculoskeletal Medicine. 2010;27(5).
[2] Ahmad J, Repka M, Raikin SM. Treatment of myotendinous Achilles ruptures. Foot Ankle Int. 2013;34(8):1074-1078.
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