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Explain Achilles Tendon MRI results in English?

1,156 Views | 7 Replies | Last: 3 yr ago by bigtruckguy3500
FamousAgg
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Can someone help me with this? Got the MRI, waiting on a referral to the next doctor.

Background is that I had a full tear of my Achilles tendon around 2013, it was repaired surgically. I have been able to be as active as I would like to be, but my calf muscles have not got back to full strength, but not really limiting anything that I do.

Seems about once a year or so my Achilles will balloon up and then go back to normal after about 2 weeks of rest. I finally got a DR involved, and the x ray suggested an MRI to look at a partial tear, the results are below

FINDINGS:
There is no acute fracture or dislocation in the left ankle. Stieda process is noted.

Small posterior subtalar joint effusion.

There is thickening and enlargement of the Achilles tendon with intermediate grade interstitial tearing of the mid to distal portions. This tear measures approximately 5.4 cm in craniocaudal
dimension.

Additional partial tearing of these posterior superficial fibers. No full thickness Achilles tendon tear. The distal Achilles attachment is intact.

The anterior and posterior distal tibiofibular ligaments are intact.

The anterior talofibular, posterior talofibular, and calcaneal fibular ligaments are intact.

The deep deltoid ligaments are intact. The tibial spring ligament is intact.

The plantar fascia is not thickened.

There is normal fat within sinus Tarsi.

IMPRESSION:
1. Thickening of the mid to distal Achilles tendon with intermediate grade interstitial tearing. Additional partial tearing of the posterior superficial fibers of the proximal Achilles tendon. No
full-thickness Achilles tear. Distal Achilles attachment is intact.

2. No acute fracture or dislocation in the left ankle. No osteochondral defect. Intact ligaments of the ankle.
aggiederelict
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Partial mid substance tear and proximal portion of the Achilles. Everything else is mostly unremarkable which is good news. You should respond well to conservative treatment. Go see a PT. Rehab can be slow for this.

What caused all of this to begin with?
zachsccr
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aggiederelict said:

Partial mid substance tear and proximal portion of the Achilles. Everything else is mostly unremarkable which is good news. You should respond well to conservative treatment. Go see a PT. Rehab can be slow for this.

What caused all of this to begin with?


This 100%. With your history, you need to be regularly addressing the tendon and your ankle mobility.
FamousAgg
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The original tear happened when I was pushing off the ball of my left foot going from stationary to a sprint.l this was back when I was still participating in some competing sports. The repair was done my an orthopedic surgeon in Houston, can't remember his name.

I over the past 4-6 months I have been doing some running trying to get into better cardiovascular shape. A typical running workout has been 2-4 miles at a 10-15 minute pace 3 days a week or so. Mostly trail running or treadmill.

I probably could help out a lot by dropping some Weight, I'm 6'2 265. Prior to this been focused on strength building so I'm carrying a good amount of muscle, but also a good amount of fat.
bigtruckguy3500
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Agree with Aggiederelict. Your achilles needs rehab to first heal, and then strengthen to prevent further degeneration that can lead to a full thickness tear.

Since you've also had surgery before, I would also see if you can follow up with these results with your surgeon if you're still able to.
FamousAgg
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aggiederelict said:

Partial mid substance tear and proximal portion of the Achilles. Everything else is mostly unremarkable which is good news. You should respond well to conservative treatment. Go see a PT. Rehab can be slow for this.

What caused all of this to begin with?


Can you explain the 5 CM tear to me? Obviously it cannot be across the Achilles, because then it would be in half. From the description is it running along the length or around the circumference? I don't understand that part
FamousAgg
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This has been an intermittent issue, it will swell up maybe once every twelve months or so, and I can rest it for a few weeks and it's like there is no issue.

I did go back to the original surgeon years ago, and I was told that he only does shoulder surgery now and was referred to one of his PAs. Basically ended up doing PT for a few weeks and back to normal.
bigtruckguy3500
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Interstitial tears run along the axis. Think of the tendon as a bunch of fibers running parallel to each other. Basically they're starting to separate.

That's kinda rude of the surgeon. He should've at least taken ownership of his work, and worst case referred you to another surgeon.

My suggestion would be to continue PT well past resolution of symptoms, as it sounds like you're getting partial healing with rest or PT. Then be sure to continue the PT exercises as part of your normal workout routine. Supposedly eccentric loading will be good for your achilles.
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