In our experience of diagnostic musculoskeletal ultrasound we have scanned hundreds of Achilles tendons, but we have never scanned an Achilles which measures nearly 22mm. The tendon is grossly thickened with multiple tendon defects and significant vascularity on power doppler likely representing neovascularisation. Normally, an Achilles tendon only measures 4-5 mm!
Figure 1. Severe mid portion Achilles tendinopathy
Figure 2. Severe mid portion Achilles tendinopathy
Figure 3. Inflammation evident on power doppler mid portion Achilles tendinopathy
Figure 4. Severe mid portion Achilles tendinopathy transverse view
