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Achilles Tendinopathies and Rupture

Katherine Wojnowich, MD Reviewed 06/2021
 


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 activitie...

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 mid...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Routine follow-up until resolution of symptoms 

Patient Monitoring

  • Achilles Tendon Total Rupture Score (ATRS) is the only validated outcome measure for acute Achill...

REFERENCES

1
Zhang  H, Tang  H, He  Q, et al. Surgical versus conservative intervention for acute Achilles tendon rupture: a PRISMA-compliant systematic review of overlapping me...

ADDITIONAL READING

  • Beyer  R, Kongsgaard  M, Hougs  Kjær B, et al. Heavy slow resistance versus eccentric training as treatment for Achilles tendinopathy: a randomized contro...

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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