Fig. 2. (A) Initial ultrasound image of the left Achilles tendon before extracorporeal shockwave therapy (ESWT) treatment. The tendon thickness at the site of injury measures approximately 12 mm (indicated by double-headed arrow, which spans the thickened area of the tendon in the ultrasound image), which is significantly thicker than the normal range for the Achilles tendon (usually around 4-6 mm in healthy individuals). The internal structure shows hypoechoic (dark) areas and irregular tendon fiber alignment, indicating inflammation and scarring. The injured region is marked for clarity, helping readers unfamiliar with musculoskeletal ultrasound to locate the affected area. (B) Follow-up ultrasound image of the left Achilles tendon after 5 weeks of ESWT. The tendon thickness has decreased to approximately 5 mm, showing a return to near-normal dimensions. The internal structure has also improved, with better-defined, parallel tendon fibers and reduced hypoechoic regions, indicating resolved inflammation and tissue healing. The area corresponding to the previous thickening is marked to assist in visual comparison.
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