Sag PDFS
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Sag T1 arrows shows old healed osteotomy
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Cor T2FS
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Ax PDFS
The referrer requested assessement of Achilles (specified “posterior tendon”) healing, now 8 months after FHL transfer for Achilles rupture.
In the T1-weighted image you can see a healed calcaneal osteotomy, and there is suture artifact around the distal achilles, related to a more remote Haglund’s procedure which pre-dated the complete tendon rupture in the hypovascular zone.
Now 8 months out, there is some intrasubstance bright T2 signal at the anterior insertion of the FHL onto the posterosuperior calcaneus, surrounding a bioabsorbable screw, possibly reaction to the screw degradation.
I am both surprised that the referrer wants to evaluate healing of the native achilles, and that there is persistent bright T2 signal in a >3cm achilles defect so long after the initial injury.
Isn’t the FHL now replacing rather than augmenting the achilles in this instance?
Why is it important to assess healing of the achilles defect?
Hilary Umans
