Musculoskeletal imaging: Achilles tendinosis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Musculoskeletal imaging: Achilles tendinosis

Sample item

A runner has chronic posterior heel pain with thickening of the tendon about 4 cm above its insertion. What does ultrasound typically show?

AFusiform thickening with hypoechoic areas and loss of the fibrillar patternBEchogenic foci with posterior acoustic shadowing in the tendon sheathCAn anechoic collection beneath the calcaneusDA fluid-filled gap between retracted tendon ends

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Fusiform thickening with hypoechoic areas and loss of the fibrillar pattern

Achilles tendinosis is degenerative, with fusiform thickening, hypoechoic areas and loss of the normal fibrillar echotexture, sometimes with neovascularity on Doppler. A complete rupture shows a gap between retracted ends.

Option by option

A. Fusiform thickening with hypoechoic areas and loss of the fibrillar pattern (correct)
Correct. Fusiform thickening with hypoechoic degeneration and a disrupted fibrillar pattern is typical of tendinosis.
B. Echogenic foci with posterior acoustic shadowing in the tendon sheath
Echogenic foci with shadowing indicate calcification, a different process from tendinosis.
C. An anechoic collection beneath the calcaneus
An anechoic collection beneath the calcaneus suggests a bursitis, not tendon degeneration.
D. A fluid-filled gap between retracted tendon ends
A fluid-filled gap between retracted ends indicates a complete tendon rupture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Fusiform thickening with hypoechoic areas and loss of the fibrillar pattern. Achilles tendinosis is degenerative, with fusiform thickening, hypoechoic areas and loss of the normal fibrillar echotexture, sometimes with neovascularity on Doppler.

Why is "Echogenic foci with posterior acoustic shadowing in the tendon sheath" not the answer?

Echogenic foci with shadowing indicate calcification, a different process from tendinosis.

Why is "An anechoic collection beneath the calcaneus" not the answer?

An anechoic collection beneath the calcaneus suggests a bursitis, not tendon degeneration.

Why is "A fluid-filled gap between retracted tendon ends" not the answer?

A fluid-filled gap between retracted ends indicates a complete tendon rupture.

What concept does this question test?

It tests Musculoskeletal imaging: Achilles tendinosis in Radiology. A complete rupture shows a gap between retracted ends.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Musculoskeletal imaging: Achilles tendinosis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.