MR Imaging of the Achilles Tendon after Surgical Repair
Kwok Fai Tam1, *, Tun Hing Lui2
Identifiers and Pagination:Year: 2017
Issue: Suppl-4, M10
First Page: 697
Last Page: 703
Publisher ID: TOORTHJ-11-697
Article History:Received Date: 11/02/2016
Revision Received Date: 18/07/2016
Acceptance Date: 23/07/2016
Electronic publication date: 31/07/2017
Collection year: 2017
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Achilles tendon tear is common and increasingly frequent. Magnetic resonance imaging (MRI) is the modality of choice for radiological evaluation. It is accurate to assess the status and integrity of the tendon with well documented features. In this article, the MR findings of a normal Achilles tendon as well as common diseases like insertional and noninsertional tendinosis, chronic tendinosis with marked lengthening, tendon rupture are illustrated. After a torn Achilles tendon receives surgical repair, it undergoes different stages of healing process including inflammatory, reparative and remodeling phases. Acute scar tissue in the surgical bed may share similar MR features of tendon re-rupture especially in the early healing phase because both are T2W hyperintense. The size of the gap may even appear larger than expected on T2W images possibly due to tendon remodeling. Understanding of the healing process in post-operative period may prevent overestimation of tendon gap and misdiagnosis of re-tear. We describe the MR features of the post-operative changes with serial studies in different months after surgery. The MR findings with the highlights of the expected sequential changes in normal healing process are illustrated in different cases. A case with surgical repair on a partial tear of Achilles tendon is also included.