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Achilles Tendinopathy by Mika Paavola, Pekka Kannus, Tero A.H. Järvinen, Karim Khan, Lászlo Józsa, and Markku Järvinen J Bone Joint Surg Am Volume 84(11):2062-2076.

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Presentation on theme: "Achilles Tendinopathy by Mika Paavola, Pekka Kannus, Tero A.H. Järvinen, Karim Khan, Lászlo Józsa, and Markku Järvinen J Bone Joint Surg Am Volume 84(11):2062-2076."— Presentation transcript:

1 Achilles Tendinopathy by Mika Paavola, Pekka Kannus, Tero A.H. Järvinen, Karim Khan, Lászlo Józsa, and Markku Järvinen J Bone Joint Surg Am Volume 84(11):2062-2076 November 1, 2002 ©2002 by The Journal of Bone and Joint Surgery, Inc.

2 Myofibroblast in the paratenon of the Achilles tendon. Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

3 Lysis of the collagen fiber can be seen around degenerated tenocytes in Achilles tendinopathy (Masson trichrome staining, ×300). Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

4 Only a few unconnected collagen fibers are visible in the mucoid degeneration (asterisks) located inside the Achilles tendon. Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

5 Calcium deposits (black) have been precipitated on the surface of the collagen fibers in the calcifying tendinopathy of the Achilles tendon (transmission electron microscope, ×6800). Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

6 Tendolipomatosis in Achilles tendinopathy. Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

7 Obliterative arteritis (thin arrows) and venous proliferation with periphlebitis (thick arrow) are visible in the paratenon of patients with chronic Achilles tendinopathy (hematoxylin and eosin, ×100). Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

8 Longitudinal ultrasound image of an Achilles tendon with intratendinous changes. Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

9 Figs. 8-A and 8-B Longitudinal (Fig. 8-A) and transverse (Fig. 8-B) T2-weighted gradient echo magnetic resonance images of Achilles tendinopathy demonstrate thickening of the tendon and signal changes within the Achilles tendon. Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

10 Photograph of a patient with chronic Achilles tendinopathy, demonstrating a tender, nodular swelling (arrows) that moved as the ankle was dorsiflexed and plantar flexed. Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.

11 This patient had an intratendinous necrotic focus, which was excised and sent for histopathologic analysis. Mika Paavola et al. J Bone Joint Surg Am 2002;84:2062- 2076 ©2002 by The Journal of Bone and Joint Surgery, Inc.


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