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Sonoanatomy of the Achilles tendon insertion in children

Wolfgang Grechenig1, Johannes M Mayr, Gernot Peicha

  • 1Department of Traumatology, Medical University of Graz, Auenbruggerplatz 7, A-8036 Graz, Austria.

Journal of Clinical Ultrasound : JCU
|August 5, 2004
PubMed

Insights

This study describes normal Achilles tendon and calcaneal apophysis sonographic features in children. These findings provide a reference for assessing pediatric heel pathologies using high-frequency ultrasound.

Area of Science:

  • Pediatric Radiology
  • Musculoskeletal Ultrasound
  • Pediatric Orthopedics

Background:

  • The pediatric heel, particularly the Achilles tendon insertion and calcaneal apophysis, is susceptible to pathologies during growth.
  • Establishing normative sonographic data is crucial for accurate diagnosis and management of heel pain in children.

Purpose of the Study:

  • To characterize age-related sonographic features of the Achilles tendon and calcaneal apophysis in children.
  • To provide a sonographic reference for evaluating heel pathologies during pediatric growth.
  • To assess the bone-cartilage interface at the calcaneal tuberosity using ultrasound.

Main Methods:

  • High-frequency gray-scale and color Doppler sonography were used to examine 100 children aged 2 months to 18 years.
  • Longitudinal and transverse imaging planes were employed to visualize the calcaneal apophysis and Achilles tendon insertion.
  • Measurements of apophyseal cartilage and Achilles tendon thickness were performed, alongside evaluation of the bone-cartilage interface.

Main Results:

  • In young children (2 months to 3 years), calcaneal apophysis cartilage was anechoic with scattered echoes, often showing vascularity on color Doppler (76%).
  • A wavy bone-cartilage interface was observed in 60% of children aged 4-6 years.
  • Sonographic features varied with age, reflecting normal developmental changes in the pediatric heel.

Conclusions:

  • High-frequency sonography provides reliable assessment of the bone-cartilage interface and Achilles tendon insertion in children.
  • The described sonographic features of the normal pediatric heel serve as a valuable reference for diagnosing pathologies.
  • This study enhances the diagnostic capabilities for heel conditions in the pediatric population through standardized ultrasound assessment.
Abstract

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