Understand the normal radiological anatomy of the Achilles tendon and its related structures Discuss the aetiology and pathophysiology of Achilles disorders with illustrated radiological examples Overview of diagnostic imaging techniques Evidence based practice of standard treatments New radiological interventional strategies including High Volume Image Guided Injection (HVIGI )

Achilles tendon anatomy: The Achilles tendon is the largest and strongest tendon in the human body. It is formed from theconvergence of tendons of gastrocnemius (superficial) and soleus (deep) muscles of the posterior calf. It inserts onto theposterior calcaneus.Uniquely it lacks a true tendon sheath, but instead is invested by a paratenonwhichfacilitates gliding. Achilles tendon biomechanics: Provides energy storage during locomotion. Itincreases top running speed and reduces energy cost. Exposed to huge forces (up to 12.5 x BW) [1] Normal Achiles tendon imaging: Ultrasound -...

Achiles tendinopathy (AT): Achilles tendinopathy represents tendon degeneration without inflammation. This typically occurs in the midsubstance of the tendon (2-6 cm from the insertion), where it is theorised there is a zone of relative hypovascularity[1]. A variant also preferentially affects the insertional part of the tendon. The lifetime incidence in the general population is 7/100000 and higher in athletes, and up to 29% of runners may be affected[1]. Athletes of all levels are affected, typically running and jumping sports. Various medical conditions can predispose to...

Achilles tendon disorders are common and include tendinopathy, partial tears and intratendinous tears. Closely related structures include the plantaris muscle/tendon, gastrocnemius and soleus and fascia cruris, which can all be injured. AT may coexist/predispose to other conditions of the Achilles and related structures. HVIGI is highly effective technique for treating AT, particularly due to the physical effects of the large volume injectate which disrupts the adhesions/neovascularity/neoneural ingrowth than underlies the condition. Several image guided injections and techniques are available to treat extra-Achiles disorders of the...

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