Abstract: Aim: was to evaluate possibilities of using of ultrasound classification of subcutaneous rupture of the Achilles tendon (AT) for hospital clinical practice. Materials and methods: we examined 11 patients (9 men and 2 women). Clinical and X-ray examinations were done. Ultrasound examination was done by the standard method; modern sonographic classification of the rupture of AT was done with functional probe Results: clinical signs of subcutaneous rupture of AT were obtained in each patient. According to sonographic classification, complete AT rupture was found in 27,2% patients (3 of 11), incomplete rupture was found in 72,8% (8 of 11). Tendinosis signs were found in 37,5% patients (3 of 8) with incomplete rupture. Conclusions: obtained data prove the effectiveness of ultrasound method of diagnosis of subcutaneous rupture of AT, in detection various variants of its trauma. It is important for optimization of treatment strategy. References 1. Hess G.W. Achilles tendon rupture: a review of etiology, population, anatomy, risk factors, and injury prevention. Foot Ankle Spec. 2010; 3(1): 29-32. 2. Jarvinen T.A., Kannus P, Paavola M. et al. Achilles tendon injuries. Curr. Opin. Rheumatol. 2001;13(2): 150-155. 3. Schepsis A.A., Jones H., Haas A.L. Achilles tendon disorders in athletes. Am. J. Sports Med. 2002; 30(2): 287-305. 4. Miller T.T. Common tendon and muscle injuries: lower extremity. Ultrasound Clin. 2007; 2(4):595-615. 5. Es'kin N.A. Ul'trazvukovaja diagnostika v travmatologii i ortopedii [Ultrasound diagnostics in traumatology and orthopedics]. M.: Social'no-politicheskaja mysl'. 2009; 440 s [In Russ]. 6. Robinson P Sonography of common tendon injuries. Am. J. Roentgenol. 2009;193(3): 607-618. 7. Hartgerink P, Fessell D.P, Jacobson J.A., van Holsbeeck M.T. Full versus partial-thickness Achilles tendon tears: sonographic accuracy and characterization in 26 cases with surgical correlation. Radiology. 2001; 220(2):406-412. 8. Paavola M., Paakkala T., Kannus P, Jarvinen M. Ultrasonography in the differential diagnosis of Achilles tendon injuries and related disorders. A comparison between pre-operative ultrasonography and surgical findings. Acta Radiol. 1998;39(6):612-619. 9. Nielsen M.B. Musculoskeletal ultrasound in an European Journal. Ultraschall in der Medizin. 2006; 27(6): P533-534. 10. Gibbon W.W., Cooper J.R., and Radcliffe G.S. Sonographic incidence of tendon microtears in athletes with chronic Achilles tendinosis. The British Journal of Sports Medicine. 1999; 33(2):129-130. 11. Grechenig W., Clement H., Bratschitsch G. et al. Ultrasonography of the Achilles tendon. Orthopade. 2002; 31(3):319-332. 12. Maffulli N. and Ajis A. Management of Chronic Ruptures of the Achilles Tendon. J. Bone Joint Surg. Am. 2008; 90(6):1348-1360. 13. Ballas M.T., Tytko J., Mannarino F. Commonly missed orthopedic problems. Am. Fam. Physician. 1998; 57(2): 267-274. 14. Nestorson J., Movin T., M^ler M., Karlsson J. Function after Achilles tendon rupture in the elderly: 25 patients older than 65 years followed for 3 years. Acta Orthop. Scand. 2000; 71: 64-68. 15. Wijesekera N.T., Calder J.D., Lee J.C. Imaging in the Assessment and Management of Achilles Tendinopathy and Paratendinitis. Seminar in musculoskeletal Radiology. 2011; 15(1): 89-100. 16. Koryshkov S.M., Platonov S.V. i dr. Lechenie zastarelyh povrezhdenij pjatochnogo (ahillova) suhozhilija [ Treatment of old lesions of Achilles tendon]. Travmatologija i ortopedija Rossii. 2012; 2 (64): 34-40 [In Russ]. 17. Amlang M.H., Zwipp H., Friedrich A. et al. Clinical Study. Ultrasonographic Classification of Achilles Tendon Ruptures as a Rationale for Individual Treatment Selection. International Scholarly Research Network ISRN Orthopedics Volume, 2011, Article ID 869703, 10 pages doi:10.5402/2011/869703. 