What You Should Know About Achilles Tendonopathy

The mechanism of Achilles tendonopathy includes overuse, imbalance of the dorsiflexors and plantar flexors, poor tendon blood supply, genetic predisposition, fluoroquinolone antibiotics, and or inflammatory arthropathy. The pathophysiology is theorized to be due to abnormal vascularity 2-6 cm proximal to the Achilles tendon insertion in response to repetitive microscopic tearing of the tendon. On physical exam, you may find tendon thickening and tenderness 2-6cm properly to the Achilles tendon Insertion. As far as imaging, on MRI, disorganized tissue will show up as intraceubstance intermediate signal intensity.