Etanerceptbehandlung bei rheumatoider Arthritis—monozentrische Langzeitbeobachtung über vier Jahre

Achilles tendon problems: not just an orthopaedic issue

PURPOSE

To review the current concepts on Achilles tendon involvement in various pathological conditions.

METHOD

A literature search was conducted to trace relevant literature on Achilles tendon problems in general pathologies.

RESULTS

The Achilles tendon can be involved in inflammatory and autoimmune conditions, genetically determined collagen abnormalities, infectious diseases, tumours, and neurological conditions which are not of a primary surgical nature.

CONCLUSIONS

Although Achilles tendon problems are classically considered frequent in active individuals from overuse or a single acute episode, problems in the Achilles tendon can be a consequence of several conditions.

[Tendon ruptures in rheumatic patients]

In the course of rheumatoid arthritis, changes to tendons occur in different areas. This can lead to rupture if not prevented at an early stage. In particular, regions with extreme joint thickness, high mechanical wear and tear and narrow regions present a higher risk of synovitis. This primarily affects the tendons of the hand, where the extensor digitorum minimus tendon and the extensor and flexor pollicis tendons are most at risk. There is a high possibility of rotator cuff lesion in the shoulder area during the course of a secondary synovitis dependent raised shoulder, or by bursitis or tendonitis. A rupture of the biceps tendon is also increased by omarthritis or synovitis in the sulcus. For the foot, the posterior tibial tendon is most commonly effected, which if primarily or secondarily damaged can lead to a rheumatic flat foot. In addition, there can be partial or complete destruction in the Achilles tendon area, which is definitely pathognomonic. The narrow syndrome in the flexor hallucis and the extensor digitorum tendons are less common.