Research On Correlation Between Image Features And Operation Selection Of Achilles Tendon’s Enthesiopathy

Objective:Discuss the correlation between the image performance and clinical operation mode of the Achilles tendon’s enthesiopathy.Methods:collect the clinical and image data of 28 cases of the Achilles tendon’s enthesiopath patients who have treatment failure in 4-6 months’ expectant treatment and select the operative treatment finally from February 2014 to February 2017.All patients have been subject to the X-ray radiography in adem position of the ankle joint and MRI plain scan of ankle joint.Two physicians with rich experience of Radiology Department analyzed the clinical and iconography inspection data,and discussed the iconography performance characters of the Achilles tendon’s enthesiopathy,and summarized the reference significance of such characters on clinical operation mode selection.Results:(1)Imaging findings:The result indicates that 3 cases of 28 patents have disease in both feet,and the rest are subject to disease in single feet.15 cases of left foot and 16 cases of right foot.20 male cases and 8 female cases.X-ray film in side position of the ankle joint:22 cases(71%)are of calcaneus Haglund malformation;28 cases(90.3%)of visible calcification in waking line area in the Achilles end.MRI:28 cases of enlargement of the Achilles tendon(90.3%);28 cases(90.3%)of denaturation of the Achilles tendon;24 cases(77.4%)of upper synovitiscapsulitis;8 cases(25.8%)of edema of Achilles tendon;8 cases of edema of calcaneal tubercle marrow.11 cases have abnormal magnetic reasonablesignal of Achilles tendon end located in the partial tibial side of the center line of the Achilles tendon,7 cases in partial phil side of the center line of the Achilles tendon,and 13 cases in center line area of the Achilles tendon.The distance between the most upper end to the attachment point of Achilles tendon bone is about 15.2mm-82mm,and the mean value is about 35.7±14.9mm.(2)Operation mode:10 cases of 31 cases received the clean-up and stop-point reconstruction operation in the Achilles tendon end;7 cases received the calcaneal bone cutting,stop-point reconstruction of Achilles tendon and bursa mucosa cutting operation;7 cases received the calcaneal bone cutting,Achilles tendon repair and bursa mucosa clearing operation.Conclusions:The thickening,denaturation,calcification of Achilles tendon end and the upper synovial membrane inflammation are the key points for the imaging diagnosis of the Achilles tendon’s enthesiopathy,and the Haglund malformation of Achilles tendon is the important cause of the Achilles tendon’s enthesiopathy.The imaging characteristics of the Achilles tendon’s enthesiopathy are of important reference significance to the selection of operation mode to such disease.