Diagnosis

Examination of the Achilles tendon using MRI

introduction

Magnetic resonance tomography, or MRI for short, is a radiological cross-sectional imaging process and makes it possible to depict organs, muscles and joints without damaging radiation. The protons, the positively charged nuclei of hydrogen that occur in every cell in the human body, are set in motion by a large magnet and the signal that they send out when they return to their original state is measured. Since organs, tendons and muscles are displayed with very high contrast, the MRI is particularly suitable for displaying the Achilles tendon. In this way, injury or inflammation of the Achilles tendon can be seen.

indication

An MRI of the Achilles tendon should be done if one is suspected chronic inflammation of the Achilles tendon exists or a possible Crack or partial crack to confirm. An MRI of the Achilles tendon can also be performed to plan a possible operation. An alternative method would be a Ultrasound of the Achilles tendon.

procedure

In the case of an MRI of the Achilles tendon, the patient is informed by the responsible radiologist about the purpose and procedure of the examination, including contraindications such as pacemakers, hearing implants or other metal parts in the body. Then the patient must all metallic objects like taking off jewelry and, if necessary, putting on a patient's shirt. Then the patient lies down on the table of the MRT, gets hearing protection because of the loud noises of the MRT and there will be Cross and lengthways shots the affected side made.

Appointment with an expert in Achilles tendonitis?

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

Athletes (joggers, soccer players, etc.) are particularly often affected by the Achilles tendonitis disease. In many cases, the cause of the Achilles tendonitis cannot be identified at first. Therefore, the treatment requires a lot of experience. I focus on Achilles tendonitis.

The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
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60311 Frankfurt am Main

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Further information about myself can be found at Dr. Nicolas Gumpert

Do I need contrast media for an MRI of the Achilles tendon?

Contrast media is not always given during MRI of the Achilles tendon, since an injury caused by the formation of edema, i.e. the accumulation of water around the injury, often occurs through special sequences (Settings on the device) can be represented well.

A rupture of the Achilles tendon can often reveal itself through an interruption of the tendon, for which no contrast agent is needed either. Changed contours or thickening of the tendon can also be displayed well without the use of contrast media. Contrast media could be used, for example, when a chronic inflammation of the Achilles tendon is suspected or when looking for necrosis, i.e. dead parts of the tendon. If contrast medium should be necessary, which the examining doctor decides on site, this is given via an intravenous access, which is placed before the examination and removed again after the examination.

Duration

An MRI of the Achilles tendon is a relatively short exam because the area to be examined is not large. With the positioning of the patient (so that he lies as comfortably and still as possible during the examination) and depending on how many series of images are taken, the examination should not be longer than 20-30 minutes last.

costs

The costs for an MRI of the Achilles tendon are based on the fee schedule for doctors (GOÄ) for privately insured patients and the uniform assessment standard (EBM) for those with statutory health insurance. According to the GOÄ, an examination of limb sections (Arms or legs) are calculated at € 139.89 to € 251.80. There may be surcharges for special imaging techniques (€ 58.29-104.92), the use of contrast media (€ 58.29) or computer calculations (€ 46.63). The MRI of the Achilles tendon can be billed at € 126.59 for legally insured patients according to the EBM.

Achilles tendon tear / rupture / partial tear

The Achilles tendon forms the end of the calf muscle (Triceps surae) and starts at the heel bone. Is it because of one thing traumas or one continuous use to a complete or incomplete crack (Rupture) the Achilles tendon, this goes with it severe, sudden shooting pain and the typical sound of a "Whipping". Furthermore, the area around the tendon swollen and reddened be. Ultrasound is an uncomplicated method of showing a tear or partial tear in the Achilles tendon. However, if the finding is unclear or the tendon cannot be adequately visualized, a MRI the method of choice. This is particularly useful because it is here that the quality of the tendon can be assessed and a possible operation can be planned. In the MRI image, the Achilles tendon appears as a black, smoothly delimited strand. A tear would show up in a bright interruption of this tendon. The surrounding structures can also be visualized and assessed in the MRI. A partial tear is not always good from irritation of the Achilles tendon (Tendinosis) to distinguish in the MRI, Thinning and irregularities of the tendon would rather suggest a partial Achilles tendon tear.

Please also read our topic on this Achilles tendon rupture'

Achillodynia / Achilles tendonitis

Constant overuse of the Achilles tendon can irritate it, which is very painful.

Achillodynia describes pain in the area of the Achilles tendon, which is caused by irritation caused by constant overuse of the tendon. At the beginning there is often an inflammation of the Achilles tendon. Achillodynia results in an inflammatory swelling of the tendon, which can be shown in the MRI, as well as typical nodular thickenings. With advanced achillodynia, necrosis, i.e. the death of parts of the tendon, can also occur. These necroses can appear on the MRI as light spots in the otherwise dark tendon, but they can also calcify over time, which would then not be distinguishable from the tendon on the MRI. The ultrasound can be used to better assess this. The MRI helps to assess whether there is a risk of an Achilles tendon rupture, which increases with increasing calcification and, as a result, the loss of elasticity.

Read more about this under Inflammation of the Achilles tendon

necrosis

Achilles tendon necrosis is one Result of chronic inflammation of the tendonwhich is associated with small tears and remodeling of the tendon. Here parts of the Achilles tendon die off. On the MRI, the tendon is due to the chronic inflammation distended and thickened and the light necroses lie between the dark tendon fibers. These necroses can calcify over time and would then be more visible in the ultrasound, as they are only shown dark in the MRI. These necrotic cavities can also be assessed by administering contrast medium, since the surrounding inflamed tissue absorbs the contrast medium well.

Tendinosis

Achilles tendinitis is one chronic inflammation of the Achilles tendon with small tears in the tendon and remodeling of the muscle into connective tissue. In the MRI, even smallest injuries to the Achilles tendon be made visible. These would get through small lightening show in the otherwise black tendon. The thickness of the Achilles tendon is also assessed, which is usually no more than 6 mm. Tendinosis is slight between 6-8 mm, moderate between 8-10 mm and severe tendinosis at more than 10 mm.