Machine Operation
Information for:
Zoom
TGC
Royal Imaging
Services
Gain
Power Doppler
Focus
Depth
- Shown above are some of the controls that are
used for an Achilles tendon scan to produce good
quality diagnostic images:
- Power Doppler –to show increase in vascularity in
the tendon and the surrounding tissues to check
for tendinitis (Colour Doppler can also be used).
- Focus is adjusted to produce a sharp image and in
some machine settings more than one focal zone
maybe used.
http://www.methodistorthopedics.com/achillestendon-problems
- Zoom button is normally used to visualize
pathology more closely. This helps in showing
extent and position of tear in the tendon.
- Depth is adjusted to fill the field of view (FOV)
with the region of interest.
- A high frequency transducer is used for better
penetration and resolution of the tendon fibers.
-
Gain/and TGC controls are set up so that the
image shows a more detailed fibrillar pattern of
the tendon and the surround tissues.
Phone: (08) 9522 4209
Fax: (08) 9522 4210
29 Prince Street
Perth, WA 6429
Achilles Tendon
Ultrasound Technique &
Protocol Adaptation
.
WWW.ROYALIMAGING.COM.AU
2015
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The Examination Room
Patient Position
- Dual screen for comparison – Achilles
tendon in transverse - ROI and

contralateral side.
Patient is asked to lie prone on the
examination table with both shoes off.
- Check for plantaris tendon, if not sure
compare with the other side but remember

Patient’s feet are slightly elevated to about
plantaris tendon can be found in only one
15 degrees and hanging off the edge of the
leg.
examination table to allow free movement
of feet during dynamic scanning as shown
in picture below.
- Extend examination accordingly in the
event of tendon rupture.
- Include evaluation of the calf muscles to
check for haematoma.
- Assess the veins for compressibility to rule
out possible DVT.
 The examination room is cleaned before a
patient is called. Any potential hazards are
removed from the room or packed securely in
a cupboard.
 Room is equipped with clean towel and
enough gel to last the entire examination. A
blanket is made available to cover up patient
if there is need.
 Patient is brought into the examination room
where the Sonographer confirms patient’s
name and date of birth as well as type of
examination required.
 Clinical history is obtained from the patient
to correlate with the General Practioner’s
clinical notes.
 Examination procedure is explained to the
patient and a verbal consent obtained.
 Good communication skills are exhibited
during the entire procedure to ensure
patient’s comfort.
** - As part of examination technique,
Sonographer position is also important **


Patient is asked to point to the region of
- Sonographer has to be seated very close to
interest (ROI) and Sonographer checks for
the feet and machined pulled closer with
obvious skin changes or swelling.
examination table at a comfortable height
Sonographer wears a glove or gloves,
such that the arm is not over extended.
selects high frequency linear probe and
applies gel to ROI.
A scanning protocol used is as follows: - Long - musculotendinous junction, mid
REVISED MAY 2015
and insertion.
- Trans – mid and ROI
- Long – Achilles tendon and kagers fat pad
- Retrocalcaneal bursa
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