Sonographic detection of a stitch abscess

A 28-year-old man with a ruptured right Achilles tendon underwent primary end-to-end suture immediately after injury. Painful swelling developed 6 months later, and a lump with discharge from a sinus was observed during physical assessment. Sonographic examination with a 10-MHz linear- array transducer demonstrated a hypoechoic mass, 8 x 6 mm, within which were 2 markedly echogenic dots. A stitch abscess was strongly suspected and was confirmed surgically.