Materiały źródłowe

• #1 Achilles Tendinopathy / Achilles Tendinitis | Diagnosis & Treatment

  https://www.physiotutors.com/conditions/achilles-tendinopathy/

  Achilles tendinopathy is a common musculoskeletal condition characterized by localized Achilles tendon load-related pain and dysfunction. […] Achilles tendinopathy affects approximately 9% of recreational runners and up to 5% of professional athletes, this condition is career-ending. […] The incidence of mid-portion Achilles tendinopathy in general practice within the adult population is 2.35 per 1000, and in 35% of cases, a relationship with sports activity has been recorded. […] The pain mechanisms in tendinopathy are not clear but are thought to involve local nociception mediated by changes within the tenocytes. […] The current understanding is the imbalance between the load demands placed on the tendon and its capacity to remodel. […] A common symptom is morning stiffness or stiffness following a period of inactivity.

• #2 Achilles Tendinopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538149/

  The diagnosis of Achilles tendinopathy mainly relies on physical examination. The patient should be evaluated while standing and in a prone position for specific clinical signs of localized pain, focal or diffuse sensitivity, swelling, stiffness, and perceived rigidity in the Achilles tendon. Clinical tests include: […] The diagnosis of Achilles tendinopathy mainly relies on physical examination. […] Tests Used to Diagnose Achilles Tendinopathy include Lateral and Axial Calcaneus X-rays, Ultrasound, Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and the Victoria Institute of Sports Assessment-Achilles (VISA-A). […] The evidence suggests that conservative treatments should be considered the first-line treatment for Achilles tendinopathy. However, despite a growing body of research in this field, there is still a lack of high-quality studies evaluating the effectiveness of these interventions.

• #3 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  Achilles tendinopathy describes the clinical presentation of pain localised to the Achilles tendon and associated loss of function with tendon loading activities. However, clinicians display differing approaches to the diagnosis of Achilles tendinopathy due to inconsistency in the clinical terminology, an evolving understanding of the pathophysiology, and the lack of consensus on clinical tests which could be considered the gold standard for diagnosing Achilles tendinopathy. […] The clinical diagnosis of Achilles tendinopathy is predominantly derived from patient history, patient reported load related pain, and pain provocation tests. Patient history, localised Achilles tendon pain and pain on palpation are considered key to diagnosing Achilles tendinopathy and can all be assessed reliably.

• #4 Tests and Methods for Achilles Tendonitis Diagnosis

  https://aidmyachilles.com/achilles-tendonitis-injury/achilles-tendinopathy-diagnosis.php

  The doctor will palpate the Achilles to assess pain abnormalities to make a diagnosis […] To help your doctor achieve a proper diagnosis, he/she will begin with a medical history about you, your current condition and symptoms, the intensity of your pain, the duration of your symptoms and the limitations you are experiencing. […] Your doctor will visually assess and palpate (feel) the bones and soft tissue in and around both of your Achilles tendons to evaluate symmetry and spot any differences. […] The Thompson Test is a common physical exam that doctors use to determine if an Achilles tendon has ruptured. […] This test involves the patient lying face down on the exam table with knees at a 90 degree angle. […] X-rays don’t show much relative to tendons and other soft tissue but it will provide an image of the overall bone structure of your ankle.

• #5 Tests and Methods for Achilles Tendonitis Diagnosis

  https://m.aidmyachilles.com/achilles-tendonitis-injury/achilles-tendinopathy-diagnosis.php

  The doctor will palpate your Achilles tendon to assess pain and abnormalities to make a diagnosis of your injury. […] Diagnosis will probably involve a localized physical exam and possibly a series of diagnostic tests. […] To help ensure a proper diagnosis, your physician will begin with a medical history about you, your current condition and symptoms, the intensity of your pain, the duration of your symptoms and any limitations of movement you are experiencing. […] Your doctor will visually assess and palpate (feel) the bones and soft tissue in and around both of your Achilles tendons to evaluate symmetry and spot any differences. […] Differences could include inflammation, swelling, bone deformity, scar tissue build up, and a weakened tendon. […] He/she will press on the injured tendon to test for tenderness, tough nodules (scar tissue), and jelly-like sections on the tendon (common in tendonosis).

• #6 Tests and Methods for Achilles Tendonitis Diagnosis

  https://m.aidmyachilles.com/achilles-tendonitis-injury/achilles-tendinopathy-diagnosis.php

  The doctor will palpate your Achilles tendon to assess pain and abnormalities to make a diagnosis of your injury. […] Diagnosis will probably involve a localized physical exam and possibly a series of diagnostic tests. […] To help ensure a proper diagnosis, your physician will begin with a medical history about you, your current condition and symptoms, the intensity of your pain, the duration of your symptoms and any limitations of movement you are experiencing. […] Your doctor will visually assess and palpate (feel) the bones and soft tissue in and around both of your Achilles tendons to evaluate symmetry and spot any differences. […] Differences could include inflammation, swelling, bone deformity, scar tissue build up, and a weakened tendon. […] He/she will press on the injured tendon to test for tenderness, tough nodules (scar tissue), and jelly-like sections on the tendon (common in tendonosis).

• #7 Common Conditions of the Achilles Tendon | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0501/p1805.html

  The diagnosis is missed in about one fourth of cases. […] A thorough history and specific physical examination are essential to make the appropriate diagnosis and facilitate a specific treatment plan. […] A detailed history is necessary, including level of training, technique, footwear, previous injury, and treatment. […] The typical symptom of tendonitis is pain or tenderness proximal to or at the insertion to the calcaneus. […] In tendonitis and peritendonitis, symptoms usually develop gradually, and the patient typically presents with pain and stiffness over the Achilles region. […] A thorough physical examination is very important to the diagnosis, and it should be performed with the patient lying prone, feet hanging off the examination table. […] The diagnosis is made following an appropriate history and physical examination. […] The Thompson test should be performed on all patients with suspected Achilles tendon injury. […] If the diagnosis is still unclear, an ultrasound or magnetic resonance imaging study may be helpful.

• #8

  https://www.healthxchange.sg/bones-joints/knee-ankle-feet/achilles-tendinopathy-diagnosis-treatment-options

  Achilles tendinopathy (Achilles tendon pain) describes an overuse condition of the Achilles tendon which may involve pain, swelling and impaired performance. […] The diagnosis of Achilles tendinopathy (Achilles tendon pain) is derived from a combination of ones history, a physical examination and imaging tests may be required. […] This may include information on an individuals participation in recreational sports during the weekends (commonly termed a „weekend warrior”), changes in training intensity or duration, and also complaints of pain around the back of the ankle. […] This may reveal tenderness over the back of ankle and some swelling at the back of the heel may be noticeable. Weakness of the calf muscle may also be observed. […] These may be used to confirm the diagnosis but they are not always necessary. An ultrasound scan is most commonly used as it is fast and less costly. It would be able to show any tendon movement, related damage and inflammation. A magnetic resonance imaging scan (more commonly known as an MRI scan) is usually a second line of testing and is useful for classifying the stage of the tendinopathy. It is also useful for diagnosing tears in the tendon. An X-ray may not be particularly helpful in identifying an Achilles tendinopathy but it may help to rule out other diagnoses. […] It is advisable for you to see a professional doctor who would be able to rule out any other conditions and to on-refer to the appropriate care needed. It would be best to identify the condition for early treatment and to correct the predisposing factors.

• #9

  https://www.healthxchange.sg/bones-joints/knee-ankle-feet/achilles-tendinopathy-diagnosis-treatment-options

  Achilles tendinopathy (Achilles tendon pain) describes an overuse condition of the Achilles tendon which may involve pain, swelling and impaired performance. […] The diagnosis of Achilles tendinopathy (Achilles tendon pain) is derived from a combination of ones history, a physical examination and imaging tests may be required. […] This may include information on an individuals participation in recreational sports during the weekends (commonly termed a „weekend warrior”), changes in training intensity or duration, and also complaints of pain around the back of the ankle. […] This may reveal tenderness over the back of ankle and some swelling at the back of the heel may be noticeable. Weakness of the calf muscle may also be observed. […] These may be used to confirm the diagnosis but they are not always necessary. An ultrasound scan is most commonly used as it is fast and less costly. It would be able to show any tendon movement, related damage and inflammation. A magnetic resonance imaging scan (more commonly known as an MRI scan) is usually a second line of testing and is useful for classifying the stage of the tendinopathy. It is also useful for diagnosing tears in the tendon. An X-ray may not be particularly helpful in identifying an Achilles tendinopathy but it may help to rule out other diagnoses. […] It is advisable for you to see a professional doctor who would be able to rule out any other conditions and to on-refer to the appropriate care needed. It would be best to identify the condition for early treatment and to correct the predisposing factors.

