[Ultrasound morphology of the Achilles tendon and differential diagnosis].

Aim: To correlate sonographic findings and clinical disorders of the Achilles tendon, considering newer aspects of their etiology and pathogenesis.

Method: In a retrospective cross-sectional study the sonographic findings in 52 patients with tendonitis, heel swelling, or suspected rupture were analysed and correlated with the final diagnosis. Tendon lesions due to lipid storage diseases or rheumatic diseases were analysed on the basis of reports in the literature.

Results: Ultrasound abnormalities were found in 41 of the 52 symptomatic patients (40 degenerative changes of the tendon and/or the peritendinous tissue, 1 inflammatory rheumatologic process, 1 metabolic disorder, 8 ruptures, 2 congenital or developmental abnormalities). Ultrasound signs were not specific for each of the diagnoses but typical combinations of distinctive signs together with clinical findings led to the correct diagnoses.

Conclusion: Patients with suspected lesions of the Achilles tendon should undergo an ultrasound investigation both to promote the exact diagnosis and to define the extent of the disease.