Hydrodissection of an Achilles Tendinopathy on a Professional Athlete

Hydrodissection of an Achilles Tendinopathy on a Professional Athlete

Abstract

We report a case of Achilles tendinosis that was treated with a high volume, hydrodissection visualized by conventional B-mode ultrasound. Prior MRI revealed a thickened right Achilles tendon with a small defect. Ultrasound examination showed a thickened Achilles tendon with physical exam revealing a prominent Haglund's deformity, mild fusiform swelling and pain along the posterior Achilles (Figure 1 & 2). The condition had been poorly responsive to standard management including protected ambulation in a cam walker boot, anti-inflammatory medication, modalities and therapeutic exercise, as well as a platelet rich plasma injection. We suggest using high volume ultrasound guided injection adjacent to (anterior to) the Achilles tendon as an adjunct to treat this difficult clinical syndrome.

Abstract

We report a case of Achilles tendinosis that was treated with a high volume, hydrodissection visualized by conventional B-mode ultrasound. Prior MRI revealed a thickened right Achilles tendon with a small defect. Ultrasound examination showed a thickened Achilles tendon with physical exam revealing a prominent Haglund's deformity, mild fusiform swelling and pain along the posterior Achilles (Figure 1 & 2). The condition had been poorly responsive to standard management including protected ambulation in a cam walker boot, anti-inflammatory medication, modalities and therapeutic exercise, as well as a platelet rich plasma injection. We suggest using high volume ultrasound guided injection adjacent to (anterior to) the Achilles tendon as an adjunct to treat this difficult clinical syndrome.

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