• #10 Achilles tendinitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/diagnosis-treatment/drc-20369025

  During the physical exam, your healthcare professional will press gently on the area to find where the pain, tenderness or swelling are and watch how the foot and ankle look moving and at rest. […] One or more of these tests can help diagnose Achilles tendinitis: […] X-rays do not show soft tissues such as tendons. But they may show some signs of Achilles tendinitis and can help rule out other conditions that can cause some of the same symptoms. […] Ultrasound also can make real-time images of the Achilles tendon to show how it moves. […] Using radio waves and a strong magnet, MRI scans can show the Achilles tendon in detail. […] If several months of more-conservative treatments don’t work or if the tendon has torn, you might need traditional surgery to repair your Achilles tendon.

• #11 Achilles Tendinitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

  Noninsertional Achilles tendinitis involves the lower portion of the tendon, where it attaches (inserts) to the heel bone (also known as the calcaneus). […] In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may calcify (harden) over time. […] Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon. […] Common symptoms of Achilles tendinitis include pain and stiffness along the Achilles tendon in the morning, pain along the tendon or back of the heel that worsens with activity, and swelling that is present all the time and gets worse throughout the day or with activity. […] After you describe your symptoms and discuss your concerns, the doctor will examine your foot and ankle. The doctor will look for these signs: swelling along the Achilles tendon or at the back of your heel, bone spurs or pain near the lower part of the tendon at the back of your heel, and pain in the middle of the tendon.

• #12 Achilles Tendinopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538149/

  The diagnosis of Achilles tendinopathy mainly relies on physical examination. The patient should be evaluated while standing and in a prone position for specific clinical signs of localized pain, focal or diffuse sensitivity, swelling, stiffness, and perceived rigidity in the Achilles tendon. Clinical tests include: […] The diagnosis of Achilles tendinopathy mainly relies on physical examination. […] Tests Used to Diagnose Achilles Tendinopathy include Lateral and Axial Calcaneus X-rays, Ultrasound, Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and the Victoria Institute of Sports Assessment-Achilles (VISA-A). […] The evidence suggests that conservative treatments should be considered the first-line treatment for Achilles tendinopathy. However, despite a growing body of research in this field, there is still a lack of high-quality studies evaluating the effectiveness of these interventions.

• #13 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  The most commonly identified objective clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). […] There is significant variation in the methodology and outcome measures used to diagnose Achilles tendinopathy. A method for diagnosing Achilles tendinopathy is proposed, that includes both results from the scoping review and recent recommendations for reporting results in tendinopathy. […] The most commonly used subjective measure was self-reported location of pain, while additional measures included pain with tendon loading activity, duration of symptoms and tendon stiffness. […] The VISA-A questionnaire as the most commonly used outcome measure to monitor Achilles tendinopathy. However, psychological factors (PES, TKS and PCS) and overall quality of life (SF-12, SF-36 and EQ-5D-5L) were less frequently measured.

• #14 Diagnosis – GPnotebook

  https://gpnotebook.com/pages/musculoskeletal-medicine/achilles-tendinitis/diagnosis

  Diagnosis of Achilles tendinopathy is often achieved through patient’s history and clinical examination. […] should inquire about pain – onset, duration and aggravating factors. […] typically pain presents after exercise, 2-6 cm proximal to the site of tendon insertion. […] as the disease progresses the patient may have pain during exercise. […] pain may interfere with daily activities in severe cases. […] the degree of morning stiffness correlates to the severity of the disease. […] during clinical examination both legs should be exposed from above the knees and examination of the leg should be done while the patient is in standing position and in prone position. […] examination of foot and heel should be done to find out any malalignment, deformity, noticeable asymmetry tendon size, localised thickening, Haglund heel or for any previous scars.

• #15

  https://www.parkwayeast.com.sg/conditions-diseases/achilles-tendonitis/diagnosis-treatment

  Your doctor will conduct a physical examination to check for symptoms such as swelling, pain on the back of the heel and limited range of ankle movement. […] Your doctor may also recommend one of these diagnostic tests to determine the extent of the damage and decide on appropriate treatments: […] Magnetic resonance imaging (MRI) produces detailed, cross-sectional images of the organs and tissues within the body and will reveal any tissue degeneration or rupture. […] Ultrasound scans can reveal inflammation or damage in the soft tissues, muscles, blood vessels, tendons, and joints. An ultrasound scan is one way to detect injuries to your Achilles tendon. […] X-rays are usually not needed to diagnose Achilles tendonitis. It may be requested to rule out bone-related causes of pain such as bone spurs on the heel or stress fractures. […] If you experience pain in your heels or ankles, it could worsen if left untreated. Speak to our orthopaedic specialists for an accurate diagnosis to find the most appropriate treatment for you.

• #16 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  The most commonly identified objective clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). […] There is significant variation in the methodology and outcome measures used to diagnose Achilles tendinopathy. A method for diagnosing Achilles tendinopathy is proposed, that includes both results from the scoping review and recent recommendations for reporting results in tendinopathy. […] The most commonly used subjective measure was self-reported location of pain, while additional measures included pain with tendon loading activity, duration of symptoms and tendon stiffness. […] The VISA-A questionnaire as the most commonly used outcome measure to monitor Achilles tendinopathy. However, psychological factors (PES, TKS and PCS) and overall quality of life (SF-12, SF-36 and EQ-5D-5L) were less frequently measured.

• #17 Achilles Tendinopathy / Achilles Tendinitis | Diagnosis & Treatment

  https://www.physiotutors.com/conditions/achilles-tendinopathy/

  As the condition progresses, pain may occur with even minor exertion and interfere with activities of daily living. […] In the acute phase, the tendon is diffusely swollen and oedematous and tenderness is usually greatest 2-6cm proximal to the tendon insertion. […] A tender nodular swelling can be present in chronic cases. […] The patient is examined standing and prone with legs exposed from the knee downwards. […] The tendon excursion is examined to determine the tightness of the tendon. […] In the Royal London Hospital test, a swelling that is most painful when the ankle is in maximum dorsiflexion indicates tendinopathy. […] Maffulli et al. (2003) studied sensitivity and specificity of palpation, painful arc test, and Royal London Hospital test in 2003 and found that all three tests had good interobserver agreement.

• #18 Diagnosis – GPnotebook

  https://gpnotebook.com/pages/musculoskeletal-medicine/achilles-tendinitis/diagnosis

  Diagnosis of Achilles tendinopathy is often achieved through patient’s history and clinical examination. […] should inquire about pain – onset, duration and aggravating factors. […] typically pain presents after exercise, 2-6 cm proximal to the site of tendon insertion. […] as the disease progresses the patient may have pain during exercise. […] pain may interfere with daily activities in severe cases. […] the degree of morning stiffness correlates to the severity of the disease. […] during clinical examination both legs should be exposed from above the knees and examination of the leg should be done while the patient is in standing position and in prone position. […] examination of foot and heel should be done to find out any malalignment, deformity, noticeable asymmetry tendon size, localised thickening, Haglund heel or for any previous scars.

• #19 Diagnosis – GPnotebook

  https://gpnotebook.com/pages/musculoskeletal-medicine/achilles-tendinitis/diagnosis

  Diagnosis of Achilles tendinopathy is often achieved through patient’s history and clinical examination. […] should inquire about pain – onset, duration and aggravating factors. […] typically pain presents after exercise, 2-6 cm proximal to the site of tendon insertion. […] as the disease progresses the patient may have pain during exercise. […] pain may interfere with daily activities in severe cases. […] the degree of morning stiffness correlates to the severity of the disease. […] during clinical examination both legs should be exposed from above the knees and examination of the leg should be done while the patient is in standing position and in prone position. […] examination of foot and heel should be done to find out any malalignment, deformity, noticeable asymmetry tendon size, localised thickening, Haglund heel or for any previous scars.

