Tom Tip: Fluoroquinolone antibiotics are commonly associated with Achilles tendinopathy, a frequent exam question. Patients should be warned to monitor for Achilles tendinitis symptoms and stop antibiotics if they occur.
Clinical Presentation
Gradual onset pain/aching in Achilles or heel, especially during activity
Stiffness, tenderness, swelling, nodularity on palpation
Diagnosis
Primarily clinical diagnosis
Essential to exclude Achilles tendon rupture
Simmons Calf Squeeze Test:
Patient prone/kneeling, feet hanging freely
Intact Achilles: plantar flexion of foot upon calf squeeze
Ruptured Achilles: no plantar flexion upon calf squeeze (positive result)
Ultrasound can confirm Achilles tendon rupture
Management Options
Rest and Altered Activity: Allow tendon healing
Ice: Reduce inflammation
Analgesia: Pain management
Physiotherapy
Orthotics: Insoles to reduce Achilles pressure
Extracorporeal Shockwave Therapy (ESWT): May be beneficial
Surgery: For persistent cases, to remove nodules/adhesions or alter tendon
Avoid Steroid Injections: Risk of tendon rupture
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