Duration
An MRI of the Achilles tendon is a relatively short examination because the area to be examined is not large. With the patient positioned (so that he or she lies as comfortably and still as possible during the examination) and depending on how many series of images are taken, the examination should not take longer than 20-30 minutes.
Costs
The costs for an MRI of the Achilles tendon are based on the German scale of fees for physicians (GOÄ) for privately insured patients and the Uniform Assessment Scale (EBM) for those with statutory health insurance. According to the GOÄ, an examination of extremities (arms or legs) may be charged between 139.89 € and 251.80 €. Surcharges may be added for special imaging techniques (58.29-104.92 €), the use of contrast medium (58.29 €) or computer calculations (46.63 €). The MRI of the Achilles tendon can be billed at 126.59 € for patients with statutory health insurance according to the EBM.
Achilles tendon tear/rupture/partial tear
The Achilles tendon forms the end of the calf muscle (triceps surae) and is located at the heel bone. If a complete or incomplete tear (rupture) of the Achilles tendon occurs due to trauma or continuous stress, this is accompanied by severe, suddenly shooting pain and the typical sound of a “whip”. In addition, the area around the tendon may be swollen and reddened.
An uncomplicated method to visualize a torn or partially torn Achilles tendon is ultrasound. However, if the findings are unclear or the tendon cannot be adequately visualized, an MRI is the method of choice. This is particularly useful because it allows the quality of the tendon to be assessed and possible surgery to be planned.
The MRI image shows the Achilles tendon as a black, smoothly bounded strand. A tear would show itself in a bright interruption of this tendon. The surrounding structures can also be displayed and assessed in the MRI image.
A partial tear is not always easy to distinguish from an irritation of the Achilles tendon (tendinosis) on MRI; thinning and irregularities of the tendon would rather indicate a partial Achilles tendon tear.Achillodynia describes a pain in the area of the Achilles tendon, which is caused by an irritation when the tendon is constantly overstrained. At the beginning, there is often an inflammation of the Achilles tendon. Achillodynia is characterized by an inflammatory swelling of the tendon, which can be visualized by MRI, as well as typical nodular thickening.
In advanced Achillodynia, necrosis, i.e. the death of parts of the tendon, can also occur. These necroses can appear in the MRI as bright spots in the otherwise dark tendon, but they can also calcify over time, which would then be indistinguishable from the tendon in the MRI. Ultrasound can then be used to better assess them. The MRI helps to assess whether there is a risk of rupture of the Achilles tendon, which increases with increasing calcification and, as a result, loss of extensibility.