• #20 Achilles Tendinopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538149/

  The diagnosis of Achilles tendinopathy mainly relies on physical examination. The patient should be evaluated while standing and in a prone position for specific clinical signs of localized pain, focal or diffuse sensitivity, swelling, stiffness, and perceived rigidity in the Achilles tendon. Clinical tests include: […] The diagnosis of Achilles tendinopathy mainly relies on physical examination. […] Tests Used to Diagnose Achilles Tendinopathy include Lateral and Axial Calcaneus X-rays, Ultrasound, Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and the Victoria Institute of Sports Assessment-Achilles (VISA-A). […] The evidence suggests that conservative treatments should be considered the first-line treatment for Achilles tendinopathy. However, despite a growing body of research in this field, there is still a lack of high-quality studies evaluating the effectiveness of these interventions.

• #21 Signs, symptoms, and assessment (diagnosis) of Achilles tendon disorders

  https://learnmuscles.com/blog/2017/01/10/signs-symptoms-assess-diagnose-achilles-tendon-disorders/

  The pinch test for Achilles tendinitis. […] Assessment/diagnosis of Achilles tendinitis is made by correlating history with physical examination findings. […] The Achilles tendon pinch test is performed by pinching the medial and lateral sides of the Achilles tendon, superior to the location of the bursae. […] The presence of pain usually confirms tendinitis. […] A rupture of the Achilles tendon is assessed by the history of a loud popping noise and/or a sudden severe pain when plantarflexing, as well as a gap where the tendon should be located near the calcaneus, bunching up of the gastrocnemius and soleus bellies proximally, and an inability to plantarflex against resistance. […] The triceps surae squeeze test, also known as the Thompson test can be used to assess Achilles rupture. […] Differential assessment of Achilles tendinitis involves the consideration of Achilles tendinosus, bursitis, paratendinitis, and rupture.

• #22 Tests and Methods for Achilles Tendonitis Diagnosis

  https://m.aidmyachilles.com/achilles-tendonitis-injury/achilles-tendinopathy-diagnosis.php

  They may ask you to push down with the ball of your foot and toes (plantarflexion) to evaluate the flexibility, alignment, range of motion and pain level. […] The Thompson Test is a common physical exam that doctors use to determine if an Achilles tendon has ruptured. […] This test involves the patient lying face down on the exam table with knees at a 90 degree angle. […] If the Achilles tendon is torn, the foot does not move. […] When calf muscles are squeezed, the foot should go into plantarflexion if the Achilles tendon is intact. […] X-rays don’t show much relative to tendons and other soft tissue but it will provide an image of the overall bone structure of your ankle. […] It is helpful in identifying bone spurs, calcifications within the tendon, fractures or degeneration of the heel bone.

• #23 Achilles Tendinitis – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/sports-injury/achilles-tendinitis

  Achilles tendinitis is very common among running athletes. […] Diagnosis of Achilles Tendinitis […] Clinical evaluation […] On examination, an inflamed or partially torn Achilles tendon is tender when squeezed between the fingers. Complete tears are differentiated by […] Sudden, severe pain and inability to walk on the extremity […] A palpable defect along the course of the tendon […] A positive Thompson test (while the patient lies prone on the examination table, the examiner squeezes the calf muscle; this maneuver by the examiner does not cause the normally expected plantar flexion of the foot).

• #24 Achilles Tendinopathy / Achilles Tendinitis | Diagnosis & Treatment

  https://www.physiotutors.com/conditions/achilles-tendinopathy/

  As the condition progresses, pain may occur with even minor exertion and interfere with activities of daily living. […] In the acute phase, the tendon is diffusely swollen and oedematous and tenderness is usually greatest 2-6cm proximal to the tendon insertion. […] A tender nodular swelling can be present in chronic cases. […] The patient is examined standing and prone with legs exposed from the knee downwards. […] The tendon excursion is examined to determine the tightness of the tendon. […] In the Royal London Hospital test, a swelling that is most painful when the ankle is in maximum dorsiflexion indicates tendinopathy. […] Maffulli et al. (2003) studied sensitivity and specificity of palpation, painful arc test, and Royal London Hospital test in 2003 and found that all three tests had good interobserver agreement.

• #25 Achilles Tendinopathy / Achilles Tendinitis | Diagnosis & Treatment

  https://www.physiotutors.com/conditions/achilles-tendinopathy/

  As the condition progresses, pain may occur with even minor exertion and interfere with activities of daily living. […] In the acute phase, the tendon is diffusely swollen and oedematous and tenderness is usually greatest 2-6cm proximal to the tendon insertion. […] A tender nodular swelling can be present in chronic cases. […] The patient is examined standing and prone with legs exposed from the knee downwards. […] The tendon excursion is examined to determine the tightness of the tendon. […] In the Royal London Hospital test, a swelling that is most painful when the ankle is in maximum dorsiflexion indicates tendinopathy. […] Maffulli et al. (2003) studied sensitivity and specificity of palpation, painful arc test, and Royal London Hospital test in 2003 and found that all three tests had good interobserver agreement.

• #26 Achilles Tendinopathy – Do I need a scan? | Treat My Achilles

  https://www.treatmyachilles.com/post/achilles-tendinopathy-do-i-need-a-scan

  You dont need a scan for us to be able to diagnose you with Achilles tendinopathy, but it can be useful. […] Achilles tendinopathy is diagnosed by listening to the patients history of how the injury happened as well as where and when they have pain. […] A group of researchers investigated ten clinical tests that are commonly used to confirm the diagnosis, and they found that the two that were the most accurate were also the simplest: If the patient points to the painful area and it’s the mid-tendon. If you can feel a swollen lump in the tendon when you squeeze it. […] Ultrasounds scans: These are extremely useful for diagnosing Achilles tendinopathy. In tendons with a tendinopathy, they can show changes in the tendon structure, and you can measure the tendon diameter and check the blood flow (neovascularization).

• #27 Achilles Tendinitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

  Your doctor may order imaging tests to help determine if your symptoms are caused by Achilles tendinitis. […] X-rays provide clear images of bones. They can show bone spurs on the back of the heel, which may be present in patients with insertional Achilles tendinitis. […] Although magnetic resonance imaging (MRI) is not necessary to diagnose Achilles tendinitis, it is important for planning surgery if nonsurgical treatment is not effective. […] In most cases of Achilles tendinitis, nonsurgical treatment options will provide adequate pain relief, although it may take a few months for symptoms to completely subside. […] The mainstays of nonsurgical treatment include anti-inflammatory pain medications, activity modification, shoe wear modification, and physical therapy exercises. […] Surgery for Achilles tendinitis should be considered only if the pain does not improve after 6 months of nonsurgical treatment.

• #28 Diagnosing Achilles Pain

  https://www.sports-health.com/sports-injuries/ankle-and-foot-injuries/diagnosing-achilles-pain

  To arrive at a clinical diagnosis of Achilles tendonitis, tendinosis, or other tendon condition, a doctor must eliminate other problems that cause similar symptoms, such as: […] A physician will diagnose the cause of the pain based on a combination of a physical exam, a detailed patient history, and if needed, diagnostic tests. […] A doctor will examine the foot and lower leg and look for signs of Achilles tendinopathy. […] The doctor may also ask the patient to do a series of exercises such as leg lifts, hops, or jumps to gauge the level of activity-related pain, as well as exactly where it occurs. […] In addition to a clinical exam the doctor will also take a detailed patient history. […] Medical imaging is usually not required to arrive at an Achilles tendinopathy diagnosis. However, in some cases a doctor may order imaging to get a detailed view of the tendon or to rule out other conditions.

• #29 Achilles tendinitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/diagnosis-treatment/drc-20369025

  During the physical exam, your healthcare professional will press gently on the area to find where the pain, tenderness or swelling are and watch how the foot and ankle look moving and at rest. […] One or more of these tests can help diagnose Achilles tendinitis: […] X-rays do not show soft tissues such as tendons. But they may show some signs of Achilles tendinitis and can help rule out other conditions that can cause some of the same symptoms. […] Ultrasound also can make real-time images of the Achilles tendon to show how it moves. […] Using radio waves and a strong magnet, MRI scans can show the Achilles tendon in detail. […] If several months of more-conservative treatments don’t work or if the tendon has torn, you might need traditional surgery to repair your Achilles tendon.

