title: Drug-induced tendinopathy: from physiology to clinical applications.
abstract: Drug-induced tendon toxicity is rare but often underestimated. To date, four main drug classes have been incriminated in tendinopathies. Quinolones and long-term glucocorticoids are the most widely known, but statins and aromatase inhibitors can also induce tendon damage. The specific pathophysiological mechanisms responsible for drug-induced tendinopathies remain unknown. Proven risk factors have been identified, such as age older than 60 years, pre-existing tendinopathy, and potentiation of toxic effects when several drug classes are used in combination. Mean time to symptom onset varies from a few days with quinolones to several months with statins and several years for long-term glucocorticoid therapy. The most common sites of involvement are the lower limb tendons, most notably the body of the Achilles tendon. The first part of this review discusses tendon anatomy and the pathophysiology and radiological manifestations of tendinopathies. The second part provides details on the main characteristics of each of the drugs classes associated with tendon toxicity.
authors: Service de Radiologie, Département d'imagerie musculo-squelettique, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium. Electronic address: Thomas.Kirchgesner@gmail.com.
authors: Thomas
authors: T
authors: Kirchgesner
authors: Service de Radiologie, Département d'imagerie musculo-squelettique, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium.
authors: Ahmed
authors: A
authors: Larbi
authors: Service de Radiologie, Département d'imagerie musculo-squelettique, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium.
authors: Patrick
authors: P
authors: Omoumi
authors: Service de Radiologie, Département d'imagerie musculo-squelettique, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium.
authors: Jacques
authors: J
authors: Malghem
authors: Service de Radiologie, Département d'imagerie musculo-squelettique, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium.
authors: Nadia
authors: N
authors: Zamali
authors: Service de Radiologie, Hôpital Bichât-Claude-Bernard, 46, rue Henri-Huchard, 75877 Paris, France.
authors: Julien
authors: J
authors: Manelfe
authors: Service de Radiologie, Département d'imagerie musculo-squelettique, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium.
authors: Frédéric
authors: F
authors: Lecouvet
authors: Service de Radiologie, Département d'imagerie musculo-squelettique, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium.
authors: Bruno
authors: B
authors: Vande Berg
authors: Service de radiologie ostéo-articulaire, Hôpital Roger-Salengro, avenue du Pr Emile-Laine, 59037 Lille, France.
authors: Sahlya
authors: S
authors: Djebbar
authors: Service de Radiologie, Département d'imagerie musculo-squelettique, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgium; Université Paris Diderot, 5, rue Thomas-Mann, 75205 Paris, France.
authors: Benjamin
authors: B
authors: Dallaudière
mesh_terms: D047072:Aromatase Inhibitors / Q000009:adverse effects; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D015363:Quinolones / Q000009:adverse effects; D011859:Radiography; D052256:Tendinopathy / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D013710:Tendons / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000502:physiology / Q000503:physiopathology
chemical_list: D047072:Aromatase Inhibitors; D005938:Glucocorticoids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015363:Quinolones
keywords: Glucocorticoid; Iatrogenic; Quinolone; Statin; Tendinopathy; Tendon