[Achillodynia is not just a sports injury]

A descriptive study of patients referred to two rheumatology clinics.

Over a period of eight months, all patients with Achilles tendon pain (AT) were registered. All patients were clinically investigated and an ultrasound scan (US) was performed.

A total of 113 patients were included (3.65% of all patients) with 132 AT. In all, 85 patients were sports active and the AT could be explained by overuse. A total of 28 patients had no relevant overuse and their ATs were considered to be degenerative. US changes were found in 112 tendons, but no pathologic changes were found in 20 symptomatic tendons. Conversely, we found US changes in 21 asymptomatic tendons. In our study, US helped to identify a misdiagnosed tendon rupture. In five patients, erosions were found, possibly as an initial sign of arthritis. US diagnosed 9% with bursitis, 35% with peritendinitis, 39% with neovascularisation within the tendon and 53% with increased thickness of the tendon. In most cases, the thickening was found 4-6 cm above the insertion, often in the vicinity of the soleus muscle-tendon junction.

AT is a common complaint in rheumatology clinics. US alone cannot diagnose AT, but it serves as a supplement to clinical investigation. US can assist in achieving more precise diagnoses. Future studies must elucidate if the various diagnoses are associated with different prognoses and treatments.