How to scan the Achilles Tendon using Ultrasound.
In this video, sonographer Milton Delves, demonstrates the achilles tendon ultrasound technique.
Probe positioning:
Make sure there is enough gel right over the heels especially when the skin surface is not flat to avoid any air gaps between the probe and the skin surface.
Place the probe longitudinal to show a long axis view of the Achilles tendon then slide up toward the calf muscles and then down along the axis towards the insertion into the heel bone.
By moving the feet up and down you can evaluate the tendon while in motion. The Achilles tendon is a cylinder like structure and should always appear hyperechoic with homogeneous fibers pattern along its axis.
Angle the probe 90 degrees to get the transverse (Short) view and repeat the scan from the beginning of the calf muscles to the insertion over the calcaneus to make sure no findings were missed in the longitudinal view.
Any swelling will be identified by an increase in tendon thickness accompanied by a mild hypoechoic (dark) areas and slight loss of fibrillar pattern.
Also pay attention to any areas of fluid collection which may occur around the tendon or in the bursa.
Finally the power or colour doppler should be used to check for areas of hyperaemia.