Achilles Tendon Disorders Flashcards
What are the most common cause of posterior heel pain?
Achilles tendon disorders
What are possible presentation of achilles tendon disorders?
Tendinopathy/tendinitis
Partial tear
Complete rupture
What are risk factors for Achilles tendon disorders?
Quinolone use (e.g. ciprofloxacin)
Hypercholesterolaemia (prediposes to tendon xanthomata)
What are symptoms and signs of Achilles tendinopathy?
Symptoms:
Gradual onset posterior heel/ankle pain
Pain worse following activity
Stiffness and pain worse in morning
Signs:
Pain on palpation of tendon (medial and lateral pressure applied anterior and superior to tendon)
Swelling and thickening of tendon
Mx of Achilles tendinopathy?
Supportive:
- Simple analgesia (NSAIDs)
- Reduction in precipitating activities
- Calf muscle eccentric exercises (physio or independent)
When should Achilles tendon rupture be suspected?
Playing sport/running and:
- Audible ankle ‘pop’
- Sudden onset significant pain in calf or ankle OR inability to WB/continue sport
What examination can be used to exclude Achilles tendon rupture?
Simmond’s triad/Thompson’s test
Pt lies prone with feet over edge of bed
Look for abnormal angle of declination (in rupture - greater dorsiflexion in injured foot)
Feel for gap in tendon
Gently squeeze calf muscles (in rupture - injured foot stays in neutral position)
Ix for Achilles tendon rupture?
USS (initially anyways)
Mx of suspected Achilles tendon rupture?
Acute referral to orthopaedic specialist
What does it mean if a pt is Simmonds’ test positive?
Absence of plantarflexion on squeezing the calf on the affected leg
Pathognomonic of Achilles tendon rupture
What is Achilles tendonitis?
inflammation of the achilles tendon sheath
risk factors for achilles tendonitis?
sports esp. running
what analgesia is most useful in achilles tendonitis mx?
NSAIDs
what is tendinopathy?
tendon degeneration - pain, swelling, impaired performance
aetiology of tendinopathy?
overuse condition leading to inadequate tendon repair, predisposing tendon to microtears and degeneration
