Two views always help for evaluation of any X-ray finding and localize to the site of problem
Tendoachilles is the largest tendon in the body , spanning two joints and is subject to stress in daily activities (reaching upto 900kg in fast running at times ). Intense short use or prolonged overuse could result in degenerative changes of focal or diffuse variety leading to calcium deposition and is usually susceptible for rupture and degeneration 2-6 cms from site of insertion
Morris etal classified calcification in to 3 types for management techniques
ü type I-localised to tendon insertion and posterosuperior aspect of calcaneum
ü Type II-localised distal 1-3 cms of tendon
ü Type III-Intratendinous and involves most of it(IIIA) and all of it (IIIB)
Excision before other complications like rupture and ulcerations and bone infection etc would be preferred
X-ray true lateral is ideal with MR playing complementary role in evaluating other soft tissue structures. Presurgical doppler of the posterior tibial vessel is recommended
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