Although most cases of Achilles tendinitis are caused by some form of biomechanical stress, other factors may play a role in its etiology. Fluoroquinolone use is a well-known contributing factor to Achilles tendon pathology. This report describes a case of fluoroquinolone-induced Achilles tendinitis in a 77-year-old woman. Eight weeks after she presented to our office, the patient reported significant improvements after a course of care that included low level laser therapy (LLLT), activity modification and graduated exercises. Management can include many of the treatment tools used for biomechanically induced tendinopathy, with particular consideration given to delaying more advanced weight-bearing rehabilitative exercise due to the increased risk of rupture.
Tendinite du tendon d’Achille induite par les fluoroquinolones: un rapport de casBien que la plupart des cas de tendinite d’Achille soient causés par une forme quelconque de stress biomécanique, d’autres facteurs peuvent jouer un rôle dans son étiologie. L’utilisation de fluoroquinolones est un facteur bien connu qui contribue à la pathologie du tendon d’Achille. Ce rapport décrit un cas de tendinite d’Achille induite par les fluoroquinolones chez une femme de 77 ans. Huit semaines après s’être présentée à notre clinique, la patiente a fait état d’améliorations notables après un traitement comprenant un traitement au laser de faible puissance, une modification de l’activité et des exercices progressifs. La prise en charge peut inclure de nombreux outils de traitement utilisés pour les tendinopathies d’origine biomécanique, avec une attention particulière pour retarder les exercices de réadaptation avec mise en charge plus avancés en raison du risque accru de rupture.

Work-related diseases of the musculoskeletal and the peripheral nervous system are classified as overload cumulative microtrauma diseases, resulting from chronic overload and/or damage of specific neuromusculoskeletal structures. Occupational activities which predispose to them are characterised by monotypy (repetition of movements during a significant part of the working shift). Authors described 4 cases of women with musculoskeletal and peripheral nervous system disorders qualified as occupational background just in the 2nd instance of medical certification. Detailed analysis of occupational exposure and medical interview with individual diagnostic approach allowed to determine the occupational etiology of diseases, regardless of non-occupational risk factors in some cases, even if the workstation was not common. Difficulties in estimating the probability of disease process induction on the background of occupational exposure are caused by frequent coexistence of non-occupational risk factors. The 2-tier system of certification provides an independent evaluation of medical history and occupational exposure. Med Pr. 2022;73(1).
Choroby układu ruchu i obwodowego układu nerwowego wywołane sposobem wykonywania pracy są zaliczane do przeciążeniowych chorób skumulowanych mikrourazów, wynikających z chronicznego przeciążenia i/lub uszkodzenia określonych struktur układu nerwowo-mięśniowo-szkieletowego. Sposób wykonywania pracy, który predysponuje do ich rozwoju, cechuje się monotypią, tj. powtarzalnością ruchów przez istotną część zmiany roboczej. W pracy opisano 4 przypadki odwoławczego postępowania diagnostyczno-orzeczniczego kobiet z chorobami układu ruchu i obwodowego układu nerwowego, u których wykazano związek przyczynowo-skutkowy pomiędzy rozwojem schorzeń a sposobem wykonywania pracy. Ponowna szczegółowa analiza narażenia zawodowego oraz pogłębienie wywiadu zawodowego pozwoliły na ustalenie zawodowej etiologii schorzeń z uwzględnieniem istnienia czynników pozazawodowych czy też w związku z wykonywaniem pracy na rzadko spotykanych stanowiskach. Trudności orzecznicze w ocenie możliwości wystąpienia procesu chorobowego w związku z ekspozycją zawodową powoduje częste współistnienie czynników pozazawodowych predysponujących do powstania choroby wymienionej w wykazie chorób zawodowych, które powinny podlegać szczegółowej ocenie w toku postepowania prowadzonego w związku z podejrzeniem choroby zawodowej. Dwustopniowy system orzeczniczy dający możliwość ponownego badania pozwala na powtórną niezależną ocenę medyczną i dotyczącą narażenia zawodowego oraz na zweryfikowanie przedstawionych wcześniej wniosków. Med. Pr. 2022;73(1).

Calcific tendinitis is a common pathology in the shoulder but is uncommon in the peroneus longus tendon, which is considered when patient presents with a palpable tenderness without signs of inflammation. Differential diagnosis is important, as the condition is often overlooked. Conservative treatment has proven successful, though surgery might be an alternative.

We present a patient in whom a combination of perinuclear antineutrophil cytoplasmic antibody-positive vasculitis, oligoarthritis, tendinitis, and myositis was considered to be associated with isotretinoin use. Discontinuation of the drug resulted in complete clinical and biochemical remission (normalization of perinuclear antineutrophil cytoplasmic antibody titer). Although we were unable to prove causality, no other underlying cause for the patient\'s course was found. We report this occurrence to bring it to the attention of physicians prescribing isotretinoin.

