This article evaluates the utility of radiography, ultrasonography, and MRI in diagnosing Achilles tendon injuries. It reviews the pertinent anatomy of the Achilles and associated structures, and signs of disorder with each imaging technique. The economics of use ultrasonography and MRI are discussed. They should serve as complementary diagnostic tools, with ultrasonography the first choice because of its ease of use, ability to view dynamic function, and cost. However, clinical examination is often best for diagnosis; MRI and ultrasonography often should be considered only when the diagnosis is confounding or a patient does not respond to recommended conservative care.
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