• #30 Achilles Tendinitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

  Your doctor may order imaging tests to help determine if your symptoms are caused by Achilles tendinitis. […] X-rays provide clear images of bones. They can show bone spurs on the back of the heel, which may be present in patients with insertional Achilles tendinitis. […] Although magnetic resonance imaging (MRI) is not necessary to diagnose Achilles tendinitis, it is important for planning surgery if nonsurgical treatment is not effective. […] In most cases of Achilles tendinitis, nonsurgical treatment options will provide adequate pain relief, although it may take a few months for symptoms to completely subside. […] The mainstays of nonsurgical treatment include anti-inflammatory pain medications, activity modification, shoe wear modification, and physical therapy exercises. […] Surgery for Achilles tendinitis should be considered only if the pain does not improve after 6 months of nonsurgical treatment.

• #31 Achilles Tendon Pain: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/orthopedics/columbia-orthopedics/achilles-tendon-pain/treatment

  How is Achilles Tendon Pain Diagnosed? Diagnosis If you think you are experiencing Achilles tendon pain, you will probably want to visit a doctor. After discussing your symptoms, the doctor will perform a physical exam, including an assessment of your foot and ankle; they will inspect the area for: Swelling at the Achilles tendon and the back of the heel […] After a physical exam, the doctor will order imaging tests to determine if the condition is Achilles tendonitis or another problem. These tests might include the following: X-rays can provide clear images of bones; therefore, bone spurs on the back of the heel can be seen, suggesting insertional Achilles tendonitis. In cases of severe non-insertional tendonitis, calcification (calcium buildup in the tendons) can be viewed from the X-rays. […] MRI (Magnetic Resonance Imaging). This imaging test is typical if nonsurgical treatments have not proven effective. Depending on the severity of damage to the tendon, which can be visualized through an MRI, the doctor can plan which surgical procedure should be used.

• #32 Achilles Tendon Disorders | Causes & Treatments | ROC

  https://www.renoortho.com/specialties/center-for-foot-ankle/achilles-tendon-disorders/

  Achilles tendon disorders are conditions that affect the Achilles tendon, typically caused by overuse or sudden injuries. Common disorders include insertional tendonitis, non insertional tendonitis and Achilles tendon rupture. […] Defined as inflammation of a tendon. Inflammation is the bodys natural response to injury or disease and can cause swelling, pain, or irritation. […] Two common types of Achilles Tendonitis are non insertional tendonitis and insertional tendonitis. […] Imaging tests may be used to help confirm Achilles tendonitis, including: […] X-ray: Gives an image of the bones. Can show if there is calcification within the tendon itself, at the insertion of the tendon, and if there is a bone spur present. […] MRI: Gives an image of the bones, tendon, ligaments, and other soft tissues. Not required for the diagnosis of Achilles tendonitis, but may be beneficial for surgical planning if you and your doctor are considering this as a treatment option.

• #33 Achilles Tendon Pain: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/orthopedics/columbia-orthopedics/achilles-tendon-pain/treatment

  How is Achilles Tendon Pain Diagnosed? Diagnosis If you think you are experiencing Achilles tendon pain, you will probably want to visit a doctor. After discussing your symptoms, the doctor will perform a physical exam, including an assessment of your foot and ankle; they will inspect the area for: Swelling at the Achilles tendon and the back of the heel […] After a physical exam, the doctor will order imaging tests to determine if the condition is Achilles tendonitis or another problem. These tests might include the following: X-rays can provide clear images of bones; therefore, bone spurs on the back of the heel can be seen, suggesting insertional Achilles tendonitis. In cases of severe non-insertional tendonitis, calcification (calcium buildup in the tendons) can be viewed from the X-rays. […] MRI (Magnetic Resonance Imaging). This imaging test is typical if nonsurgical treatments have not proven effective. Depending on the severity of damage to the tendon, which can be visualized through an MRI, the doctor can plan which surgical procedure should be used.

• #34

  https://www.parkwayeast.com.sg/conditions-diseases/achilles-tendonitis/diagnosis-treatment

  Your doctor will conduct a physical examination to check for symptoms such as swelling, pain on the back of the heel and limited range of ankle movement. […] Your doctor may also recommend one of these diagnostic tests to determine the extent of the damage and decide on appropriate treatments: […] Magnetic resonance imaging (MRI) produces detailed, cross-sectional images of the organs and tissues within the body and will reveal any tissue degeneration or rupture. […] Ultrasound scans can reveal inflammation or damage in the soft tissues, muscles, blood vessels, tendons, and joints. An ultrasound scan is one way to detect injuries to your Achilles tendon. […] X-rays are usually not needed to diagnose Achilles tendonitis. It may be requested to rule out bone-related causes of pain such as bone spurs on the heel or stress fractures. […] If you experience pain in your heels or ankles, it could worsen if left untreated. Speak to our orthopaedic specialists for an accurate diagnosis to find the most appropriate treatment for you.

• #35 Achilles Tendon Differential Diagnosis — Physio Network

  https://www.physio-network.com/blog/achilles-tendon-differential-diagnosis-by-peter-malliaras-carly-johnson/

  If there is a lot of fluid or thickening of the bursa on imaging it is very likely to be a pain generator and should be treated. […] Ultrasound imaging is excellent for imaging plantaris tendon abnormality vs paratenon fluid vs midportion Achilles but of course needs to be married with clinical symptoms. […] Ultrasound often shows what is sometimes referred to as delamination of the fat pad and tendon, with a definite hypo- or an-echoic region ie a black hole, that is continuous with the periphery of the tendon. […] Ultrasound is very useful in confirming that there is a low lying soleus (or accessory) soleus. […] The diagnosis is always clinical and based on differential palpation of the fat pad and tendon simple but often missed!

• #36 Achilles tendinopathy | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/achilles-tendinopathy?lang=us

  Achilles tendinopathy is a combination of pathological changes affecting the Achilles tendon, usually due to overuse and excessive chronic stress. It can be seen both in athletes and non-athletes. It is hard to differentiate clinically from paratendinopathy. […] Ultrasound is the first-line imaging modality. […] Often shows thickening and rounding of the affected portion of the tendon. A cutoff value of 1 cm in anteroposterior diameter is usually used for diagnosis. There is also evidence of neovascularization, which, if present, is usually indicative of a poorer outcome and more severe clinical symptoms. […] MRI can show increased intratendinous signal and tendon enlargement, with edema in Kager fat pad in cases of tendinosis. […] The following should be included as a minimum: AP diameter of the Achilles tendon, altered structure (e.g. echotexture on ultrasound, signal on MRI), peritendinous or intratendinous vascularization, insertional calcifications.

• #37 Achilles tendinitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/diagnosis-treatment/drc-20369025

  During the physical exam, your healthcare professional will press gently on the area to find where the pain, tenderness or swelling are and watch how the foot and ankle look moving and at rest. […] One or more of these tests can help diagnose Achilles tendinitis: […] X-rays do not show soft tissues such as tendons. But they may show some signs of Achilles tendinitis and can help rule out other conditions that can cause some of the same symptoms. […] Ultrasound also can make real-time images of the Achilles tendon to show how it moves. […] Using radio waves and a strong magnet, MRI scans can show the Achilles tendon in detail. […] If several months of more-conservative treatments don’t work or if the tendon has torn, you might need traditional surgery to repair your Achilles tendon.

• #38

  https://tohealthyfeet.com/blog/How+Does+A+Podiatrist+Diagnose+And+Treat+Achilles+Tendonitis+/73

  X-rays cannot actually visualize tendon damage; they serve to rule out other conditions that cause similar symptoms. […] Ultrasound: Sound waves can produce real-time images of the Achilles tendon in motion. […] When ultrasound imaging cannot provide a clear diagnosis, your podiatrist may turn to MRI for an even more detailed look of your injury. […] See a podiatrist before your condition puts your Achilles tendon at risk of a tear of rupture. […] You should seek professional treatment if the pain or swelling in the affected area is not responding to physical therapy at home.

