Achilles tendon pathologies

Abstract

Achilles tendon pathologies are afrequent problem in the clinical practice. Adistinction must be made between insertional and noninsertional tendinopathies. In addition to intrinsic risk factors, such as diabetes mellitus, there are also extrinsic risk factors, such as overuse and running. Sonography, X‑ray imaging and magnetic resonance imaging (MRI) are established imaging methods, depending on the question. The primary treatment includes aconservative approach. First-line treatment includes administration of nonsteroidal anti-inflammatory drugs (NSAID), physical rest and the use of assistive devices. Established conservative treatment procedures include eccentric stretching, shockwave therapy and infiltration with, e.g., platelet-rich plasma. There are numerous other conservative treatment options. After exhausting the conservative treatment options, asurgical approach can be considered. The surgical procedure depends on the clinical symptoms and findings. Established procedures are minimally invasive or endoscopic procedures or even open debridement.