Abstract
IntroductionWe present an interesting case of spontaneous non-traumatic bilateral rupture of the Achilles tendons, which is a rare condition. Delayed or missed diagnosis of Achilles tendon ruptures by primary treating physicians is relatively common.Case reportA 78-year-old Caucasian woman presented with spontaneous non-traumatic bilateral rupture of the Achilles tendons. Her symptoms started two days after she took ciprofloxacin 500 mg twice daily for a urinary tract infection and prednisolone 30 mg once daily for chronic obstructive airway disease.ConclusionThis case report aims to increase the awareness of this rare condition, which should be borne in mind with regard to patients who are on steroid therapy and are concurrently started on fluoroquinolones.
Highlights
We present an interesting case of spontaneous non-traumatic bilateral rupture of the Achilles tendons, which is a rare condition
This case report aims to increase the awareness of this rare condition, which should be borne in mind with regard to patients who are on steroid therapy and are concurrently started on fluoroquinolones
We present an interesting case of spontaneous bilateral Achilles tendon rupture
Summary
Spontaneous non-traumatic rupture is rare and is commonly associated with long-term use of corticosteroids [1] or fluoroquinolones [2]. We present an interesting case of spontaneous bilateral Achilles tendon rupture. Two days after starting the medications the patient developed intense bilateral ankle pain The patient was unable to bear weight because of pain Both ankles appeared to be swollen with bruising over the Achilles tendon region. There was tenderness over both Achilles tendons near their insertions into the calcaneus with palpable gaps in the substance of the tendons She had a positive Thompson’s test and was unable to perform active plantar flexion with either ankle joint. Magnetic resonance imaging (MRI) scans were obtained for both ankles, which confirmed bilateral Achilles tendon rupture 5 cm proximal to insertion into the calcaneus (Figures 1 and 2). Some stiffness in both ankle joints continued as residual symptoms, for which physiotherapy was continued
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