• #39 Achilles tendinopathy | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/achilles-tendinopathy?lang=us

  Achilles tendinopathy is a combination of pathological changes affecting the Achilles tendon, usually due to overuse and excessive chronic stress. It can be seen both in athletes and non-athletes. It is hard to differentiate clinically from paratendinopathy. […] Ultrasound is the first-line imaging modality. […] Often shows thickening and rounding of the affected portion of the tendon. A cutoff value of 1 cm in anteroposterior diameter is usually used for diagnosis. There is also evidence of neovascularization, which, if present, is usually indicative of a poorer outcome and more severe clinical symptoms. […] MRI can show increased intratendinous signal and tendon enlargement, with edema in Kager fat pad in cases of tendinosis. […] The following should be included as a minimum: AP diameter of the Achilles tendon, altered structure (e.g. echotexture on ultrasound, signal on MRI), peritendinous or intratendinous vascularization, insertional calcifications.

• #40 Achilles Tendinopathy Diagnosis and Treatment – Sonoscope

  https://sonoscope.co.uk/conditions-treated/achilles-tendinitis-ultrasound-guided-injections/

  Ultrasound can very clearly show the difference between a normal Achilles tendon and one that has tendinopathy as the tendinopathic tendon is often significantly thicker than a normal Achilles tendon. […] The Achilles tendon might demonstrate thickening or inflammation or irritation of the peritenon.

• #41 Achilles tendinopathy | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/achilles-tendinopathy?lang=us

  Achilles tendinopathy is a combination of pathological changes affecting the Achilles tendon, usually due to overuse and excessive chronic stress. It can be seen both in athletes and non-athletes. It is hard to differentiate clinically from paratendinopathy. […] Ultrasound is the first-line imaging modality. […] Often shows thickening and rounding of the affected portion of the tendon. A cutoff value of 1 cm in anteroposterior diameter is usually used for diagnosis. There is also evidence of neovascularization, which, if present, is usually indicative of a poorer outcome and more severe clinical symptoms. […] MRI can show increased intratendinous signal and tendon enlargement, with edema in Kager fat pad in cases of tendinosis. […] The following should be included as a minimum: AP diameter of the Achilles tendon, altered structure (e.g. echotexture on ultrasound, signal on MRI), peritendinous or intratendinous vascularization, insertional calcifications.

• #42 Diagnostic Musculoskeletal Ultrasound of the Achilles Tendon | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/129050-diagnostic-musculoskeletal-ultrasound-of-the-achilles-tendon

  Achilles tendinopathy is a degenerative condition characterized by tendon thickening, hypoechoic areas, and disrupted fibrillar architecture on ultrasound. […] Doppler imaging often reveals neovascularization in chronic cases, particularly in the mid-portion of the tendon. […] Tears typically occur in the hypovascular watershed area 2-6 cm proximal to the calcaneal insertion. […] Partial tears appear as focal hypoechoic defects with preserved tendon continuity, while full-thickness tears demonstrate complete fiber disruption, visible as a hypoechoic or anechoic gap. […] Insertional tendinopathy affects the distal 2 cm of the tendon. […] Sonographic findings include hypoechoic and thickened tendon fibers, calcifications or enthesophytes at the calcaneal insertion, and fluid-filled retrocalcaneal bursitis.

• #43 Achilles Tendinopathy Diagnosis and Treatment – Sonoscope

  https://sonoscope.co.uk/conditions-treated/achilles-tendinitis-ultrasound-guided-injections/

  Achilles’ tendinitis is a common musculoskeletal condition that usually affects one of two different areas of the Achilles tendon. The most common site is the middle portion of the Achilles tendon. The other area is the insertion of the Achilles tendon, which is where the tendon inserts into the bone. It is often seen in runners, and more so still in middle-aged runners. […] Typical symptoms of Achilles tendinopathy are: Significant tenderness when touching the Achilles tendon, noticeable swelling of the Achilles tendon, pain and stiffness of the Achilles tendon particularly after periods of rest, aggravation of symptoms with activity such as walking or running. […] A diagnostic ultrasound scan and MRI scan are both used to diagnose Achilles tendonitis. Ultrasound is particularly useful as the Achilles tendon is easy life scanned in the clinic, and the images obtained are of a very high resolution, which makes it an ideal imaging modality to help diagnose Achilles tendinitis. Imaging allows us to differentiate between Achilles tendonitis (tendinopathy) and Para tendinitis (tendinopathy) or -partial or complete -tendon tearing. This is very important as these conditions require a different treatment regime.

• #44 Achilles Tendinopathy Diagnosis and Treatment – Sonoscope

  https://sonoscope.co.uk/conditions-treated/achilles-tendinitis-ultrasound-guided-injections/

  Ultrasound can very clearly show the difference between a normal Achilles tendon and one that has tendinopathy as the tendinopathic tendon is often significantly thicker than a normal Achilles tendon. […] The Achilles tendon might demonstrate thickening or inflammation or irritation of the peritenon.

• #45 Achilles tendinitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/diagnosis-treatment/drc-20369025

  During the physical exam, your healthcare professional will press gently on the area to find where the pain, tenderness or swelling are and watch how the foot and ankle look moving and at rest. […] One or more of these tests can help diagnose Achilles tendinitis: […] X-rays do not show soft tissues such as tendons. But they may show some signs of Achilles tendinitis and can help rule out other conditions that can cause some of the same symptoms. […] Ultrasound also can make real-time images of the Achilles tendon to show how it moves. […] Using radio waves and a strong magnet, MRI scans can show the Achilles tendon in detail. […] If several months of more-conservative treatments don’t work or if the tendon has torn, you might need traditional surgery to repair your Achilles tendon.

• #46 Diagnosing Achilles Injury | NYU Langone Health

  https://nyulangone.org/conditions/achilles-injury/diagnosis

  NYU Langone doctors use a physical exam and advanced imaging tests to diagnose injury to the Achilles tendon, including Achilles tendinitis and Achilles rupture. […] Our doctors conduct a physical exam and imaging tests to determine whether you have injured your Achilles. […] An MRI scan, which creates images of soft tissues in the body, including muscles and tendons, can help your doctor determine whether you have a partial or complete rupture and find its precise location along the tendon.

• #47 Achilles Tendinitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

  Your doctor may order imaging tests to help determine if your symptoms are caused by Achilles tendinitis. […] X-rays provide clear images of bones. They can show bone spurs on the back of the heel, which may be present in patients with insertional Achilles tendinitis. […] Although magnetic resonance imaging (MRI) is not necessary to diagnose Achilles tendinitis, it is important for planning surgery if nonsurgical treatment is not effective. […] In most cases of Achilles tendinitis, nonsurgical treatment options will provide adequate pain relief, although it may take a few months for symptoms to completely subside. […] The mainstays of nonsurgical treatment include anti-inflammatory pain medications, activity modification, shoe wear modification, and physical therapy exercises. […] Surgery for Achilles tendinitis should be considered only if the pain does not improve after 6 months of nonsurgical treatment.

• #48 Achilles Tendon Pain: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/orthopedics/columbia-orthopedics/achilles-tendon-pain/treatment

  How is Achilles Tendon Pain Diagnosed? Diagnosis If you think you are experiencing Achilles tendon pain, you will probably want to visit a doctor. After discussing your symptoms, the doctor will perform a physical exam, including an assessment of your foot and ankle; they will inspect the area for: Swelling at the Achilles tendon and the back of the heel […] After a physical exam, the doctor will order imaging tests to determine if the condition is Achilles tendonitis or another problem. These tests might include the following: X-rays can provide clear images of bones; therefore, bone spurs on the back of the heel can be seen, suggesting insertional Achilles tendonitis. In cases of severe non-insertional tendonitis, calcification (calcium buildup in the tendons) can be viewed from the X-rays. […] MRI (Magnetic Resonance Imaging). This imaging test is typical if nonsurgical treatments have not proven effective. Depending on the severity of damage to the tendon, which can be visualized through an MRI, the doctor can plan which surgical procedure should be used.

• #49 Diagnosing Achilles Injury | NYU Langone Health

  https://nyulangone.org/conditions/achilles-injury/diagnosis

  NYU Langone doctors use a physical exam and advanced imaging tests to diagnose injury to the Achilles tendon, including Achilles tendinitis and Achilles rupture. […] Our doctors conduct a physical exam and imaging tests to determine whether you have injured your Achilles. […] An MRI scan, which creates images of soft tissues in the body, including muscles and tendons, can help your doctor determine whether you have a partial or complete rupture and find its precise location along the tendon.

