Author: David Oh, MD
Co Author #1: Anton Matveev, MD
Co Author #2: Tunc Kiymaz, MD
Co Author #3: Reed C. Williams, MD
Senior Editor: Warren Bodine, DO, FAMSSM
Editor: Reno Ravindran, MD
30-year-old male marathon runner with six-week history of left worse than right posterior ankle pain.
30-year-old male marathon runner with six-week history of left worse than right posterior ankle pain. Notably, the patient was prescribed levofloxacin for a sinus infection 1-2 weeks prior to the onset of his symptoms. He experienced worsening pain and function limitation during eccentric based therapy protocols and conservative running despite prior treatments including activity modification, non-steroidal anti-inflammatories and AirHeel orthoses.
Gait: Non-antalgic gait without abnormalities of limb advancement, stability or foot clearance.
Inspection: No excessive foot pronation/supination, pes planus/cavus, or calcaneovalgus/varus bilaterally.
Ankle Exam: There was left greater than right swelling of the Achilles tendon with tenderness to palpation on the left. Ankle range of motion was full and without crepitus, but painful with plantarflexion bilaterally. Strength 5/5 throughout the lower extremities. Sensation intact to light touch. Thompson test was negative bilaterally.
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