Achilles tendon rupture - MRI

The STIR and T1 weighted sagittal images of the lower leg and ankle of a 52 year old female presented with trauma showing ruptured Achilles tendon (arrow) with proximal retraction of the tendon evidenced by wavy pattern of the hypointense tendon (arrow heads).

Achilles tendon tears may be grouped into 4 types ( according to severity of the tear and degree of retraction).

• type I : partial ruptures <= 50%
  • typically treated with conservative management
• type II : complete rupture with tendinous gap <= 3 cm
  • typically treated with end-end anastomosis
• type III : complete rupture with tendinous gap 3 to 6 cm
  • often requires tendon / synthetic graft
• type IV : complete rupture with defect of > 6 cm (neglected ruptures)
  • often requires tendon / synthetic graft and gastrocnemius recession.
  Reference: MAFFULLI NICOLA. “Current Concepts Review - Rupture of the Achilles Tendon.” J Bone Joint Surg Am 81, no. 7 (July 1, 1999): 1019-36.