A 22-year-old male presents with posterior heel pain after starting a new job that requires a lot of walking. His skin over the heel is red. The skin is intact. There is no swelling or “pump bump”.
The following images of the Achilles tendon were obtained in long and short axis.

Figure 1a. Long axis grayscale ultrasound image of the Achilles tendon at the calcaneal insertion. The white arrow indicates a hypoechoic area.

Figure 1b. Short axis grayscale ultrasound of the Achilles tendon. The tendon measures 4.9mm in AP thickness, this is normal.
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