Inflammation of the Achilles tendon

Aetiology

• Can occur due to repetitive strain (from sports) which leads to a peritendonitis or due to degenerative process with intrasubstance microtears

Risk factors

• Overtraining (sports)
• Quinolone antibiotics (ciprofloxacin)
• Rheumatoid arthritis, gout and other inflammatory arthritis

Pathophysiology

• Repetitive microtrauma, failure of collagen repair with loss of fibre alignments/structure
• Hypovascular region 2-6cm proximal to insertion

Clinical features

• Pain of the Achilles tendon or at its insertion in the calcaneus
• Morning stiffness
• Pain and stiffness eases with walking

Investigations

• Clinical diagnosis
• Imaging: can confirm with USS/MRI if uncertainty

Management

• Activity modification, analgesia, NSAIDs