The spectrum of tears ranges from microtears to interstitial tears (parallel to the long axis of the Achilles), to partial tears, and eventually to complete tears (ruptures).
Typically, in a young 'normal' individual, the Achilles tendon ruptures in the 'critical zone’, which is a region of relative watershed hypovascularity 2-6 cm proximal to insertion.
The Achilles tendon tear classification is primarily based on the degree of retraction.
Appearances can vary:
- a full-thickness tear often shows a tendinous gap filled with edema or blood
- complete rupture shows retraction of tendon ends
- T2: partial thickness or interstitial tears may show a high signal on long TR, and tendon swelling to >7 mm AP
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