Department of Radiology, Ulsan Medical College, AMC Department of Radiology, College of Medicine, Chungnam University1
ABSTRACT
PURPOSE : To differentiate a complete rupture of Achilles tendon from an incomplete one which is importantbecause its treatment is quite different. And it is necessary to know the exact site of the rupturepreoperatively. MATERIAL & METHODS : Fifteen cases of fourteen patients which were diagnosed as Achilles tendonrupture by ultrasonography and surgery were reviewed. We compared sonographic rupture site with surgical findings.Ultrasonographic criteria for differentiation of complete and incomplete rupture was defined as follows ; thediscreteness, which means the proximal intervening hypoechogenicity to the interface echogenicity of distal marginof ruptured tendon ; the slant sign, which represents the interface of ruptured distal margin which was seen overthe 3/4 of the thickness of the tendon without intervening low echogeneicity ; the invagination sign, which meansthe echogenic invagination from Kager triangle into posterior aspect of Achilles tendon over the half thickness ofthe tendon. RESULTS : The sites of complete tendon rupture were exactly corresponded to surgical finding in fourcases of ten complete ruptures. And the discrepancy between sonographic and surgical findings in the site ofcomplete rupture was 1.2 ± 0.4 cm in six cases. Three of ten complete ruptures showed the discreteness sign, allof ten showed the slant sign and two of ten showed the invagination sign. CONCLUSION : It is helpful todifferentiate a complete from incomplete rupture of the Achilles tendon and to localize the site of the completerupture with the ultrasonographic evaluation.
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