Q. My mom met with two major falls. Is that due to Achilles tendon weakness?
Hi doctor,
I have a question for my mother. My mother is 50 years old. She complains of an episodic, sudden loss of weight-bearing ability on the left Achilles tendon. This has resulted in two major falls, which resulted in trauma. These are present for the past few months and have become more frequent in the last month. She also has pain in her knees bilaterally, which has been attributed to osteoarthritis. She also complains of hip pain associated with swelling and difficulty in standing, lying, and changing sides while sleeping. There is episodic stiffness present in the shoulders, which causes some discomfort in raising arms above the shoulder level. She is taking Bisoprolol 5 mg and Amlodipine 5 mg for high BP and it is well-controlled. She has no history of any allergies. She has kidney stones and so occasional pain in the lumbar area. She used to get constipation frequently. She was hospitalized four times for normal vaginal deliveries and once for abortion. She is monogamous with her husband. She has a positive family history of hypertension in her mother, CAD in her father, mother, and brother, and uterine cancer in her mother. She has a history of menorrhagia and cycles have become more irregular now. Then, diagnostics D and C were performed last year, which was normal. She will not smoke or drink. She sleeps four to six hours daily and snores at night.
Hello,
Welcome to icliniq.com.
I have gone through your mother's elaborative history provided here, along with the reports attached (attachment removed to protect patient identity) with this query. She has mild osteoarthritic changes in the lumbosacral region with osteoarthritis knee, anemia, periarthritis shoulder or osteoarthritis shoulder joint. For diagnosing it X-ray of the shoulder will be required. Early osteoarthritis and periarthritis (frozen shoulder) can be managed by similar guidelines with range of motion exercises and steroid injections. Arthroscopic procedures can also give good results during early cases. If it is osteoarthritis shoulder joint, then the treatment will depend on the severity of the disease. I think it is more likely to be frozen shoulder(periarthritis shoulder) rather than osteoarthritis considering her age group. Although, your mother has uric acid in the high normal range, I would not consider starting any gout medication as the medication once started will become a lifelong therapy in addition to her hypertension treatment. Secondly, there are no signs or symptoms of the effects of increased uric acid. My recommendation is to have dietary and lifestyle modifications to lower uric acid concentration and drug therapy to be started if there are symptoms of polyarthralgia involving small joints especially foot. There is no condition where the Achilles tendon is intermittently unable to bear weight. People with traumatic injury to Achilles tendon are able to walk although with difficulty. So, kindly assess the function of Achilles tendon properly as there is some other pathology in falling episodesof your mother rather than an intermittent giving way by TA.
Thank you.
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