• #50 Achilles Tendon Injuries Workup: Approach Considerations, Imaging Studies

  https://emedicine.medscape.com/article/309393-workup

  Laboratory studies usually are not necessary in evaluating and diagnosing an Achilles tendon rupture or injury, although evaluation may help to rule out some of the other possibilities in the differential diagnosis. […] Imaging studies can aid in the diagnosis and evaluation of Achilles tendon pathology, but typically they are not needed. […] MRI can facilitate definitive diagnosis of a disrupted tendon. This is especially useful when considering the possibility of partial disruption of the Achilles tendon. […] MRI can also distinguish between paratenonitis, tendinosis, and bursitis. […] In tendinosis, increased MRI signal is evident in the tendon and degenerative changes, and partial tears may occasionally be seen.

• #51 Achilles Tendon Injuries Workup: Approach Considerations, Imaging Studies

  https://emedicine.medscape.com/article/309393-workup

  Laboratory studies usually are not necessary in evaluating and diagnosing an Achilles tendon rupture or injury, although evaluation may help to rule out some of the other possibilities in the differential diagnosis. […] Imaging studies can aid in the diagnosis and evaluation of Achilles tendon pathology, but typically they are not needed. […] MRI can facilitate definitive diagnosis of a disrupted tendon. This is especially useful when considering the possibility of partial disruption of the Achilles tendon. […] MRI can also distinguish between paratenonitis, tendinosis, and bursitis. […] In tendinosis, increased MRI signal is evident in the tendon and degenerative changes, and partial tears may occasionally be seen.

• #52 Achilles Tendon Injuries Workup: Approach Considerations, Imaging Studies

  https://emedicine.medscape.com/article/309393-workup

  Laboratory studies usually are not necessary in evaluating and diagnosing an Achilles tendon rupture or injury, although evaluation may help to rule out some of the other possibilities in the differential diagnosis. […] Imaging studies can aid in the diagnosis and evaluation of Achilles tendon pathology, but typically they are not needed. […] MRI can facilitate definitive diagnosis of a disrupted tendon. This is especially useful when considering the possibility of partial disruption of the Achilles tendon. […] MRI can also distinguish between paratenonitis, tendinosis, and bursitis. […] In tendinosis, increased MRI signal is evident in the tendon and degenerative changes, and partial tears may occasionally be seen.

• #53 Diagnosing Achilles Pain

  https://www.sports-health.com/sports-injuries/ankle-and-foot-injuries/diagnosing-achilles-pain

  To arrive at a clinical diagnosis of Achilles tendonitis, tendinosis, or other tendon condition, a doctor must eliminate other problems that cause similar symptoms, such as: […] A physician will diagnose the cause of the pain based on a combination of a physical exam, a detailed patient history, and if needed, diagnostic tests. […] A doctor will examine the foot and lower leg and look for signs of Achilles tendinopathy. […] The doctor may also ask the patient to do a series of exercises such as leg lifts, hops, or jumps to gauge the level of activity-related pain, as well as exactly where it occurs. […] In addition to a clinical exam the doctor will also take a detailed patient history. […] Medical imaging is usually not required to arrive at an Achilles tendinopathy diagnosis. However, in some cases a doctor may order imaging to get a detailed view of the tendon or to rule out other conditions.

• #54 Common Conditions of the Achilles Tendon | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0501/p1805.html

  The diagnosis is missed in about one fourth of cases. […] A thorough history and specific physical examination are essential to make the appropriate diagnosis and facilitate a specific treatment plan. […] A detailed history is necessary, including level of training, technique, footwear, previous injury, and treatment. […] The typical symptom of tendonitis is pain or tenderness proximal to or at the insertion to the calcaneus. […] In tendonitis and peritendonitis, symptoms usually develop gradually, and the patient typically presents with pain and stiffness over the Achilles region. […] A thorough physical examination is very important to the diagnosis, and it should be performed with the patient lying prone, feet hanging off the examination table. […] The diagnosis is made following an appropriate history and physical examination. […] The Thompson test should be performed on all patients with suspected Achilles tendon injury. […] If the diagnosis is still unclear, an ultrasound or magnetic resonance imaging study may be helpful.

• #55 Achilles Tendinitis – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/sports-injury/achilles-tendinitis

  Achilles tendinitis is very common among running athletes. […] Diagnosis of Achilles Tendinitis […] Clinical evaluation […] On examination, an inflamed or partially torn Achilles tendon is tender when squeezed between the fingers. Complete tears are differentiated by […] Sudden, severe pain and inability to walk on the extremity […] A palpable defect along the course of the tendon […] A positive Thompson test (while the patient lies prone on the examination table, the examiner squeezes the calf muscle; this maneuver by the examiner does not cause the normally expected plantar flexion of the foot).

• #56 Diagnostic Musculoskeletal Ultrasound of the Achilles Tendon | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/129050-diagnostic-musculoskeletal-ultrasound-of-the-achilles-tendon

  This bony prominence at the posterosuperior calcaneus causes mechanical irritation of the Achilles tendon. […] Ultrasound reveals a prominent osseous contour, thickened tendon fibers, and retrocalcaneal bursitis with fluid accumulation. […] Tendinosis reflects chronic degenerative changes without inflammation, appearing as hypoechoic regions with tendon thickening and disorganized fibrillar architecture. […] Chronic tendinosis may also exhibit calcifications or fatty degeneration. […] Retrocalcaneal bursitis is associated with overuse and manifests as anechoic or hypoechoic fluid distension of the bursa anterior to the Achilles tendon. […] This entity can co-exist with tendinopathy or inflammatory conditions. […] There are several advantages in using MSK-US to evaluate the Achilles Tendon in patients with posterior ankle pain. […] Dynamic Imaging: Allows visualization of the Achilles during active movement, aiding in the diagnosis of Achilles tendon abnormalities.

• #57 Achilles Tendon Enthesopathy – Bone, Joint, and Muscle Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/bone-joint-and-muscle-disorders/foot-and-ankle-problems/achilles-tendon-enthesopathy

  Achilles tendon enthesopathy is pain where the Achilles tendon attaches to the back of the heel bone. […] Diagnosis includes an examination of the tendon and sometimes x-ray. […] The diagnosis of Achilles tendon enthesopathy is based on a physical examination of the tendon. The diagnosis is confirmed if people have tenderness of the tendon where it attaches to the heel bone. Manually bending (flexing) the ankle upwards during the examination usually makes the pain worse.

• #58 Diagnostic Musculoskeletal Ultrasound of the Achilles Tendon | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/129050-diagnostic-musculoskeletal-ultrasound-of-the-achilles-tendon

  This bony prominence at the posterosuperior calcaneus causes mechanical irritation of the Achilles tendon. […] Ultrasound reveals a prominent osseous contour, thickened tendon fibers, and retrocalcaneal bursitis with fluid accumulation. […] Tendinosis reflects chronic degenerative changes without inflammation, appearing as hypoechoic regions with tendon thickening and disorganized fibrillar architecture. […] Chronic tendinosis may also exhibit calcifications or fatty degeneration. […] Retrocalcaneal bursitis is associated with overuse and manifests as anechoic or hypoechoic fluid distension of the bursa anterior to the Achilles tendon. […] This entity can co-exist with tendinopathy or inflammatory conditions. […] There are several advantages in using MSK-US to evaluate the Achilles Tendon in patients with posterior ankle pain. […] Dynamic Imaging: Allows visualization of the Achilles during active movement, aiding in the diagnosis of Achilles tendon abnormalities.

• #59 Achilles Tendon Differential Diagnosis — Physio Network

  https://www.physio-network.com/blog/achilles-tendon-differential-diagnosis-by-peter-malliaras-carly-johnson/

  I see about 5-10 new Achilles per week, 300 per year. […] This blog highlights signs and symptoms of common differential diagnoses in Achilles, and how ultrasound imaging can help. […] Ultrasound can never MAKE a diagnosis, but is excellent for CONFIRMING many conditions that present similarly to Achilles tendinopathy. […] Often I see Achilles injuries that have failed treatment, and incorrect diagnosis explains a considerable number of these, so its important to get the right diagnosis. […] Imaging does not really help to confirm a diagnosis, but can be useful in identifying the extent of pathology our patient below had diffuse minor degenerative changes with Doppler signal, but presented with midportion pain. […] On ultrasound there may be an associated traction spur with the low insertion but this is not necessary symptomatic.

