[Achilles tendon pathologies]

Area of Science:

• Orthopedics and Sports Medicine
• Radiology
• Physical Therapy

Background:

• Achilles tendon pathologies are prevalent in clinical practice.
• These conditions are categorized as insertional or noninsertional tendinopathies.
• Risk factors include intrinsic elements like diabetes mellitus and extrinsic factors such as overuse and running.

Purpose of the Study:

• To provide a comprehensive overview of Achilles tendon pathologies.
• To outline diagnostic imaging modalities and treatment strategies.
• To differentiate between conservative and surgical management approaches.

Main Methods:

• Review of established diagnostic imaging techniques including sonography, X-ray, and MRI.
• Analysis of conservative treatment options: NSAIDs, physical rest, assistive devices, eccentric stretching, shockwave therapy, and platelet-rich plasma injections.
• Consideration of surgical interventions for cases unresponsive to conservative care.

Main Results:

• Conservative management is the primary treatment approach.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), rest, and assistive devices are first-line treatments.
• Eccentric stretching, shockwave therapy, and platelet-rich plasma injections are established conservative procedures.

Conclusions:

• Achilles tendon pathologies require a tailored treatment strategy based on individual patient factors.
• Conservative treatments should be exhausted before considering surgical options.
• Surgical procedures, including minimally invasive, endoscopic, or open debridement, are reserved for refractory cases.