Adrienne Hoffmann MD, Presenter: Nothing to Disclose

Nadja Mamisch, Abstract Co-Author: Nothing to Disclose

Florian Buck MD, Abstract Co-Author: Nothing to Disclose

Norman Espinosa, Abstract Co-Author: Nothing to Disclose

Christian W. A. Pfirrmann MD, Abstract Co-Author: Research Consultant, Medtronic, Inc

Marco Zanetti MD, Abstract Co-Author: Nothing to Disclose

To evaluate the presence of edema and fatty atrophy in patients with Achilles tendon lesions.

Forty-five consecutive patients (mean 51 years; range 14 – 84 years) with achillodynia were examined with sagittal T1-weighted and axial STIR images of the Achilles tendon and axial T1-weighted and axial STIR images of both lower legs. Complete tear, partial tear and tendinopathy of the Achilles tendon as well as edema and fatty atrophy in the soleus muscle and gastrocnemius muscle were determined by two musculoskeletal radiologists in consensus.

Two patients had a complete tear of the Achilles tendon, 17 patients had a partial tear, 20 patients had tendinopathy and 6 patients had a normal Achilles tendon. Edema was found in each part of the triceps surae in the two patients with complete tear of the Achilles tendon, in 7 patients with partial tear ((1/17) soleus muscle; (7/17) gastrocnemius muscle, caput mediale; (6/17) gastrocnemius muscle, caput laterale), and in 4 patients with tendinopathy ((1/20) soleus muscle; (4/20) gastrocnemius muscle, caput mediale; (2/20) gastrocnemius muscle, caput laterale). Edema never occurred in patients with normal Achilles tendons. Fatty atrophy was found in the two patients with complete tear of the Achilles tendon ((2/2) soleus muscle; (1/2) gastrocnemius muscle caput mediale; (1/2) gastrocnemius muscle, caput laterale), in 4 patients with partial tear ((4/17) soleus muscle; (3/17) gastrocnemius muscle caput mediale; (1/17) gastrocnemius muscle, caput laterale), in one patient with tendinopathy ((1/20) soleus muscle; (1/20) gastrocnemius muscle caput mediale; (1/20) gastrocnemius muscle, caput laterale) and did not occur in patients with normal Achilles tendons.  

Edema (up to 40 %) and fatty atrophy (up to 25 %) of the calf muscles is found in patients with Achilles tendon lesions. Such findings are not seen in patients with normal Achilles tendons.

Edema and fatty atrophy of the calf muscle detected in patients with Achilles tendon abnormalities may help the orthopaedic food surgeon for the therapy decision making.

Hoffmann, A, Mamisch, N, Buck, F, Espinosa, N, Pfirrmann, C, Zanetti, M, Edema and Fatty Atrophy of the Calf Muscles on MR Images in Patients with Achilles Tendon Lesions.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007082.html