Case Study

ORTHO – Chronic bilateral achilles degeneration with partial rupture of deep calcaneal tendon in a 3 year old FS Mastiff

This 3 year old FS Mastiff dog presented with right hind lameness and swelling in the achilles region

Image Interpretation

Ultrasound of the left and right achilles –

Right:

Both portions of the deep calcaneal tendon – the gastrocnemius and the common calcaneal tendon – present a severe focal swelling proximal to the calcaneus. The affected area extends 3 cm proximal from the calcaneus. The maximum diameter is 2.5 cm. Marked loss of the fibre pattern, decreased echogenicity and heterogeneity is noted. A mild amount of anechoic fluid is interspersed between the tendon layers. The calcaneus presents marked modeling with an irregular concave surface. Multifocal mineralization is seen within the gastrocnemius and common calcaneal tendon.

Left:

Similar but less advanced changes are noted for the left deep calcaneal tendon. The affected area extands 2 cm proximal to the calcaneus and is 1 cm in diameter. The loss of fibre pattern is advanced here too. However mineralization and bony modeling of the calcaneus are not seen here yet

DX

The ultrasonographic findings are compatible with chronic bilateral degenerative partial rupture of the deep calcaneal tendon.

Outcome

The changes are more severe on the right side with advanced stages of degerenation, fibre disruption, avulsion and bony modeling. Loss of biomechanical stability has to be assumed for the right side.
Temporary fixation of the tarsal joint in a slightly extended position is indicated for the right side.
Consider physical treatment (including laser, shock wave therapy) as well as ultrasonographic monitoring of the tendon healing.
Progression of the changes has to be expected without treatment.