What role do imaging studies play in the diagnosis and management of tendon problems in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Role of Imaging in Diagnosis and Management of Tendon Problems in Primary Care

In primary care, imaging studies have a limited role in the initial diagnosis of tendon problems, which are primarily diagnosed clinically based on history and physical examination.

For suspected Achilles tendon rupture, urgent referral for admission or same-day orthopaedic assessment is recommended, and imaging (such as ultrasound or MRI) may be used in secondary care to confirm the diagnosis and guide management.

For chronic or non-improving tendinopathy, imaging is not routinely required in primary care but may be considered in secondary care to assess tendon structure and guide further treatment.

Imaging modalities such as ultrasound and MRI are more commonly used in specialist settings to evaluate tendon pathology, exclude differential diagnoses, and plan interventions.

Routine imaging is not recommended for uncomplicated tendinopathy in primary care, and management should focus on clinical assessment, conservative treatment, and physiotherapy referral.

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