Bedside Ultrasound Diagnosis of Complete Achilles Tendon Tear in a 25-Year-Old Man with Calf Injury

Use of point-of-care ultrasound in a low-resource setting to diagnose Achilles tendon rupture and avulsion fracture of the calcaneal bone

BACKGROUND

Point-of-care ultrasound (POCUS) is becoming more prevalent in recent years for evaluating patients presenting with musculoskeletal injuries in the emergency department (ED). This imaging modality has been utilized to diagnose soft tissue and bony injuries accurately, obtain appropriate consultation, and perform timely interventional procedures in the ED.

CASE PRESENTATION

We present the case of a 55-year-old man who presented to the ED with significant left ankle pain following a ground-level fall. His physical examination showed swelling and tenderness around the ankle. POCUS examination aided the rapid and accurate detection of acute Achilles tendon rupture.

CONCLUSION

This case demonstrates that POCUS is a valuable diagnostic tool in evaluating patients with a suspected Achilles tendon rupture, especially in a resource-limited setting.

Point-of-Care Ultrasound Diagnosis of Achilles Tendon Rupture in Pediatric Patients

ABSTRACT

Achilles tendon injuries are common in the adolescent population, particularly in individuals who participate in sports. The diagnosis of Achilles tendon rupture can be missed on clinical examination in 20% to 30% of patients. In the adult literature, there are several case reports describing the diagnosis of Achilles tendon rupture by point-of-care ultrasound POCUS. There is currently no literature examining POCUS for the diagnosis of Achilles tendon rupture in pediatric patients. This case series describes 2 pediatric patients who were diagnosed with Achilles tendon rupture by POCUS.

A Step in the Right Direction: Point-of-Care Ultrasound as an Evaluation Tool of Achilles Tendon Injuries in the Emergency Department

This report describes the diagnosis of an Achilles tendon tear in a female patient with an inconclusive physical exam, which was limited by the patient’s body habitus. Expedient use of point-of-care ultrasound supported the diagnosis of an Achilles tear with findings of a tendinous defect, fibrous stranding, and surrounding anechoic fluid, suggestive of localized hemorrhage. The patient was splinted in plantar flexion and had prompt orthopedic referral with MRI that verified Achilles tear.

Ultrasound Imaging of Orthopedic Injuries

With the high cost and limited availability of gold standard imaging modalities, ultrasound has become an alternative in many musculoskeletal (MSK) injuries. Ultrasound has become increasingly portable and readily available in many acute care settings. Its ability to diagnose MSK injuries and help guide management has the potential to improve patient safety and flow. Ultrasound has been shown to diagnose fractures, dislocations, and tendon and ligament injuries. It helps guide fracture and dislocation reductions and aids in regional anesthesia for pain management. This article reviews the common MSK injuries that can be diagnosed with ultrasound with a focus on point-of-care ultrasound.