Achilles tendon disorder

 Disorders of the Achilles tendon are common in active people—competitive and

recreational athletes alike—but they can occur in less active people.
 As the largest tendon in the body, the Achilles experiences repetitive strain from
running, jumping, and sudden acceleration or deceleration, so is susceptible to rupture
and degenerative changes.
 Achilles tendon pathologies include rupture and tendonitis.

 Achilles tendon ruptured

- a complete disruption of the tendon
- observed most commonly in patients aged 30-50 years who have had no previous
injury or problem in the affected leg and are typically "weekend warriors" who are
active intermittently
- Patients present with complaints of a sudden snap in the lower calf associated with
acute, severe pain.
- The patient reports feeling like he or she has been shot, kicked, or cut in the back
of the leg,
- result in an inability to ambulate further.
- unable to stand on his or her toes on the affected side.
- Partial or full tendon ruptures may result from end-stage paratenonitis.
 Tendonitis
- refers to inflammation of the tendon or paratenon, usually resulting from overuse
associated with a change in playing surface, footwear, or intensity of an activity.
Many experts now believe, however, that tendonitis is a misleading term that
should no longer be used, because signs of true inflammation are almost never
present on histologic examination.
 Paratenonitis
- Characterized by paratenon inflammation and thickening, as well as fibrin
adhesions
- Patients present with warmth, swelling, and diffuse tenderness localized 2-
6 cm proximal to the tendon's insertion
 Tendinosis
- Characterized by intrasubstance disarray and degeneration of the tendon
- Tendinosis is often pain free.
- the only sign of the condition may be a palpable intratendinous nodule
that accompanies the tendon as the ankle is placed through its range of
motion (ROM).
 Paratenonitis with tendinosis
- This is diagnosed in patients with activity-related pain, as well as swelling
of the tendon sheath and tendon nodularity.