Ankle and foot- achilles tendon injury (tnedonitis, rupture)

Question 1

Define both achilles tendon disorders

Answer 1

2 presentions/disease
tendonitis-
and tear (partial/complete)

RF-
Mid portion tendinopathy (flat feet, diabetes, gout, inflamation (ankSpon, RA), Injury
Insertional (age (old), Systemic rheum)
Rupture (age, tendinopathy, vascular issues, repetive jumps)

FOR ALL -
Diabetes
Rheum disease/chronic inflam, trauma
QUINOLONES (eg ciproflaxin), cholesterol

Question 2

Presentation and Signs of achilles tendinopathy

Answer 2

Gradual onset of posterior heel pain worse after activity
often stiff in morning

Pain worse on pressure
If tender in mid portion - mid portion
if tender around heel- Insertional
Pain worse on dorsiflexion

Question 3

Presentation and Signs of Achilles tendon Rupture

Answer 3

Suspect if —Classical a “pop” in the Ankle, with sudden onset pain/difficulty walking (1/3 no pain tho)

Simmonds trial - Angle of declination, palpation for gap and calf squeeze test
–lie prone with feet over couch - ruptured feet will be more dorsiflexed
feel for gap in tendon
Squeeze calf- normal foot flexed. If rupture stay neutral

Ix if needed is USS

Question 4

management of Achilles tendon rupture

Answer 4

Arrange admission /same day refferal if achilles tendon rupture is SUSPECTED ====

There can be given surgery
or exercise programs/ shock wave therapy

Question 5

Management of Achilles tendinopathy

Answer 5

RICE
Rest, Ice, Compress,
Paracetamol for relief
should improve in 7-10 days
thats IT

after 7 days no improvement->physio

if underlying causes–
Stop any fluroquinolones
Manage cholesterol
Manage Diabetes