MSK

Question 1

Simmond’s traid

Answer 1

• Increased resting ankle dorsiflexion in prone position with knees bent
• Palpable gap above the knee
• Lack of plantar flexion when calf is squeezed (Thompson’s test +ve)

Question 2

Achilles tendon PX and RF

Answer 2

PX
- Tendinopathy, partial tear, complete rupture of tendon

RF
- Quinolone use (e.g. ciprofloxacin) associated
- Hypercholesterolaemia (prediposes to tendon xanthomata)

Question 3

Achilles tendinopathy FX

Answer 3

• Gradual onset of posterior heel pain
  o Worse with activity
• Morning pain and stiffness

Question 4

Achilles tendinopathy MX

Answer 4

Supportive
- Analgesia
- Reduce precip. activities
- Calf muscle eccenteric exercise (self or physio)

Question 5

Achilles tendon rupture FX

Answer 5

• Playing a sport or running
• Audible ‘pop’ in the ankle
• Sudden, onset sign pain in the calf or ankle or inability to walk or continue the sport

Question 6

Achilles tendon rupture IX

+ Referral

Answer 6

• Simmond’s triad (Thompton’s test)
  o Lie prone feet over edge of the bed
  o Foot remains in neutral position when calf squeezed
• US - 1st line
• Sus = acute referral to orthopa.