Achilles tendonitis Flashcards
what is achilles tendonitis?
inflammation of the achilles tendon
may lead to achilles tendon rupture resulting in a complete loss of function
what are the risk factors?
- high intensity activities e.g running or jumping
- unfit individual who suddenly increases exercise frequency
- poor footweal
- male
- obesity
what is the pathophysiology of achilles tendonitis?
achillies tendon unites gastrocnemius, soleus and plantaris muscle allows ankle plantarflexion
repetitive action results in microtears, leading to localised inflammation. Tendon becomes thickened and more fibrotic with repeated episodes.
rupture occurs when substantial sudden force is applied across the tendon, usually with exisiting achilles tendonitis. Can be triggered by jumps or rapid change in direction when running.
what are the clinical features?
- gradual onset pain and stiffness in posterior ankle, worse with movement
- tenderness over tendon on palpation
- pressure over tendon with finger causes pain
IN RUPTURE:
- sudden onset severe pain in posterior calf
- audible popping sound
- loss of power in ankle plantarflexion
- can use simmonds test to confirm
what is the differential diagnosis?
- ankle sprain
- stress fractures
- osteoarthiritis
what investigations can be done?
both rupture and tendonitis are diagnosed clinically, but US scan can be used, especially to determine complete and partial tears.
how can tendonitis be treated?
- supportive measures
- stop precipitating in exercise
- ice area
- regular NSAID use
- chronic may need rehabilitation and physiotherapy
how is a rupture managed?
- analgesia and immobilisation
- splint and plaster ankle
- crutches, cant weight bear
- hold for 2 weeks, then bring into semi equines and hold for further 4 weeks.
if presentation is delayed (2 weeks+) or cases of re rupture, requires surgical fixation.
