ORTHOPAEDICS
Case 18 :
History of left ankle sprain, with swelling over the left ankle.
MRI has been performed. What is the diagnosis?
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Diagnosis

Paratendinitis

Discussion
Achilles tendon does not have a true tendon synovial sheath; inflammatory lesions are thus classified as tendinitis, paratendinitis & peritendinitis

Tendinitis-intrinsic/intrasubstance inflammation of Achilles tendon

Paratendinitis-inflammatory changes about the tendon

Peritendinitis-inflammation of peritenon

Hallmark of all the above changes are an irregular pre-Achilles fat pad

Paratendinitis

Overuse of calf muscles is a predisposing factor
Focal/fusiform thickening of Achilles tendon
Diffuse or linear low to intermediate SI on T2WI
Treatment is by immobilization, if not successful, stripping & excision of thickened peritenon & granulation tissue is performed.

 

Contribution

 MRI CENTRE, NANAVATI HOSPITAL, MUMBAI


 

 

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