Focal swelling of AT and EHL tendon

[Xue Heng]

Hi, Steve.
This patient was a 38-year-old female with motor neuron disease, and she is now paralyzed.
The clinician fonund swelling of dorsal foot, and ask for US exam.
The US finding was simple, with focal hypoechoic change for AT and EHL tendon, and increased signal of Color Doppler.
She cannot walk by herself, so the focal swelling of AT and EHL tendon is not related to sport injury.
I just wonder is this related to motor neuron disease, or caused by other etiologies?
Thank you, Steve.

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[Stephen Bird]

Hi Xue,

I don’t have much experience in ultrasound for MND,

It looks like tendinosis of these two tendons,

But what is the cause of the tendinosis?

It can’t be overloading of the tendon unless there is some spasticity of the muscle bellies.

MND can give spasticity issues and i wonder if these muscles have spasticity issues overloading the tendons.

Is the neural dysfunction possibly the direct cause of the tendinosis?

Or is it related to the underuse?

I would value comments from anyone who has seen this in cases of MND before.

My first option would be to think it is related to MND spasticity issues of the muscle bellies leading to tendinosis degenerative changes in the tendons

Steve.

[Xue Heng]

Hi, Steve.
Thank you very much for giving me so many possibilities and explanations.
I learned a lot form your forums and your answers.
Thank you again.

[Stephen Bird]

My pleasure mate,

I am sorry I don’t have much experience with MND patients in my clinical practice.

Steve

[Xue Heng]

You have taught me a lot.
No one is master for everything.
Thank you, Steve.

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