Ultrasound tutorial – Achilles Ultrasound

Achilles ultrasound – Technique and Findings

Positioning

• Prone
• Ankle dorsiflexed

Ultrasound probe for the Achilles tendon

• High frequency linear probe
  • Gives good field of view
  • High resolution
• Hockey stick probe
  • Useful for ultrasound guided intervention

Normal Appearance

• Minimally decreasing thickness from the musculoskeletal junction to the insertion
• Fascicular architecture

Pathology

• Tendinosis
  • Hypoechoic
  • Thickened
  • Loss of fascicular architecture
• Tear
  • Interstitial
    • Linear anechoic signal
  • Partial/full thickness
    • Pre-achilles fat (echogenic) extends into the tear