Gandis Ayu Wardani, Elysanti Dwi Martadiani, Dewa Gde Mahiswara Suadiatmika

Tendon xanthomatosis of the Achilles tendon

Introduction

Tendon xanthomatosis of the achilles tendon. Discover Achilles tendon xanthomatosis, a fatty deposit indicator of systemic lipid disorders like familial hypercholesterolemia. Explore radiological features for diagnosis.

Abstract

Introduction: Tendon xanthomatosis is a fatty deposit within the tendon, specifically cholesterol in macrophages/foam cells—which causes thickening and structural changes in the tendon. This case report aims to provide radiological features in establishing the diagnosis of xanthomatosis. Case report: A 44-year-old man complained of a lump on his left foot for 25 years. MRI of the pedis with contrast revealed a thickened left Achilles tendon accompanied by a heterogeneous solid mass with fat components and solid nodules distal to the peroneus longus tendon to the cutis subcutis on the lateral aspect of the left pedis. Conclusion: This case report demonstrates the importance of clinician awareness of tendon xanthomatosis as a manifestation of systemic lipid metabolism disorders, particularly familial hypercholesterolemia. Although benign and often asymptomatic, tendon xanthomas have high diagnostic value as markers of chronic LDL-cholesterol exposure and an increased risk of atherosclerosis.

Review

This case report effectively highlights the diagnostic significance of Achilles tendon xanthomatosis. It presents a detailed account of the radiological features observed in a 44-year-old male presenting with a long-standing lump, emphasizing the utility of MRI in identifying the characteristic thickening, heterogeneous masses, and fat components within the tendon. The report successfully underscores how these localized tendon abnormalities serve as crucial clinical indicators of underlying systemic lipid metabolism disorders. A key strength of this abstract lies in its explicit focus on the radiological features, providing valuable descriptive insights for clinicians and radiologists in recognizing this often-overlooked condition. The conclusion particularly strengthens the paper by emphasizing the profound diagnostic value of tendon xanthomas. By linking them directly to chronic LDL-cholesterol exposure and an increased risk of atherosclerosis, the report effectively reinforces the critical need for clinician awareness in identifying high-risk individuals and prompting appropriate systemic metabolic workup. While concise for an abstract, a full report would ideally benefit from including specific MRI sequences and perhaps comparative imaging or pathology confirmation, if available, to further support the diagnosis. However, this abstract successfully achieves its stated aim of providing clear radiological features for establishing the diagnosis of xanthomatosis. It serves as a valuable reminder that seemingly benign musculoskeletal findings can be powerful markers for severe systemic conditions, compelling clinicians to consider a broader metabolic context.

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