ACHILLES TENDON& Plantaris Tendon

Tendinosis, Paratendinosis Haglund’s Deformity

ACHILLES TENDON

PLANTARIS TENDON

PLANTARIS MUSCLE

Fig 1(1) Fig 2(2)

Achilles Tendon Is the large tendon formed by the medial and lateral gastrocnemius muscles and the soleal muscle, inserting onto the Calcaneum.The Achilles tendon provides the power to ‘push off’ when walking or running.

Achilles tendon long and trans-normal ultrasound appearance

Two of the more commonly encountered pathologiesTendinosis and Paratendinitis symptoms and appearances compared.

Tendinosis Paratendinitis

MAY CO-EXIST

Acute- pain, stiffness, limitation daily activities

Pain and swelling

Chronic- absent/moderate pain, induced with exercise +/- nodules

Normal intratendinous structure (when isolated paratendinitis)

Tendon swelling, textural heterogeneity, intratendinous focal hypoechoic areas

Effusion, irregular tendon margins, adhesions, heterogeneous appearance of pre Achilles fat pad.

Demonstrating tendinosis of the Achilles Tendon and a swollen Retro Achilles bursa

Retro Achilles bursitis

Haglund’s Deformity possible cause of Retroachilles swelling/burstis

Haglund’s deformity

bursitis

Medical multimedia groupFig 3(3)

Retrocalcaneal Bursa.Situated between the Achilles tendon and the Calcaneum- pain similar to the presentation of Achilles tendinosis

Retrocalcaneal bursitis

Increased vascularity within Achilles tendon and the retrocalcaneal bursa.

Increased vascularity within the Achilles tendon and retroachilles bursa

Note:- always relax the foot when Using colour so as not to compress the vessels.

Increased vascularity –paratenonperitendinitis

An intact Plantaris tendon can cause a false impression of a partially torn Achilles tendon.Care must be taken to assess the Plantaris Tendon and to be aware that when performing Thompsons’ manoeuver- squeezing the calf to produce plantar flexion of the foot whichindicates an intact Achilles Tendon that the Plantaris tendon may cause plantar flexion of the foot in a ruptured Achilles, leading to a false impression of intact Achilles tendon.

References1. Muscle system pro.III 3d4Medical. Ipad Application.2012 available from www.Apple.com/app 2. Netta. Elsiever. Ipad Application. 2011.available from www.Apple.com/App 3. Medical Multimedia group www.orthi=ogate.org/patient-education/foot