• #60 Achilles Tendinopathy | PM&R KnowledgeNow

  https://now.aapmr.org/achilles-tendinopathy/

  Plain radiography has a low yield in detecting soft tissue pathology. However, it can be helpful for detecting bony pathology such as enthesopathy. Both ultrasound (US) and magnetic resonance imaging (MRI) provide the necessary anatomical detail for detecting AT pathology. Typical findings include a thickened paratenon, heterogeneity of tendon structure and increased vascularity of the ventral aspect of the tendon on color Doppler-augmented US and MRI. […] New advances in ultrasound-based technologies, such as shear wave sonoelastography (SWE) and strain sonoelastography (SE), not only allow for the evaluation of both AT stiffness and elasticity, but ultimately can aid in an early diagnosis. […] Visual analog pain scale (VAS) and Victorian Institute of Sports Assessment Achilles (VISA-A), an 8-question survey, have been validated for use in the AT population.

• #61 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  The most commonly identified objective clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). […] There is significant variation in the methodology and outcome measures used to diagnose Achilles tendinopathy. A method for diagnosing Achilles tendinopathy is proposed, that includes both results from the scoping review and recent recommendations for reporting results in tendinopathy. […] The most commonly used subjective measure was self-reported location of pain, while additional measures included pain with tendon loading activity, duration of symptoms and tendon stiffness. […] The VISA-A questionnaire as the most commonly used outcome measure to monitor Achilles tendinopathy. However, psychological factors (PES, TKS and PCS) and overall quality of life (SF-12, SF-36 and EQ-5D-5L) were less frequently measured.

• #62 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  The introduction of the nine core health domains in tendinopathy in addition to previously identified gaps in the literature, including; a lack of consistency in terminology used to diagnose Achilles tendinopathy, lack of a consensus on the clinical diagnosis of Achilles tendinopathy, and the need for a uniform method with which to clinically diagnose Achilles tendinopathy. […] The most commonly identified clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). […] Painful regions were described as the midportion, middle third, 2 to 4, 2 to 5, 2 to 6, 2 to 7, 4 to 6 and 4 to 7 cm above the calcaneal insertion. […] The most common outcome measure for disability was the VISA-A questionnaire, being used in 75% of the studies reporting outcome measures.

• #63 Achilles Tendinopathy | PM&R KnowledgeNow

  https://now.aapmr.org/achilles-tendinopathy/

  Plain radiography has a low yield in detecting soft tissue pathology. However, it can be helpful for detecting bony pathology such as enthesopathy. Both ultrasound (US) and magnetic resonance imaging (MRI) provide the necessary anatomical detail for detecting AT pathology. Typical findings include a thickened paratenon, heterogeneity of tendon structure and increased vascularity of the ventral aspect of the tendon on color Doppler-augmented US and MRI. […] New advances in ultrasound-based technologies, such as shear wave sonoelastography (SWE) and strain sonoelastography (SE), not only allow for the evaluation of both AT stiffness and elasticity, but ultimately can aid in an early diagnosis. […] Visual analog pain scale (VAS) and Victorian Institute of Sports Assessment Achilles (VISA-A), an 8-question survey, have been validated for use in the AT population.

• #64 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  The most commonly identified objective clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). […] There is significant variation in the methodology and outcome measures used to diagnose Achilles tendinopathy. A method for diagnosing Achilles tendinopathy is proposed, that includes both results from the scoping review and recent recommendations for reporting results in tendinopathy. […] The most commonly used subjective measure was self-reported location of pain, while additional measures included pain with tendon loading activity, duration of symptoms and tendon stiffness. […] The VISA-A questionnaire as the most commonly used outcome measure to monitor Achilles tendinopathy. However, psychological factors (PES, TKS and PCS) and overall quality of life (SF-12, SF-36 and EQ-5D-5L) were less frequently measured.

• #65 Achilles Tendinitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

  Achilles tendinitis is a common condition that occurs when the large tendon that runs down the back of the lower leg becomes irritated and inflamed. […] Achilles tendinitis pain can occur within the tendon itself or at the point where it attaches to the heel bone, called the Achilles tendon insertion. […] Simply defined, tendinitis (also spelled „tendonitis”) is acute inflammation of a tendon. Inflammation is the body’s natural response to injury and often causes swelling, pain, or irritation. […] Achilles tendinitis is different than an Achilles rupture, a condition where the tendon becomes separated off the heel bone or completely torn in half. […] There are two types of Achilles tendinitis, based on which part of the tendon is inflamed. The two types can occur separately or at the same time.

• #66 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  The introduction of the nine core health domains in tendinopathy in addition to previously identified gaps in the literature, including; a lack of consistency in terminology used to diagnose Achilles tendinopathy, lack of a consensus on the clinical diagnosis of Achilles tendinopathy, and the need for a uniform method with which to clinically diagnose Achilles tendinopathy. […] The most commonly identified clinical test for Achilles tendinopathy was tendon palpation (including pain on palpation, localised tendon thickening or localised swelling). […] Painful regions were described as the midportion, middle third, 2 to 4, 2 to 5, 2 to 6, 2 to 7, 4 to 6 and 4 to 7 cm above the calcaneal insertion. […] The most common outcome measure for disability was the VISA-A questionnaire, being used in 75% of the studies reporting outcome measures.

• #67 Diagnosis – GPnotebook

  https://gpnotebook.com/pages/musculoskeletal-medicine/achilles-tendinitis/diagnosis

  Diagnosis of Achilles tendinopathy is often achieved through patient’s history and clinical examination. […] should inquire about pain – onset, duration and aggravating factors. […] typically pain presents after exercise, 2-6 cm proximal to the site of tendon insertion. […] as the disease progresses the patient may have pain during exercise. […] pain may interfere with daily activities in severe cases. […] the degree of morning stiffness correlates to the severity of the disease. […] during clinical examination both legs should be exposed from above the knees and examination of the leg should be done while the patient is in standing position and in prone position. […] examination of foot and heel should be done to find out any malalignment, deformity, noticeable asymmetry tendon size, localised thickening, Haglund heel or for any previous scars.

• #68 Diagnostic Musculoskeletal Ultrasound of the Achilles Tendon | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/129050-diagnostic-musculoskeletal-ultrasound-of-the-achilles-tendon

  Achilles tendinopathy is a degenerative condition characterized by tendon thickening, hypoechoic areas, and disrupted fibrillar architecture on ultrasound. […] Doppler imaging often reveals neovascularization in chronic cases, particularly in the mid-portion of the tendon. […] Tears typically occur in the hypovascular watershed area 2-6 cm proximal to the calcaneal insertion. […] Partial tears appear as focal hypoechoic defects with preserved tendon continuity, while full-thickness tears demonstrate complete fiber disruption, visible as a hypoechoic or anechoic gap. […] Insertional tendinopathy affects the distal 2 cm of the tendon. […] Sonographic findings include hypoechoic and thickened tendon fibers, calcifications or enthesophytes at the calcaneal insertion, and fluid-filled retrocalcaneal bursitis.

• #69 Achilles Tendinitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

  Noninsertional Achilles tendinitis involves the lower portion of the tendon, where it attaches (inserts) to the heel bone (also known as the calcaneus). […] In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may calcify (harden) over time. […] Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon. […] Common symptoms of Achilles tendinitis include pain and stiffness along the Achilles tendon in the morning, pain along the tendon or back of the heel that worsens with activity, and swelling that is present all the time and gets worse throughout the day or with activity. […] After you describe your symptoms and discuss your concerns, the doctor will examine your foot and ankle. The doctor will look for these signs: swelling along the Achilles tendon or at the back of your heel, bone spurs or pain near the lower part of the tendon at the back of your heel, and pain in the middle of the tendon.

• #70 Diagnostic Musculoskeletal Ultrasound of the Achilles Tendon | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/129050-diagnostic-musculoskeletal-ultrasound-of-the-achilles-tendon

  Achilles tendinopathy is a degenerative condition characterized by tendon thickening, hypoechoic areas, and disrupted fibrillar architecture on ultrasound. […] Doppler imaging often reveals neovascularization in chronic cases, particularly in the mid-portion of the tendon. […] Tears typically occur in the hypovascular watershed area 2-6 cm proximal to the calcaneal insertion. […] Partial tears appear as focal hypoechoic defects with preserved tendon continuity, while full-thickness tears demonstrate complete fiber disruption, visible as a hypoechoic or anechoic gap. […] Insertional tendinopathy affects the distal 2 cm of the tendon. […] Sonographic findings include hypoechoic and thickened tendon fibers, calcifications or enthesophytes at the calcaneal insertion, and fluid-filled retrocalcaneal bursitis.

