SM Musculoskeletal Disorders Gr up SM How to cite this article Babaei-Ghazani A, Ebadi S, Forogh B and Eftekharsadat B. Sonographic Diagnosis of Acute Achilles Tendon Tear: A case report. SM Musculoskelet Disord. 2016; 1(1): 1002. https://dx.doi.org/10.36876/smmd.1002 OPEN ACCESS ISSN: 2576-5442 Introduction Complete ruptures of the Achilles tendon occur relatively infrequently and it has a disabling efect on the level of function and gait. Prompt diagnosis and operative repair continued with rehabilitation is required to assure an optimal result. We present a case of complete achilles tendon tear in a patient, using Ultrasonography (US) with accuracy and efciency in a dynamic real-time property and cost-efective manner. Case presentation A 41-year-old man referred to our physical medicine and rehabilitation department with mild swelling and pain in posterior portion of lef ankle and lower one third of posterior leg. He stated that 7 days prior to his visit he had a mild kick to his posterior leg during a non-professional friendly sport activity. During seven days he had limping and only used 400 mg of Ibuprofen and Ice pack for frst 48 hours with continuing his daily work. His past medical history was negative for any acute or chronic disease. He had no allergies, had never smoked cigarettes and had never consumed alcoholic beverages. He was working in a sedentary ofce work, and did have regular sport activity including jugging and football. Physical examination of his lef leg and ankle demonstrated a deformity in the contour of the achilles tendon and gastrocnemius-soleus muscle. Tere was no signifcant ecchymosis. He was unable to toe walking in the afected side. At the rest the lef ankle was in mild dorsifexion in compare to right side (Figure 1). Tere was an obvious plantar fexion weakness with 4/5 power in Manual Muscle Testing (MMT) and no tendon was palpable in middle third of actual tendon site. Dorsifexion MMT was 5/5. His lef ankle active Range Of Motion (ROM) was 35 degrees in plantar fexion, 20 degrees in dorsifexion. Passive ROM was normal. His right achilles tendon and gastrocnemius-soleus muscle had normal contour and palpation. He had plantar and dorsifexion power 5/5. His right ankle active and passive ROM was 50 degrees in plantar fexion, 20 degrees in dorsifexion. Functions of Tibial, Deep Peroneal, Sural, Saphenous, Superfcial Peroneal, Medial and Lateral plantar nerves were intact on both sides, and the vascular status was normal. We performed the palpation test [1], a recommended test and position to observe diferences in the contour and shape of the achilles tendon. Tis test is performed by having the patient lied in the prone position with the feet extending over the edge of the examining table. Tis action permits maximum relaxation of the achilles tendon in its resting position. Te examiner gently palpates the contour of tendon and looking for a gap and tenderness. Tis test was positive only in the lef side. Te Tompson 1 test, used in the assessment of Achilles tendon rupture was also positive in lef side. In the Tompson test, the examiner provides squeezing the calf muscle and looking for plantar fexion of the foot. Te test result is considered positive when no plantar fexion produced with this maneuver. Tompson test was positive only in the lef side. Tests for lumbosacral radiculopathy and sensory tests were normal bilaterally. Case Report Sonographic Diagnosis of Acute Achilles Tendon Tear: A Case Report Arash Babaei-Ghazani 1,2 , Safoora Ebadi 1,2 , Bijan Forogh 1,3 and Bina Efekharsadat 4 * 1 Neuromusculoskeletal Research center, Iran University of Medical Sciences, Tehran, Iran 2 Assistant professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 3 Associate professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 4 Associate professor of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Article Information Received date: Jul 02, 2016 Accepted date: Aug 09, 2016 Published date: Aug 11, 2016 *Corresponding author Bina Eftekharsadat, Physical Medicine and Rehabilitation Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Daneshagh Street, Tabriz, Eastern Azerbaijan, Iran, Tel: +98(411)3845526, +989143153011; Fax: +98(411)3373970; Email: dr.corresponding@gmail.com Distributed under Creative Commons CC-BY 4.0 Keywords Achilles; Tendon rupture; Ultrasonography Article DOI 10.36876/smmd.1002 Abstract Achilles tendon is a common site of foot and ankle discomfort but its rupture is not frequent. It’s a superfcial tendon and this lends it to excellent evaluation by sonography instead of magnetic resonance imaging. Recently ultrasonography has been widely used in musculoskeletal practice. We present a case of Achilles tendon ruptures diagnosed based on fundamental sonographic fndings.