title: Neglected spontaneous rupture of the Achilles tendon in elderly patients with rheumatoid arthritis.
abstract: Spontaneous Achilles tendon rupture associated with rheumatoid arthritis (RA) is a very rare complication. In this report, we have experienced neglected spontaneous rupture of the Achilles tendon in 5 elderly RA patients, and report its clinical features and management. These patients had taken corticosteroids for a long time for RA control. Moreover, they did not show any signs, such as click or impact on the rear foot at the moment of the rupture, and had few complaints or obvious symptoms around their ankles or the rear of the foot after the rupture. This suggests that the lack of severe symptoms prevented the early diagnosis of the Achilles tendon rupture, and that this injury had been neglected during treatment for RA. Therefore, careful diagnosis of the Achilles tendon rupture is needed in elderly patients with RA, even if they have little or no history of trauma.
authors.affiliation: Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mikashima
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kawamura
authors.forename: Motoko
authors.initials: M
authors.lastname: Miyawaki
authors.forename: Kaoru
authors.initials: K
authors.lastname: Murakoshi
authors.forename: Norio
authors.initials: N
authors.lastname: Usami
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000209:etiology / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones