Achilles Tendon Injuries and Tendonitis Workup

  • Author: Anthony J Saglimbeni, MD; Chief Editor: Consuelo T Lorenzo, MD   more...
 
Updated: Jan 18, 2012
 

Laboratory Studies

Laboratory studies usually are not necessary in evaluating and diagnosing an Achilles tendon rupture or injury. Evaluation may help rule out some of the other possibilities in the differential diagnosis. These may include CBC count with differential, coagulopathy panel, erythrocyte sedimentation rate, and arthritis panel. Results are all normal in these injuries.

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Imaging Studies

  • Imaging studies are not necessary to diagnose common Achilles problems; however, they can be helpful in evaluating possibilities in the differential diagnosis and should be ordered as clinically indicated.
  • Plain radiography
    • Radiographs of the tibia and fibula often are indicated when the history shows trauma that could have resulted in fracture of these long bones. In Achilles tendonitis, some calcification in the distal Achilles may be evident. With Achilles rupture, the bones appear normal and soft tissue swelling may be evident.
    • Radiographs of the knee and ankle may help discover findings of degenerative or inflammatory arthropathies.
  • Ultrasonography of leg and thigh: Ultrasonography of the leg and thigh can help evaluate the possibility of deep vein thrombosis (DVT) and also can be used to rule out a Baker cyst. In experienced hands, ultrasonography also can identify a ruptured Achilles tendon or the signs of tendinopathy.
  • Magnetic resonance imaging (MRI): MRI can facilitate definitive diagnosis of a disrupted tendon. This is especially useful when considering the possibility of partial disruption of the Achilles tendon. Partial disruption often is undetectable clinically and may be misdiagnosed as simple Achilles tendonitis; however, partial Achilles disruption often responds to surgical intervention. Imaging the knee can confirm a Baker cyst, as well as the probable underlying pathology causing the Baker cyst.[2]
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Contributor Information and Disclosures
Author

Anthony J Saglimbeni, MD  President, South Bay Sports and Preventive Medicine Associates; Private Practice; Team Internist, San Francisco Giants; Team Internist, West Valley College; Team Physician, Bellarmine College Prep; Team Physician, Presentation High School; Team Physician, Santa Clara University; Consultant, University of San Francisco, Academy of Art University, Skyline College, Foothill College, De Anza College

Anthony J Saglimbeni, MD, is a member of the following medical societies: California Medical Association and Santa Clara County Medical Association

Disclosure: South Bay Sports and Preventive Medicine Associates, Inc Ownership interest Other

Coauthor(s)

Christian J Fulmer, DO  Private Practice in Sports and Family Medicine; Team Physician, Valley Christian High School

Christian J Fulmer, DO is a member of the following medical societies: American Academy of Family Physicians, American Academy of Osteopathy, American Medical Society for Sports Medicine, and American Osteopathic Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM  President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, and Texas Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Michael T Andary, MD, MS  Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists

Disclosure: Allergan Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Kelly L Allen, MD  Medical Director, Medevals

Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD  Physiatrist, Department of Physical Medicine and Rehabilitation, Alegent Health Immanuel Rehabilitation Center

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

References

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