The painful Achilles tendon is a common presentation in orthopaedic and sports medicine clinics. Traditionally described as "Achilles tendonitis" it is now recognised that the inflammatory process is absent in most patients, and that this is a degenerative and overuse condition with attempted repair.
Maffuli (1999) recommended the term “Achilles tendonopathy” to describe the clinical syndrome of pain, swelling and impaired performance in the Achilles tendon, reserving “tendinosis” for histopathological findings. Tendonopathy and tendinosis do not always co-exist. A further revision of terminology was recommended by van Dijk (2011):
- paratendonopathy for pain, swelling and impaired performance arising from the paratenon, with paratendonitis as a histopathological entity
- insertional tendonopathy for the syndrome arising from the distal 2cm of the tendon
- mid-portion Achilles tendonopathy for the syndrome arising from the tendon 2-7cm above the insertion
- retrocalcaneal bursitis
- superficial calcaneal bursitis
van Dijk recommended discontinuation of the term "Haglund's deformity". The diagram above shows where this is traditionally applied for reference.
While there may be some further modification to this nomenclature, it seems rational and will be adopted by the Hyperbook