Bad news? Breaks take less time to heal that tendons and ligaments.

Sorry to hear about it.

-Jot

Definitely bad news - I would much rather break my ankle than deal with a PT tendon tear. How was this diagnosed, X-ray? PT tendonitis/opathy does OK in orhtotics, but tears (esp if larger than 2.5cm) do not and usually require more immobilization (boot) or even surgical repair.

Good luck!

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

This was diagnosed by MR.

I'm not sure of the extent of the tear, but in his voicemail to me, he was talking about going the othortics route.

I will know more tomorrow.

Thanks for the replies!!!

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Breakfast is for Closers

Hi rroof, how would anyone Dx a tendon tear from a radiograph? And btw, how do you feel about diagnostic ultrasound? I'm thinking of purchasing a machine and getting trained. I've heard good things. I'm curious to see what others think.

P.S. I can't help thinking that you believe in the importance of biomechanics.
P.P.S. I am a maniacal cycling fan.

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I love France. I just hate Toulouse. I'd really hate to lose le Trek.

Was going to ask why are asking this since you can't then I read my post! Meant to type MRI :)

I have been using diagnostic ultrasound for a while now. I have 2 different machines (depending upon what office I'm at). There is a HUGE learning curve (the training helps very little - experience mostly). Works great for things like this, not so much for nerve related issues or more subtle things on most machines. My smaller, portable machine can't give the same fine detail as my 12.5 Mhz color one with 17" screen (but they are 50K each - most are 8-12K). I have 5 offices, so do the math :) I find people well versed in the complicated anatomy of an area (foot and ankle especially) do better as a diagnostician than others. Surgeons do particularly well since they have first hand knowledge because of their training/experience. Radiologist do great as well because of their unique training and the way they see/look at things.

I mostly use this as a screening tool for highly suspicious tendon tears (except achilles - those are easy to see!) and still rely on MRI if I'm contemplating surgery. They work very well though for foreign bodies, ganglion injections/draining, nerve blocks, most tendonopathies, DVT screening, etc.

Yup - I'm a firm proponent in human biomechanics on both a personal and professional level :0

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

I'd love to pick your brain. It's great that you take the time to post here. It's a treat for me. Thanks for the US tips. No one in my area of the world seems to do this technique. Patients have to go a few hours to the nearest big city for it. That's why I think I could make it work where I am. One more question--how fine a detail (i.e. resolution) can you get? Could you see, for example, damage to a cervical spine facet cartilage with your 12.5 MHz? colour machine?

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I love France. I just hate Toulouse. I'd really hate to lose le Trek.

You can PM me for any details re: the ultrasound machine itself and/or the company I use (they are out of Indy right near Zipp wheels to put it in cycling terms) ;)

I don't think you can really see detail on a joint/facet like you are asking. There is an inverse relationship between depth of penetration (need low frequency) and detail (high frequency). Can't have both, so a good exam is a constant changing of parameters/settings. An MRI (especially the new 3D reconstruction ones) or newer CT can REALLY show great detail that an US just can't. However, a US can show motion in real time which is excellent for joint congruity/capsule injuries, tendon motion/tears, that static images can't.

Anesthesia at one of my hospitals uses a fairly cheap ultrasound to guide spinal blocks, but I don't know of anyone using DUS for much bone/joint work, esp complex areas like the spine.

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD