الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 81 |  |  |
| | | from | 81 | | |
Abstract
Achilles tendon disorders are among the more frequent maladies encountered in sports medicine. They are not only common but have shown an enormous rise in incidence over the past three decades. They are commonly associated with overuse injuries and can affect the quality of movement leading to thickening, vascularization, and hypo echogenicity of the diseased tendon.
There are various types of overuse tendon injuries include tendinopathies, peri tendinitis, and tendon rupture. Increased tendon thickness is the most mentioned indicator of tendinopathies.
Multiple imaging modalities have been used to diagnose Achilles tendon lesions, which include plain radiography, magnetic resonance imaging (MRI), and ultrasound (US). Each test has its own advantages and disadvantages. Tendinopathy and full-thickness tears may be assessed effectively both on MRI and ultrasound.
The US performed has become increasingly important in the assessment of ligaments and tendons around the ankle because it is low cost, fast, readily available, and free of ionizing radiation.
The aim of the work was to assess the role of ultrasound imaging in the evaluation of tendon Achilles lesions.
The current study was conducted on thirty patients who are complaining of pain and swelling in Achilles’ region and either recent or old trauma they are aged from 23- 68 years old with a mean of 49.3±13.24 years. In addition, 17 (56.7%) patients were males, and 13 (43.3%) patients were females. BMI of patients ranged from 20.6 to 37.89 kg/m2 with mean ±SD= 28.62± 10.5 kg/m2.
According to US findings, cases were initially diagnosed as Achilles Para tendinopathy in 6.7% of the studied cases, Achilles tendinopathy in 30% of cases, partial thickness tears in 20.0% of cases, and full-thickness tear in 20.0% of cases including 6.7% had tendon gap < 5 mm and 13.3% had significant tendon gap as the gap was ≥5 mm.
While ultrasound features of tendinopathy & para tendinopathy included hypoechoic swelling without disruption of the fibers in 5 cases (45.4%), Hyperemia (hypervascularity) on color doppler study in 4 cases (36.3%) and Isoechoic fluid surrounding the tendon 2 cases (18.1%). Moreover, regarding ultrasound features of full-thickness tendon tear, our data showed that amount of tendon retraction was 1 cm in 2 cases (33.3%), posterior acoustic shadow was also 1cm in 2 cases (33.3%) and 2 cases (33.3%) showed Kager fat herniation into the area of tendon abnormality. Moreover, features of partial-thickness tendon tear by the US were hypoechoic _ anechoic cleft which was found in 100% of cases.
MRI was done in 10 cases (33.3%) where there was no significant difference between US and MRI regarding the diagnosis of different Achilles tendon pathology. In addition, ROC curve analysis of ultrasound performance in comparison to MRI in the diagnosis of Achilles tendon pathology showed that sensitivity, specificity, and accuracy of ultrasound were 60%, 100%, and 86.67% respectively with PPV of 100% and NPP of 83.33%.