Synopsis The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in differential diagnosis, the diagnosis of patellar tendinopathy remains clinical, as asymptomatic tendon pathology may exist in people who have pain from other anterior knee sources. A thorough examination is required to diagnose patellar tendinopathy and contributing factors. Management of patellar tendinopathy should focus on progressively developing load tolerance of the tendon, the musculoskeletal unit, and the kinetic chain, as well as addressing key biomechanical and other risk factors. Rehabilitation can be slow and sometimes frustrating. This review aims to assist clinicians with key concepts related to examination, diagnosis, and management of patellar tendinopathy. Difficult clinical presentations (eg, highly irritable tendon, systemic comorbidities) as well as common pitfalls, such as unrealistic rehabilitation time frames and overreliance on passive treatments, are also discussed. J Orthop Sports Phys Ther 2015;45(11):887-898. Epub 21 Sep 2015. doi:10.2519/jospt.2015.5987.

We present a rare case of severe neck pain in a 45-year-old man with severe hidradenitis suppurativa who was participating in a study involving adalimumab. The neck pain was associated with acute longus colli calcific tendinitis, which is a noninfectious inflammatory response in the longus colli tendons secondary to deposition of calcium hydroxyapatite crystal. The diagnosis was made by computed tomography, which showed calcifications and deposits, and magnetic resonance imaging, which showed a retropharyngeal effusion. Ears, Nose, and Throat Services performed a fiberoptic scope examination, which revealed a patent airway and no drainable abscess. Nonsteroidal anti-inflammatory drugs resulted in a dramatic improvement in the patient\'s clinical symptoms. In acute longus colli tendinitis, differentiating retropharyngeal aseptic effusion from infection is important. Of note, the confounding factor in this case was that the patient was blinded to whether he was receiving the placebo or adalimumab, so whether the patient was immunosuppressed and at risk for infection was unknown. Clinician familiarity and education concerning acute calcific longus colli tendinitis may lead to decreased costs stemming from incorrect diagnosis and unnecessary treatment.

BACKGROUND: Shoulder pain is one of the most common problems in ages older than 60 years of age. Rotator cuff pathology is the most common etiology of shoulder pain. Most of rotator cuff pathologies are treated conservatively in old ages and exercise therapy is not an accepted intervention for management of rotator cuff tear yet.
METHODS: The case was a man of 53 years age with shoulder pain who had total tear of supraspinatus tendon and biceps tendinitis in the right shoulder. He had regularly gone swimming, mountain climbing and running in the last 10 years. The case was managed by exercise therapy for 3 months and physical modalities for 20 sessions. Shoulder pain and his function and right shoulder range of motion increased after 3 months. Para clinical findings did not change after treatment, though. The improvements continued 15 months after the beginning of the treatment.
CONCLUSIONS: Exercise therapy was very effective for improving pain and function in total tear of supraspinatus tendon and tendinitis of biceps.

BACKGROUND: Rotator cuff disease is a common condition in the general population, but relatively little is known about its associated risk factors.
METHODS: We have undertaken a large case-control study using The Health Improvement Network database to assess and to quantify the relative contributions of some constitutional and environmental risk factors for rotator cuff disease in the community. Our data set included 5000 patients with rotator cuff disease who were individually matched with a single control by age, sex, and general practice (primary care practice).
RESULTS: The median age at diagnosis was 55 years (interquartile range, 44-65 years). Multivariate analysis showed that the risk factors associated with rotator cuff disease were Achilles tendinitis (odds ratio [OR] = 1.78), trigger finger (OR = 1.99), lateral epicondylitis (OR = 1.71), and carpal tunnel syndrome (OR = 1.55). Oral corticosteroid therapy (OR = 2.03), oral antidiabetic use (OR = 1.66), insulin use (OR = 1.77), and \"overweight\" body mass index of 25.1 to 30 (OR = 1.15) were also significantly associated. Current or previous smoking history, body mass index of greater than 30, any alcohol intake, medial epicondylitis, de Quervain syndrome, cubital tunnel syndrome, and rheumatoid arthritis were not found to be associated with rotator cuff disease.
CONCLUSIONS: We have identified a number of comorbidities and risk factors for rotator cuff disease. These include lateral epicondylitis, carpal tunnel syndrome, trigger finger, Achilles tendinitis, oral corticosteroid use, and diabetes mellitus. The findings should alert the clinician to comorbid pathologic processes and guide future research into the etiology of this condition.