Presentation
Posterior ankle pain radiating up calf after jumping.
Patient Data
No fracture. No malaligned. Abnormal lucency centered on the distal gastrocnemius muscle with increased density of Kager's fat pad is suspicious for soft tissue injury.
Comparison x-ray demonstrates that the lucency at the Achilles myotendinous junction is new.
Achilles tendon is completely ruptured at the myotendinous junction, approximately 5 cm proximal to its insertion. The gap measures 3 -4 cm and is filled with blood.
Cropped and zoomed ankle x-ray with the panoramic ultrasound cropped and rotated to demonstrate the Achilles rupture on the x-ray.
Case Discussion
An example of not forgetting the soft tissue on x-rays although, in this case, there was high clinical suspicious for Achilles tendon rupture and the patient would have proceeded to appropriate imaging regardless.
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