Achilles tendon rupture: Difference between revisions
m (Rossdonaldson1 moved page Achilles Tendon Rupture to Achilles tendon rupture) |
(→DDX) |
||
| Line 4: | Line 4: | ||
*Quinolone associated rupture occurs in only 12 per 100,000 treatment episodes | *Quinolone associated rupture occurs in only 12 per 100,000 treatment episodes | ||
== | ==Differential Diagnosis== | ||
*[[DVT]] | *[[DVT]] | ||
*[[Compartment Syndrome]] | *[[Compartment Syndrome]] | ||
Revision as of 06:01, 30 December 2014
Background
- Most frequently ruptures 2-6cm above calcaneus (where blood supply is weakest)
- Typical pt is 30-50yr old man who participates in strenuous activities on occasional basis
- Quinolone associated rupture occurs in only 12 per 100,000 treatment episodes
Differential Diagnosis
- DVT
- Compartment Syndrome
- Gastrocnemius Strain
- Calcaneal bursitis
Clinical Features
- Sudden, severe pain typically with rapid acceleration or pivoting
- May hear a "pop"
- Inability to run, stand on toes, or climb stairs
- Palpable defect in Achilles tendon 2-6cm proximal to calcaneus (SN 73% and SP 89% for partial tear)
- 20-30% of ruptures will have some amount of active plantar flexion or be able to walk
- Thompson test (SN 96% and SP 93%)
- Lay pt prone w/ knee bent at 90'
- In normal pt, squeezing calf results in plantarflexion
Work Up
- Clinical diagnosis
- Ultrasound can be used in equivocal cases
- Comparing to normal ankle can reveal smaller defects or tears
Treatment
- Rest, ice, elevation
- Non-weightbearing
- Short leg posterior splint w/ ankle slightly plantarflexed
- Ortho referral
Source
- Tintinalli
- Uptodate