Clarius Classroom

Achilles Tendon Ultrasound Evaluation

Dr. Christopher 'CJ' Miller

In this Clarius Classroom video, CJ Miller from Frontline Function provides a step-by-step demonstration of how to evaluate the Achilles tendon using a musculoskeletal ultrasound.

Key Highlights

Initial Assessment: The exam begins with physical palpation to check for tenderness, sensitivity, and volume differences between the two tendons.

Patient History: The patient, Mike, has a surgical history for an Achilles rupture on one side and is currently experiencing mid-tendon tenderness on the opposite (left) side.

Scanning Technique: Miller uses a Clarius handheld scanner to examine the superficial tendon structures, pointing out visible stitches and expected tissue thickening on the surgical side.

Advanced Imaging Features: The practitioner utilizes Doppler ultrasound to check for blood flow—which acts as an indicator of healing and inflammation—and an AI tool to automatically measure the tendon’s thickness, capturing a measurement of 5.55mm.

Dynamic Stress Testing: The video concludes by demonstrating a major advantage of ultrasound: the ability to observe and capture video of the tendon while it is actively being stressed and moved.

Specialties: MSK, Physiotherapy
Applications: Achilles, MSK

07:55
–
09:17
So Doppler picks up on blood flow. So Doppler would pick up on a vessel. So if you looked at like a vein or an artery, it would pick up on that. But oftentimes after an injury there is um, inflammation. Just like if you got a cut on your skin and it would turn red and your body would heal it and scab it over, um, and send new blood to that area.
The same thing happens in your tendons, except tendons typically don't have a lot of vascular to them. So then as they're healing, uh, we'll see this increase in Doppler blood flow to a tendon that's healing. So it's just a sign of inflammation. And oftentimes that does correlate with like people who are in um, maybe pain kind of all the time.
So you're getting a lot of pain with activity. And if I make you hop and jump, but you're not achy when you're just lying here and I don't see a ton of Doppler, um, either, which is good. So that means that there's not a significant inflammatory process happening within that tendon. Um, I will compare it back to your other side, because I think it'd be interesting to see, um, if and how your body is still kind of healing the, um, surgical side.
So we're going to take some pictures and we can actually use, um, we can look side to side and
09:19
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09:28
take some side by side pictures. I think it's interesting to look at, um, your surgical side compared to the other side. We'll jump back and forth here.
09:39
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09:40
Perfect.
09:45
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09:49
And we'll do that one more time. Closer to where your pain is.
10:12
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10:14
Sweet. We'll take some measurements now,
10:15
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10:20
and I'm going to use this AI function to highlight that tendon.
10:22
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10:27
And we'll have it give me the thickest part which tells me this over here. I'll move that over a little bit.
10:32
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10:41
Perfect. Measuring about 5.5cm. No, 5.55mm here.
10:44
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10:45
And.
10:48
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10:50
See if this picks up your surgical side.
10:53
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10:57
Like I said, it's normal for things to look quite different after a surgery.
11:02
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11:07
I don't think there's there's no it's not okay. Let me get out of that and then we'll go. In this case,
11:09
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11:12
I might struggle a little bit here. Oh, there we go.
11:18
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11:19
Okay.
11:23
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11:26
Sweet. All right. We'll take a few more pictures and videos here.
11:29
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11:31
Freeze. Capture image.
11:32
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11:33
Unfreeze
11:35
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11:37
capture video.
11:48
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11:50
Perfect. Let's do that. One more on the other side.
11:55
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11:58
Freeze. Capture image.
11:59
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12:02
Unfreeze capture video.
12:15
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12:18
All right, last things we'll look at here, which is
12:19
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12:27
a huge advantage of ultrasound is the ability to actually stress your tendons while we're looking at it. So you can just stay totally relax I'm going to move you capture video.
12:36
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12:37
Okay.
12:38
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12:42
look up here at your surgical site capture video.
12:53
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12:55
And we'll look at your other side.
12:58
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13:00
Capture video.
13:13
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13:15
And one more time. Capture video

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