musculoskeletal and connective tissue disorders
Achilles Tendon Enthesopathy
Introduction
Achilles tendon enthesopathy is pain at the insertion of the Achilles tendon at the posterosuperior aspect of the calcaneus. Diagnosis is clinical. Radiographs in the lateral view may show enthesophytes (osseous spurs). Treatment is with stretching, splinting, and heel lifts. (See also Overview of Foot and Ankle Disorders .) The cause of Achilles tendon enthesopathy is chronic traction of the Achilles tendon on the calcaneus. Contracted or shortened calf muscles (resulting from a sedentary lifestyle and obesity) and athletic overuse are factors. Enthesopathy may be caused by a Overview of Seronegative Spondyloarthropathies . Fluoroquinolone antibiotics increase the risk of Pain at the posterior heel below the top of the shoe counter during ambulation is characteristic. Pain on palpation of the tendon at its insertion in a patient with these symptoms is diagnostic. Manual dorsiflexion of the ankle during palpation usually exacerbates the pain. Recurrent and especially multifocal enthesitis should prompt evaluation (history and examination) for a spondyloarthropathy. 