Tendinosis is a chronic condition due to degenerative tendinopathy. It usually occurs in patients who are between 35 and 45, and who are not necessarily athletic. The Achilles tendon is swollen and thickened.
Ultrasonography is an excellent method for the diagnosis of acute and chronic Achilles tendon disorders. By using sonography it is possible to detect many conditions that affect this tendon such as peritendinous edema, bursitis, ruptures of the Achilles tendon, and calcified insertion of the tendon at the calcaneous.
B mode ultrasonographic findings in Achilles tendinosis may include:
- enlargement (AP >6 mm) usually presenting as localized fusiform enlargement
- disruption of the normal fibrillar striation pattern of the tendon
- intratendinous hypoechoic areas due to chronic mucoid degeneration
- extra-tendinous hypoechoic areas due to edema
- focal calcifications
Color Doppler may show increased flow in the intra and extra-tendinous regions, depending on the grade of inflammation present; the higher the grade, the more Doppler signal can be observed.