Tenon Disorders: A Literature Review

Discussion The ankle is the most frequently injured major joint in the body. Ultrasonography (US) performed with high-resolution broadband linear-array probes has become increasingly important in the assessment of ligaments around the ankle because it is low cost, fast, readily available, and free of ionizing radiation. US can provide a detailed depiction of normal anatomic structures and is effective for evaluating ligament integrity. In addition, US allows the performance of dynamic maneuvers, which may contribute to increasing the visibility of normal ligaments and improved detection of tears (1). US has shown valuable results in the evaluation of the normal and pathologic anatomic structures of the ankle and provides an imaging

Although tendon Achilles is the strongest tendon in the human body, all literature agreed that the tendon Achilles is the most commonly injured ankle tendon. the site of pathological findings is typically within the critical zone, a zone of relative hypovascularity 2- 6 cm from the calcaneal insertion. In this study Achilles tendon injuries represented 38 % of all diagnosed ankle tendon injuries and ranged in severity from enthesopathy, tendinosis, partial tear, to complete tear. In this study, ultrasound was capable in detecting all Achilles tendon disorders indentified by MRI, clinical correlation, operative findings, and follow up (100% sensitivity). One of the potential advantages of ultrasonography over MRI in cases of Achilles tendon injuries is its ability to depict intratendinous calcifications or ossifications which are usually missed among the similar low signal pattern of the tendon at MRI. In this study, ultrsonography could identify distal Achilles tiny intratendinous calcific foci in two cases which were not clearly demonstrable at

MRI ,however, may not be an accurate gold standard, because M. A. Arnoldner et al,(66) found a 87% concordance between MRI and ultrasound for evaluating PTT pathology, Image findings for US were confirmed in 66.7% by intraoperative inspection, whereas imaging findings for MRI were concordant with 55.6%. Although the small number of posterior tibial tendon pathology in this study group, our results were similar to the results acheived by miller et al, who correlated ultrasound findings in posterior tibial tendon injuries with surgical findings and showed that ultrasound allowed correct diagnosis in all of the cases of tendon diseases, including tendinosis, tenosynovitis, partial and complete tear. they also stated that ultrasound can demonstrate bony spurs or osteophytes adjacent to the posterior tibial tendon that may be difficult to identify by