Achilles tendon rupture

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Achilles tendon rupture

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Questions

USMLE® Step 1 style questions USMLE

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USMLE® Step 2 style questions USMLE

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A 40-year-old man comes to the office for evaluation of right heel pain. He was playing tennis with his son when he experienced a sharp, stabbing pain of his right heel with an associated “popping” sound. The patient has been unable to ambulate since the injury occurred. Past medical history is significant for type 2 diabetes mellitus which is adequately managed with metformin. Vitals are within normal limits. Physical examination demonstrates a palpable gap two centimeters proximal to the right heel. The right leg does not yield plantar flexion with squeezing of the calf. Which of the following is the most likely cause of this patient’s condition?  

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Summary

The Achilles tendon is a fibrous band of tissue that links the calf muscles to the heel bone, enabling us to walk, run, and jump. Achilles tendon rupture occurs when there is a complete disruption of this tendon, which mostly occurs as a result of physical injury. When this tendon ruptures, it can be extremely painful and difficult for one to walk.

The diagnosis of Achilles tendon rupture is mainly a physical exam, even though MRI or ultrasound may be done for confirmation. The management mainly focuses on pain, and surgery for tendon repair is usually needed as a definitive treatment.