Achilles Tendinopathies and Rupture

Katherine F. Wojnowich, MD, CAQSM and Patrick M. Del Santo, DO Reviewed 06/2019

BASICS

DESCRIPTION

Spectrum of disorders involving Achilles tendon, paratenon, and retrocalcaneal bursa
Painful inflammation of Achilles tendon and its sheath due to chronic degenerative tendinosis and ...

DIAGNOSIS

HISTORY

Tendinopathy
- Pain, swelling, warmth along tendon
- Noninsertional most common
- Pain exacerbated by activity, relief with rest
Peritonitis—localized burning pain accompanies/follows activit...

TREATMENT

GENERAL MEASURES

Tendinopathy
- Ice, nonsteroidal anti-inflammatory drugs (NSAIDs), rest (LOE: C)
- Heel lift, orthotics, appropriate footwear (LOE: C)
- Eccentric exercises/Alfredson protocol for m...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Routine follow-up until resolution of symptoms

Patient Monitoring

Achilles Tendon Total Rupture Score is the only validated outcome measure.

PATIENT EDUCATION

Adher...

REFERENCES

Zhang H, Tang H, He Q, et al. Surgical versus conservative intervention for acute Achilles tendon rupture: a PRISMA-compliant systematic review of overlapping meta-analyses. Medicine (Balt...

ADDITIONAL READING

Beyer R, Kongsgaard M, Hougs Kjær B, et al. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized controlled trial. Am J Sports Med. ...

CODES

ICD10

M76.60 Achilles tendinitis, unspecified leg
S86.009A Unspecified injury of unspecified Achilles tendon, initial encounter
S86.019A Strain of unspecified Achilles tendon, initial encounter
S86....

CLINICAL PEARLS

Majority of midportion and chronic insertional Achilles tendinopathies respond well to conservative therapies.
Achilles rupture can generally be diagnosed clinically; ultrasound is usef...

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