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How can I determine the extent of alkalis tendon tear?

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Internal Medicine Specialist
Practicing since : 2000
Answered : 1417 Questions
I have been diagnosed with a partial tear of the alkalis tendon and been placed in a cast in palter flexion for 6 weeks. At the time of the injury I did not experience any pain and also noticed discomfort on the medial aspect of the calf muscle. An utra sound was given with a result showing a "possible" 50% tear. 2 days leading up to the injury my alkalis tendon was sore and stiff. I am now wondering, now that I have rested for 2 weeks and have noticed that my tendon is now getting full activation when planter flexing in the cast ( I can put my hand down the back and feel the tendon contacting where it connects to my calf) wether I have in fact partially torn it or something less severe. Any ideas?
Posted Tue, 21 Jan 2014 in Blood Disorders
Answered by Dr. Sudhir 3 hours later
Brief Answer: It would be still be partial tear. Detailed Answer: Hello, Ultrasound is pretty reliable investigation when it comes to Achilles tendon injury. Partial tear can range from anything between few fibers torn to only few fibers left. Extent can be measured by thickness and area of tendon at site of tear. But since all such tears are treated same way, many times such quantification of tear might not be done. In most patient with partial tear after initial swelling and muscle spasm subsides they can move the tendon and feel it as tout structure. In fact untreated patients feel they are back to normal but more rest is desired for better healing. So feeling better in two weeks is not exact parameter which can help us know that tear was less than partial. Only thing which can help us know is review ultrasound. But I would suggest you, not to worry about the extent of partial tears as whether high or low grade.All such tears if treated well, will have same results.So dont get yourself worried and do follow all doctor's instructions till 6 weeks or even more if doctor says. Hope this helps.Please feel to ask if there are any doubts. Regards.
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Follow-up: How can I determine the extent of alkalis tendon tear? 1 hour later
My main concern is the comment made "possible partial tear" at the time of diagnosis. I had no swelling, no pain and no tenderness when examined. I was able to bear weight without discomfort but found it difficult to planter flex when standing, I have experienced this before when twisting my ankle. I did tell them that I had tenderness at the medial aspect of the calf but that was not investigated by ultrasound which frustrated me. I am concerned that this has been diagnosed correctly because this has put me out of work for the duration of the cast being on which = less pay which = inability to pay bills. stress stress. I am wondering if in fact I have done something to the tendon closer to the calf which never got investigated.
Answered by Dr. Sudhir 24 minutes later
Brief Answer: In that cases MRI would be the answer. Detailed Answer: Since the cast may prevent from getting ultrasound done you can consider getting a MRI done.It is costly but a better investigation than ultrasound. This will help to reach a correct diagnosis.If needed doctor might have to remove and redo the cast for this. MRI will also evaluate other ligaments of ankle in case that was cause of original symptoms. As its common to have multiple ligament injuries in ankle trauma. After MRI you would be in better position to decide about extent of rest needed. Hope this answers your question.
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