%0 Journal Article
%T Bilateral spontaneous non-traumatic rupture of the Achilles tendon: a case report
%A Zubair Khanzada
%A Ulfin Rethnam
%A David Widdowson
%A Ahmed Mirza
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-263
%X A 78-year-old Caucasian woman presented with spontaneous non-traumatic bilateral rupture of the Achilles tendons. Her symptoms started two days after she took ciprofloxacin 500 mg twice daily for a urinary tract infection and prednisolone 30 mg once daily for chronic obstructive airway disease.This case report aims to increase the awareness of this rare condition, which should be borne in mind with regard to patients who are on steroid therapy and are concurrently started on fluoroquinolones.Spontaneous non-traumatic rupture is rare and is commonly associated with long-term use of corticosteroids [1] or fluoroquinolones [2]. When prescribed together, steroids and fluoroquinolones can have a potentiating effect, causing an increase in the risk of Achilles tendon rupture [3]. Bilateral spontaneous Achilles tendon rupture is extremely rare, with fewer than 20 cases reported in the literature [4]. We present an interesting case of spontaneous bilateral Achilles tendon rupture.A 78-year-old Caucasian woman presented to the Accident and Emergency Department with spontaneous onset of severe pain in both ankles. There was no history of trauma. The patient was given oral ciprofloxacin hydrochloride 500 mg twice daily for urinary tract infection. She was also given oral prednisolone 30 mg once daily for chronic obstructive airway disease. Two days after starting the medications the patient developed intense bilateral ankle pain. She was unable to walk. The symptoms started on the left side first, followed by the right side a few hours later. There was nothing in the patient's history to suggest chronic Achilles tendinopathy.At the initial assessment, the patient was unable to bear weight because of pain. Both ankles appeared to be swollen with bruising over the Achilles tendon region. There was tenderness over both Achilles tendons near their insertions into the calcaneus with palpable gaps in the substance of the tendons. She had a positive Thompson's test and was unable to
%U http://www.jmedicalcasereports.com/content/5/1/263