High-Resolution Ultrasonography Versus MRI in the Diagnosis of Achilles Tendon Lesions

Achilles tendon lesions are commonly assessed using noninvasive imaging methods such as ultrasound and magnetic resonance imaging (MRI). Both techniques are well-established in diagnosing and evaluating the condition of the Achilles tendon. This prospective study aimed to compare the diagnostic efficacy of high-resolution ultrasonography and MRI in identifying Achilles tendon lesions. The focus was on understanding the respective strengths of each imaging modality in diagnosing different types of lesions, including tendinopathy, partial thickness tear, and full thickness tear. Twenty patients, aged between 23 and 63 years, participated in the study, presenting with symptoms ranging from posterior ankle pain to limited movement and swollen ankles. Ultrasonography, performed with patients in a prone position, examined the Achilles tendon from its musculotendinous junction to its calcaneal insertion. MRI, conducted with patients in a supine position, utilized axial and sagittal T1, T2-weighted images, STIR, and proton density. Among the 20 patients examined, diagnoses included eight cases of tendinopathy, five cases of partial thickness tear (one inconclusive by ultrasound), and seven cases of full thickness tear. The results indicate that ultrasound is comparable to MRI in diagnosing tendinopathy and full thickness tear. However, MRI demonstrates superiority in identifying partial thickness tears, while ultrasound excels in early enthesitis detection. Ultrasound emerges as a valuable complementary diagnostic tool for Achilles tendon lesions, demonstrating effectiveness comparable to MRI in certain aspects. While MRI outperforms in diagnosing partial thickness tears, ultrasound proves superior in the early detection of enthesitis.