Achilles Tendon Partial Tear MRI Images

This patient presented with a 9 month history of pain in the achilles tendon area. There was no incident of acute pain, however the pain did come on during a long run. The patient continued to finish the 10 mile run, but knew that the achilles was a problem. The MRI (now 9 months post injury) shows surrounding swelling (white regions) and over 50% of the body of the tendon showing changes. The achilles tendon should be solid black, if healthy, in this imaging like the less than 50% on the right side. Within the injured part of the tendon, while the healing goes on, the tendon is part swelling, part tendon, part scar tissue, part stuff that makes it take on an irregular appearance. It is 50% unhealthy. 

A different image of the above tendon which does not highlight swelling. In this image the tendon does not look as bad. This is a T1 image where the above is a T2 image. 

There the side view of a T2 image showing the body of the tendon looking unhealthy (you want solid black). 

Another side view of the achilles with T2 weighting showing the area of partial rupture and the healing process. The central area would look very white if this image was within 2 weeks of the actual injury.

A final side view through the more normal 50% of the tendon showing swelling in front of the tendon, a little tear within the tendon, but overall a very healthy part of the tendon. The swelling in front of the achilles is called a retrocalcaneal bursitis.