Achilles Tendon

Ultrasound

5 MHz LINEAR transducer -sag and transverse images -scan contralateral side aids in determining normalcy

Achilles Tendon

Large, strong fibrous tendon connects gastrocnemius and soleus muscle to the calcaneus -helps move the foot downward, push off when walking, and rise up on toes

Blood supply to Achilles

The longitudinal arteries that run length of gastrocnemius and soleus muscles

Hypoechoic Kager fat pat

Special attention must be given to the ____________. Located deep to the Achilles

Paratenon

Connective tissue sheath that surrounds the Achilles tendon

Scanning techniques

Dorisflexion and plantar flexion of the foot increase the change of imaging tear

5-6mm

Normal AP diameter of tendon

Thompsons Test

Patient kneels on the examination table with the feet hanging off, examiner squeezes the calf while observing the plantar flexion If no movement of the foot is noted, Achilles' tendon rupture is indicated

Patient prep

Position patient PRONE with foot hanging over the edge

Indications of Achilles' tendon u/s

Trauma Knot or bulge over proximal tendon Audible pop or snap followed by sharp pain Inability to stand on toes Swelling Heel pain for more than 4 weeks Decreased strength Postoperative monitoring Displacement of Kagers fat pad on radiograph