Semin Musculoskelet Radiol 2011; 15(1): 089-100
DOI: 10.1055/s-0031-1271961
© Thieme Medical Publishers

Imaging in the Assessment and Management of Achilles Tendinopathy and Paratendinitis

Nevin T. Wijesekera1 , James D. Calder2 , Justin C. Lee1
  • 1Department of Radiology, Chelsea and Westminster Hospital, London, United Kingdom
  • 2Department of Orthopaedic Surgery, Basingstoke and North Hampshire Hospital, Basingstoke, United Kingdom
Further Information

Publication History

Publication Date:
17 February 2011 (online)


Achilles tendinopathy is a common overuse injury in patients engaged in athletic activities. Tendon degeneration is often accompanied by paratendinitis. Radiologists are frequently asked to use imaging techniques to evaluate patients with problems at or around the Achilles tendon. The main imaging modalities used in the assessment of Achilles tendon disorders are plain radiography, ultrasound, and magnetic resonance imaging. In recent years, ultrasound has also been used to guide minimally invasive local treatments for Achilles tendinopathy, which may prevent the need for surgery if conservative treatments have failed. In this article, we review the imaging features of Achilles tendinopathy and consider the relative strengths and weaknesses of the various imaging techniques. The role of imaging in directing patient management is also discussed, with particular focus on ultrasound-guided treatments.


Justin C. Lee, M.R.C.S. , F.R.C.R. 

Department of Radiology, Chelsea and Westminster Hospital

369 Fulham Road, London SW10 9NH, UK