18. Bertolotto M., Perrone R., Martinoli C. et al. High resolution ultrasound anatomy of normal Achilles tendon. Br. J. Radiol. 1995; 68(813): 986-991. 19. Kainberger F.M., Engel A., Barton P., Huebsch P. et al. Injury of the Achilles tendon: diagnosis with sonography. Am. J. Roentgenol. 1990;155(5):1031-1036. 20. Koivunen-Niemela T., Parkkola K. Anatomy of the Achilles tendon (tendo calcaneus) with respect to tendon thickness measurements. Surg. Radiol. Anat. 1995; 17(13):263-268. 21. Bleakney R.R., White L.M. Imaging of the Achilles tendon. Foot Ankle Clin. 2005;10(2):239-254. 22. Daftary A., Adler R.S. Sonographic evaluation and ultrasound-guided therapy of the Achilles tendon. Ultrasound Q. 2009; 25(3):103-110. 23. Crass J.R. van de Vegte G.L., Harkavy L.A. Tendon echogenicity: ex vivo study. Radiology. 1988; 167(2): 499-501. 24. McNally E.G. The development and clinical applications of musculoskeletal ultrasound. Skeletal. Radiol. 2011; 40(9): 1223-1231. 25. Bianchi S., Martinoli C., Gaignot C. et al. Ultrasound of the ankle: anatomy of the tendons, bursae, and ligaments. Semin Musculoskelet Radiol. 2005; 9(3): 243-259. 26. Webb J.M., Bannister G.C. Percutaneous repair of the ruptured tendo Achilles. J. Bone Joint Surg. Br. 1999; 81(5): 877-880. 27. Young J., Sayana K., McClelland D. et al. Percutaneous repair of acute Achilles tendon. Tech Foot Ankle Surg. 2006; 5(1): 9-14. 28. Ebeling T., Farin P., Pyorala K. Ultrasonography in the detection of Achilles tendon xanthomata in heterozygous familial hypercholesterolemia. Atherosclerosis. 1992; 97(2-3): 217-228. 29. Maffulli N., Regine R., Angelillo M. et al. Ultrasound diagnosis of Achilles tendon pathology in runners. Br. J. Sports Med. 1987;21(4):158-162. 30. Giacomozzi C., D’Ambrogi E., Uccioli L, Macellari V. Does the thickening of Achilles tendon and plantar fascia contribute to the alteration of diabetic foot loading? Clin. Biomech. 2005; 20(5): 532-539. 31. Brountzos E., Syrgiannis K., Panagiotou I. et al. Ultrasonographic alterations in Achilles tendon in relation to parathormone in chronic hemodialysis patients. J. Nephrol. 2009; 22(4):476-483. 32. Genc H., Cakit B.D., 33. Buckwalter J.A. Pharmacological treatment of soft-tissue injuries. J. Bone and Joint Surg. 1995; 77 (appl): 1902-1914. 34. Fornage B.D. Achilles tendon: US examination. Radiology. 1986;159(3):759-764. 35. Abate M., Silbernagel K.G., Siljeholm C. et al. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res. Ther. 2009; 11 (3)doi: 10.1186/ ar2723. 36. Zanetti M., Metzdorf A., Kundert H.P. et al. Achilles tendons: clinical relevance of neovascularization diagnosed with power Doppler US. Radiology. 2003; 227(2):556-560. 37. Nazarian L.N. The top 10 reasons musculoskeletal sonography is an important complementary or alternative technique to MRI. AJR Am. J. Roentgenol. 2008; 190(6): 1621-1626. 38. Kainberger F., Mittermaier F., Seidl G. et al. Imaging of tendons: аdaptation, degeneration, rupture. Eur. J. Radiol. 1997; 25: 209-222. 39. James S.L., Bates B.T., Osternig L.R. Injuries to runners. Am. J. Sports Med. 1978; 6(2): 40-50. 40. Paavola M., Kannus P., Jarvinen T.A. et al. Achilles tendinopathy. J. Bone Joint Surg. Am. 2002; 84A(11): 2062-2076. 41. Khan K.M., Forster B.B., Robinson J. et al. Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two year prospective study. Br. J. Sports Med. 2003; 37:149-153. 42. Asplund C.A., Best T.M. Achilles tendon disorders. BMJ. 2013; 346:f1262 doi: 10.1136/bmj.f1262 43. Kuwada G.T. Classification of tendo Achillis rupture with consideration of surgical repair techniques. J.Foot Surg. 1990; 29(4): 361-365. 44. Thompson J., Baravarian B. Acute and Chronic Achilles Tendon Ruptures in Athletes. Clin. Podiatr. Med. Surg. 2011; 28(1):117-135
