Ultrasound diagnosis and percutaneous treatment of Achilles tendon tethering: a case series

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• 作者：Lulu He ; Jason Genin ; Patricia Delzell
• 刊名：Skeletal Radiology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：45
• 期：9
• 页码：1293-1298
• 全文大小：4,428 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Orthopedics
  Pathology
  Nuclear Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-2161
• 卷排序：45

文摘

The purpose of this article is to report 3 cases of Kager’s fat pad scarring and tethering to the deep surface of the Achilles tendon in patients with Achilles tendinosis symptomatology. The 3 patients were diagnosed sonographically by the use of a dynamic maneuver we described and named the “Kager's squeeze” technique. The key finding for diagnosis is the deformation and bowing of the deep fibers of the Achilles tendon during dynamic squeezing of Kager’s fat pad. After diagnosis, the patients were treated with ultrasound-guided hydrodissection and scar release to restore normal motion between Kager’s fat pad and the Achilles tendon. All 3 patients experienced significant clinical improvement shortly after treatment. Therefore, we suspect that Kager’s fat pad scarring with Achilles tendon tethering may mimic or exacerbate Achilles tendinosis symptomatology and should be considered a possible diagnosis when conservative treatments for Achilles tendinosis fail. We demonstrate that Kager’s fat pad scarring with Achilles tendon tethering can be diagnosed and treated with a simple in-office hydrodissection technique, leading to improved patient outcomes.KeywordsUltrasound-guided hydrodissectionAchilles tendinopathyAchilles tendinitisKager’s fat padPre-Achilles fatAnkle pain