Ankle Pain Disorders
1- Achilles Tendinitis (Tendonitis) is most commonly caused by overuse. Also, intense repetitive exercising without warm up is another cause. Achilles tendinitis maybe associated with psoriasis, obesity, HTN and ingestion of certain medication like fluoroquinolones (ofloxacin, levofloxacin and ciprofloxacin). It is characterized by tenderness and pain along the tendon with painful dorsiflexion of the foot.
2- Achilles Tendinosis is usually the sequalae of chronic or untreated tendinitis where scar tissue will form and bumps along the tendon can be palpated.
3- Achilles Tendon Rupture usually happens due to sudden stress on the tendon as in jumping or falling into a hole. Some medications like steroids and fluoroquinolones can predispose to that. The patient usually feels a pop or snap sound with pain. It characterized by palpation of a gap in the tendon area with swelling and tenderness of the calf. Matles test is positive (absence of foot plantar flexion while the patient tis prone with leg flexed 90°). Thompson test is positive (absence of plantar flexion while the patient tis supine and the legs hanging on the edge of the table while the calf is being squeezed). Refer to orthopedics for possible surgery.
4- Tarsal Tunnel Syndrome usually occur due to entrapment of the posterior tibial nerve behind the medial malleolus resulting in foot pain at the medial and plantar aspects. Can be caused by local swelling as in ganglion cyst, varicose veins, tendinitis or by strain as in case of flat feet. Tinel's sign is positive at this area.
You can read more about the ankle disorders using this book Practical office orthopedics.
This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your local emergency services or your primary care provider. Please refer to your doctor for medical advice.