[Normal sonoanatomy and ultrasound diagnosis of achilles tendon pathology]

The aim of the research was to outline the normal sonoanatomy and improve achilles tendon pathology ultrasound diagnosis (Refinement of sonosemiotics) in order to optimize the diagnostic process and improve the treatment, to avoid the possible complications. 135 patients (age ranges from 15 to 70 years) underwent the radiological study of ankle joint posterior aspect. Pathology types: traumatic injuries--45%, inflammatory pathology--30% and degenerative-dystrophic diseases--25%. Unilateral pathology was diagnosed in 85%, bilateral--in 15% of cases. The diagnostic studies include: a) ultrasound, performed on digital ultrasound system using high frequency (7.5-12.0 MHz) linear probe with Doppler capability (all patients) b) X-Ray filming in antero-posterior and lateral projections (32 patients) and c) MRI - T1 and T2 weighted images in sagittal and transverse planes (5 patients). Ultrasound was successful in ankle joint posterior compartment pathology diagnosis in 132 cases (97.8%). It was ineffective in osseous pathology definition. Ultrasound failed defining pathology (posterior impingement-syndrome, due to the presence of triangular bone) in 3 cases (2.2%). In this cases MRI was helpful; it was also critical in differential diagnosis of massive partial tear and complete tear of the tendon. Ultrasound should be used as a Gold Standard when the patient presents with localized clinical symptoms (pain and swelling). Critical is the possibility of dynamic and Doppler studies in real-time. X-Ray should be used when the bony pathology is suspected and MRI should be considered if the pain is not localized exactly.