Achilles Tendon Tear Senario

Question 1

Onset

Answer 1

1. Acute tears
   
   1. 75% acute tears occur during athletic activity
      
      1. esp in de-conditioned weekend warriors
   2. Prior to acute tear
      
      1. 15% had prodromal pain, swelling, stiffness
   3. Mechanism of acute tear = Pushing off or landing (eccentric load) on a plantarflexed foot
   4. Feel/hear a pop or think some-one behind them kicked them
2. Paratenonitis
   
   1. Insidious onset of Well localized tenderness and burning pain after activity
   2. more chronic
      
      1. pain starts on commencement of activity
3. Training errors
   
   1. Excessive training
   2. Training on hard surfaces
   3. Running on sloping, hard, slippery roads
   4. Inquire about recent change in activity

Question 2

Symptoms associated

Answer 2

Neurologic

Weakness of push-off

Question 3

1. PSHX, PMHX, Meds, Allergies

Risk factors for achilles tendon tear

Answer 3

1. Diabetes
2. Chronic renal disease
3. Rheumatoid arthritis
4. Systemic steroids
5. Fluoroquinolones
6. Seronegative arthropathy (Psoriasis, Reiter’s syndrome)
7. Spondyloarthropathy (ank spond)
8. Gout
9. Hyperlipidemia
10. Sarcoidosis
11. DISH
12. Meds:
    
    1. systemic steroids or fluoroquinolones