• #71 Achilles Tendinitis – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

  Achilles tendinitis is a common condition that occurs when the large tendon that runs down the back of the lower leg becomes irritated and inflamed. […] Achilles tendinitis pain can occur within the tendon itself or at the point where it attaches to the heel bone, called the Achilles tendon insertion. […] Simply defined, tendinitis (also spelled „tendonitis”) is acute inflammation of a tendon. Inflammation is the body’s natural response to injury and often causes swelling, pain, or irritation. […] Achilles tendinitis is different than an Achilles rupture, a condition where the tendon becomes separated off the heel bone or completely torn in half. […] There are two types of Achilles tendinitis, based on which part of the tendon is inflamed. The two types can occur separately or at the same time.

• #72 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  Achilles tendinopathy describes the clinical presentation of pain localised to the Achilles tendon and associated loss of function with tendon loading activities. However, clinicians display differing approaches to the diagnosis of Achilles tendinopathy due to inconsistency in the clinical terminology, an evolving understanding of the pathophysiology, and the lack of consensus on clinical tests which could be considered the gold standard for diagnosing Achilles tendinopathy. […] The clinical diagnosis of Achilles tendinopathy is predominantly derived from patient history, patient reported load related pain, and pain provocation tests. Patient history, localised Achilles tendon pain and pain on palpation are considered key to diagnosing Achilles tendinopathy and can all be assessed reliably.

• #73 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  Achilles tendinopathy describes the clinical presentation of pain localised to the Achilles tendon and associated loss of function with tendon loading activities. However, clinicians display differing approaches to the diagnosis of Achilles tendinopathy due to inconsistency in the clinical terminology, an evolving understanding of the pathophysiology, and the lack of consensus on clinical tests which could be considered the gold standard for diagnosing Achilles tendinopathy. […] The clinical diagnosis of Achilles tendinopathy is predominantly derived from patient history, patient reported load related pain, and pain provocation tests. Patient history, localised Achilles tendon pain and pain on palpation are considered key to diagnosing Achilles tendinopathy and can all be assessed reliably.

• #74 Achilles Tendonitis: Diagnosis & Treatment | Onward Physical Therapy

  https://onwardphysicaltherapy.com/achilles-tendonitis-diagnosis-treatment/

  Diagnosing this condition comes down to four common findings: […] Pain with loading the calf and Achilles (calf raises, running, jumping, etc.) […] This pain often warms up as you run and then will often come painful again later in runs or after runs […] Pain with palpation of the Achilles tendon (the rope-like structure connecting the calf muscles to the heel bone) […] Often, this pain follows a change in training volume.

• #75 The clinical diagnosis of Achilles tendinopathy: a scoping review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8485842/

  Achilles tendinopathy describes the clinical presentation of pain localised to the Achilles tendon and associated loss of function with tendon loading activities. However, clinicians display differing approaches to the diagnosis of Achilles tendinopathy due to inconsistency in the clinical terminology, an evolving understanding of the pathophysiology, and the lack of consensus on clinical tests which could be considered the gold standard for diagnosing Achilles tendinopathy. […] The clinical diagnosis of Achilles tendinopathy is predominantly derived from patient history, patient reported load related pain, and pain provocation tests. Patient history, localised Achilles tendon pain and pain on palpation are considered key to diagnosing Achilles tendinopathy and can all be assessed reliably.

• #76 Diagnosis – GPnotebook

  https://gpnotebook.com/pages/musculoskeletal-medicine/achilles-tendinitis/diagnosis

  Achilles tendon should be inspected for any swelling, tenderness, heat, increased erythema, nodularity and crepitation. […] during the acute phase – the tendon is diffusely swollen, palpation reveals tenderness (usually greatest in its middle third), crepitation. […] in more chronic phase – crepitation and swelling may diminish, exercise induced pain remains the cardinal symptom, a tender, nodular swelling in patients with chronic disease signify tendiniosis and particularly in these patients dorsiflexion and plantar flexion of the ankle may cause the focal tender nodules to move. […] Achilles tendon rupture should be excluded during clinical examination. […] if the tendon is intact, its function should be assessed by provoking tendon pain during tendon-loading activities. […] in majority a simple single-leg heel raises will be adequate to cause pain.

• #77 Achilles Tendinopathy / Achilles Tendinitis | Diagnosis & Treatment

  https://www.physiotutors.com/conditions/achilles-tendinopathy/

  Achilles tendinopathy is a common musculoskeletal condition characterized by localized Achilles tendon load-related pain and dysfunction. […] Achilles tendinopathy affects approximately 9% of recreational runners and up to 5% of professional athletes, this condition is career-ending. […] The incidence of mid-portion Achilles tendinopathy in general practice within the adult population is 2.35 per 1000, and in 35% of cases, a relationship with sports activity has been recorded. […] The pain mechanisms in tendinopathy are not clear but are thought to involve local nociception mediated by changes within the tenocytes. […] The current understanding is the imbalance between the load demands placed on the tendon and its capacity to remodel. […] A common symptom is morning stiffness or stiffness following a period of inactivity.

• #78 Achilles tendinopathy – Overview | Guy’s and St Thomas’ NHS Foundation Trust

  https://www.guysandstthomas.nhs.uk/health-information/achilles-tendinopathy

  Achilles tendinopathy is an injury to this tendon. […] You do not need an X-ray or other scans to diagnose Achilles tendinopathy. We usually confirm the diagnosis by asking about your medical history and examining you. […] If you have any questions or concerns, please speak to your physiotherapist. […] If your symptoms do not improve in 6 to 9 months (even after following an appropriate exercise programme), we can consider other treatment options.

• #79 Achilles tendinitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/symptoms-causes/syc-20369020

  Achilles tendinitis is an injury of the Achilles (uh-KILL-eez) tendon. It can be caused by using it too much or too hard without enough rest, called overuse. […] Most often, Achilles tendinitis can be treated with at-home care guided by a healthcare professional. […] Serious cases of Achilles tendinitis can lead to tendon tears, also called ruptures. Tears might need surgery to fix them. […] If you have pain around the Achilles tendon that doesn’t go away, call your healthcare professional. If the pain is suddenly severe or keeps you from moving, you may have torn your Achilles tendon. Seek medical help right away. […] Repeated or intense strain on the Achilles tendon can cause Achilles tendinitis, though sometimes the cause is not clear. […] Achilles tendinitis can weaken the tendon. The weakness makes it more likely to tear, also called rupture. An Achilles rupture is a serious injury that often needs surgery to repair it.

• #80 Achilles tendinitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/symptoms-causes/syc-20369020

  Achilles tendinitis is an injury of the Achilles (uh-KILL-eez) tendon. It can be caused by using it too much or too hard without enough rest, called overuse. […] Most often, Achilles tendinitis can be treated with at-home care guided by a healthcare professional. […] Serious cases of Achilles tendinitis can lead to tendon tears, also called ruptures. Tears might need surgery to fix them. […] If you have pain around the Achilles tendon that doesn’t go away, call your healthcare professional. If the pain is suddenly severe or keeps you from moving, you may have torn your Achilles tendon. Seek medical help right away. […] Repeated or intense strain on the Achilles tendon can cause Achilles tendinitis, though sometimes the cause is not clear. […] Achilles tendinitis can weaken the tendon. The weakness makes it more likely to tear, also called rupture. An Achilles rupture is a serious injury that often needs surgery to repair it.

• #81 Achilles Tendon Disorders

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2015.138/html?srsltid=AfmBOopdQjWGfLmC-P7YRtKFqKds0lu6elXAnOPVNw5P8gz4JARkTvQs

  Given the broad spectrum of disorders that may present similarly to Achilles tendon disorders, a detailed musculoskeletal examination of both lower extremities should always be performed simultaneously. […] The initial evaluation of Achilles tendon disorders does not often require the use of diagnostic imaging. However, magnetic resonance imaging, ultrasonography, and radiographic imaging may be necessary in the presence of equivocal examination findings, to narrow the differential diagnosis, or for surgical planning. […] The diagnosis of these injuries is most commonly based on a thorough history and physical examination and may require imaging in certain cases. Acute tendon ruptures should always be ruled out at initial presentation.

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