Achilles tendon rupture

Summary of Achilles tendon rupture

Achilles tendon rupture is when the achilles tendon breaks. The Achilles is the most commonly injured tendon. Rupture usually occurs while performing actions requiring explosive acceleration, such as pushing off or jumping.

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Achilles tendon rupture

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ACHILLES TENDON RUPTURE osms.it/achilles-tendon-rupture PATHOLOGY & CAUSES ▪ Acute, complete disruption of achilles tendon ▫ Commonly traumatic, but can be iatrogenic CAUSES ▪ Recreational Sports: > 80% of achilles tendon ruptures ▫ Increased activity, shear stress on achilles, direct trauma to tendon ▫ Sudden, forced dorsiﬂexion of ankle outside normal range of motion RISK FACTORS ▪ ▪ ▪ ▪ ▪ Age: 30–40 years old Biologically-male individuals Obesity Fluoroquinolone use: unknown mechanism Systemic corticosteroid use ▪ Proximal achilles ▫ Likewise collected proximally Physical examination maneuvers ▪ Calf squeeze test (Simmonds/Thompson test) ▫ Squeezing calf of affected leg does not elicit plantar ﬂexion (very high sensitivity, speciﬁcity) ▪ Palpable gap test ▫ Posterior leg palpation at level of achilles to palpate gap in tendon ▪ Knee ﬂexion test (Matles test) ▫ Individual is prone with knees ﬂexed at 90° → observe angle of ankle ▫ Ruptured achilles → acute angle (unopposed dorsiﬂexion of foot by grativity) COMPLICATIONS ▪ Re-injury: 10% of individuals with rupture have history of previous rupture SIGNS & SYMPTOMS ▪ Ankle pain ▪ Poor ambulation DIAGNOSIS OTHER DIAGNOSTICS Physical inspection ▪ History: sudden, painful pop in lower leg; inability to walk; pain immediately after injury ▪ Calf muscles ▫ Soft, lumped together toward knee 666 OSMOSIS.ORG Figure 115.1 A positive Simmond’s test (left) in an individual with a ruptured achilles’ tendon

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Achilles tendon rupture

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USMLE® Step 1 style questions USMLE

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USMLE® Step 2 style questions USMLE

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Preview

A 36-year-old woman presents to the emergency department because she has had severe left ankle pain and an inability to walk. She first experienced these conditions 30-minutes ago when she felt as though she had been “kicked behind the ankle” while playing tennis. This was associated with acute, severe left ankle pain. Patient’s medical history includes antibiotic treatment for a recurrent urinary tract infection (UTI) two weeks ago. Examination shows inability to plantar flex her left ankle and the Simmonds-Thompson test is positive. Which of the following antibiotics did she most likely receive as for treatment of her UTI?

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