Fig 2.

Preoperative and postoperative T1-weighted magnetic resonance imaging (MRI) of the lateral view of the left calcaneus of a patient with insertional Achilles tendinopathy who underwent fluoroscopic and endoscopic calcaneal exostosis resection and Achilles tendon debridement. (A) Preoperative MRI. Calcaneal bone exostosis (black arrowhead), intratendon ossification (white arrowhead), and degenerative Achilles tendon (gray arrowhead) were visible. Before surgery, the surgeon should confirm the area of the Achilles tendon attachment (circle) and take care not to damage the portion of the attachment other than the exostosis during fluoroscopic resection of the exostosis. In addition, the surgeon should confirm the volume of the tendon at the level of the intratendon ossification (white arrows) and the range of the degenerated Achilles tendon (gray arrowhead) to be debrided. (B) MRI at 1 year after surgery. The calcaneal exostosis and intratendon ossification were resected, and the defect that remained after resection was filled with soft tissue showing the same signal as the Achilles tendon (arrowhead).