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Achilles insertional calcific tendinosis

Case contributed by Varun Babu
Diagnosis certain

Presentation

Long standing posterior ankle pain with recent aggravation and localized tenderness.

Patient Data

Age: 35 years old
Gender: Male

MRI ankle

mri

Thickened achilles tendon at it's insertion with intrasubstance PD hyperintense signals within the medial aspect. 

Two small intratendinous calcific foci - enthesophytes due to chronic repetitive stress identified in the altered signal fibers of the tendoachilles. 

Case Discussion

Repetitive microtrauma results in hemorrhage, intratendinous collagen degeneration and fibrosis , eventually culminating in calcific foci within the injured segment as a compensatory mechanism to counter the excess stress encountered. 

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