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Ankle Arthritis

Ankle arthritis is probably rarer than knee or hip arthritis, but the patient still is going to be presenting ankle arthritis, ankel, artritis with pain, limitation of motion, swelling about the ankle, with or without deformity. X-rays are going to show joint space narrowing with the loss of cartilage, there may be subchondral cyst formation on both the distal tibia and on the talus, and para-articular osteophyte formation. Then your options to treat them are, beginning with activity modification, use of anti-inflammatory medications to control pain and symptoms, some people with severe arthritis would do well with an ankle

Medial gastrocnemius rupture, tennis leg or medial head of the gastrocnemius strain can occur in the same population of patients, it occurs by the same mechanism, eccentric contraction, so the muscle is trying to shorten, while it’s actually lengthening because of the external force applied through the joint, and some musculotendinous disruption, so it’s higher up in the leg, it’s up in the sort of the meaty part of the calf and it’s more subtle, and perhaps even a less severe injury than Achilles tendon rupture. If it occurs in an older patient, you might confuse it with a DVT, you may get a duplex study, you may think it’s a palpable cord or a Homans sign, so make sure you see that it’s not the medial head of the gastrocnemius strain, and for that reason, there can also be a delay in presentation because the patient is able to walk on this and the pain may be less severe than with

Achilles tendon rupture. So, they are going to present with a painful, swollen calf, there are times when tests are going to be negative, so when you squeeze their calf, it may hurt, but you are going to watch the ankle plantar flex, because overall, the Achilles tendon is still in continuity, so the ankle is going to plantar flex, and there may be a severe sign and very severe tears, but it’s going to be more subtle, so I have to feel through the fleshy portion of the calf, they don’t need to be casted, they

Achilles tendon rupture is sort of the weekend warrior injury, the recreational athlete that perhaps at the start of his or her recreational season, they are out to perform their activities, they haven’t sufficiently warmed up and it’s been a long winter and they haven’t really been doing much activity, they tear their Achilles tendon, and the mechanism here is an eccentric contracture, meaning, as they are trying to contract their Achilles tendon or put the foot into the ankle into plantar flexion, the ankle is actually is actually dorsiflexing from the stress applying to it, so you have that large force to pull the Achilles tendon apart. That patient