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The tendon receives nutrients from the tendon sheath or paratendon. When an injury occurs to the tendon, cells from surrounding structures migrate into the tendon to assist in repair. Some of these cells come from blood vessels that enter the tendon to provide direct blood flow to increase healing. With the blood vessels come nerve fibers.
Tendinopathy is a type of tendon disorder that results in pain, swelling, and impaired function. [2] The pain is typically worse with movement. [2] It most commonly occurs around the shoulder (rotator cuff tendinitis, biceps tendinitis), elbow (tennis elbow, golfer's elbow), wrist, hip, knee (jumper's knee, popliteus tendinopathy), or ankle (Achilles tendinitis).
Non-surgical treatment is an alternative as there is supporting evidence that rerupture rates and satisfactory outcomes are comparable to surgery. [2] If appropriate treatment does not occur within 4 weeks of the injury outcomes are not as good. [8] Achilles tendon rupture occurs in about 1 per 10,000 people per year. [5]
The ankle joint marks the point of connection between the bones of the leg and those of the foot, and controls the raising and lowering of the foot. The ankle is often considered to comprise not only the ankle joint itself but also the structures surrounding it at the lower end of the leg and the beginning of the foot proper.
Stage 1: Tendon is intact, but damaged. Stage 2: Tendon has ruptured. Foot begins to deform. Stage 3: The foot is significantly deformed. Cartilage begins to degenerate. Stage 4: Ankle joint begins to degenerate. [1] In early stages, patients will describe foot and ankle pain. Swelling will also be present.
Full recovery is to be expected, though some patients will need rehabilitation. [1] However, relapse can occasionally occur, especially if only conservative treatments are undergone. [8] Sinus tarsi syndrome can be misdiagnosed as a chronic ankle sprain. Untreated sinus tarsi syndrome can develop into chronic ankle pain and disability. [9]
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Sagittal magnetic resonance images of ankle region: psoriatic arthritis. (a) Short tau inversion recovery (STIR) image, showing high signal intensity at the Achilles tendon insertion (enthesitis, thick arrow) and in the synovium of the ankle joint (synovitis, long thin arrow). Bone marrow oedema is seen at the tendon insertion (short thin arrow ...