Rotura Parcial Tendon Aquiles

 Masculino 59 años edad corredor de fondo ( varios kilometros) cada dia,presenta desde hace 2 meses dolor en talon de Aquiles derecho. A pesar de ello ha seguido corriendo y ha estado siendo asistido por un fisioterapeuta. La exploracion sonografica con transductor lineal de 10.0 MHz muestra engrosamiento del tendon ( el lesionado mide aprox: 1.28 cm, el contralateral,sano mide 0.81 cm).Se aprecia una bursa retrocalcanea con paredes irregulares y con un volumen aumentado hasta 0.32 c.c.,compatible con Bursitis Retrocalcanea y/o coleccion liquida dependiende de la lesion fibrilar del tendon.

Cerca de su insercion calcanea,en la zona posterior de esta, se visualiza imagen lacunar de limites irregulares, mide aprox: 0.79 X 0.46 cm, en esta zona se aprecia marcado aumento del flujo vascular al aplicar el Doppler Color, compatible con proceso inflamatorio.La Elastografia de la zona muestra un score 3-4 en el score de Ueno con Strain Ratio de 3.01, mostrando por tanto, mayor dureza en el area lesionada ( en tendon sano seria de aprox: 1.14 (+ /- ) 0.38). Se concluye con los diagnosticos de Rotura parcial fibrilar del Tendon cerca de su insercion calcanea y /o Bursitis retrocalcanea. En esta caso se demuestra la eficacia tanto del Doppler Color y sobre todo de la Elastografia con Strain Ratio para demostrar las lesiones tendinosas.

Achilles Tendon Partial Rupture

A 59-year-old male long-distance runner (several kilometers) every day, has had pain in the right Achilles heel for 2 months. Despite this, he has continued to run and has been assisted by a physiotherapist. Sonographic exploration with a 10.0 MHz linear transducer shows thickening of the tendon (the injured one measures approx: 1.28 cm, the contralateral, healthy one measures 0.81 cm). A retrocalcaneal bursa with irregular walls and with an increased volume up to 0.32 c.c., is compatible with Retrocalcaneal bursitis and/or liquid collection depending on the fibrillar lesion of the tendon.

Near its calcaneal insertion, in its posterior area, a lacunar image with irregular limits is displayed, measuring approx: 0.79 X 0.46 cm, in this area a marked increase in vascular flow can be seen when applying Color Doppler, compatible with an inflammatory process. Elastography of the area shows a score of 3-4 in the Ueno score with a Strain Ratio of 3.01, therefore showing greater hardness in the injured area (in a healthy tendon it would be approx: 1.14 (+/-) 0.38). It concludes with the diagnosis of partial fibrillary rupture of the tendon near its calcaneal insertion and/or retrocalcaneal bursitis. In this case, the effectiveness of both Color Doppler and especially Strain Ratio Elastography to demonstrate tendon injuries is demonstrated.