Current RMA Instruments:
Reasonable Hypothesis SOP | 86 of 2024 |
|---|---|
Balance of Probabilities SOP | 87 of 2024 |
Changes from Previous Instruments:
ICD coding:
ICD-10-AM: M76.6
Brief description:
Achilles tendinopathy is a condition involving pain, stiffness and impaired function of the Achilles tendon caused by inflammation (Achilles tendinitis) or degeneration (Achilles tendinosis). This SoP can cover microtears as part of degeneration, though it does not cover traumatic tears.
Confirming the diagnosis:
Diagnosing this condition involves clinical history and examination findings (i.e. symptoms and signs) consistent with Achilles tendinopathy. Ultrasound or MRI imaging studies are often useful in confirming this diagnosis and ruling out other conditions such as retrocalcaneal heel bursitis.
To establish the diagnosis, the assessment and/or management may involve consultation with an orthopaedic surgeon or sports physician. However, general practitioners are commonly able to confirm this diagnosis with imaging results and the consistent clinical evaluation.
Additional diagnoses covered by these SOPs
- Achilles enthesopathy or enthesitis
- Achilles tendonitis
- Achilles tendinosis
- Achilles tendon degenerative tear
- Insertional tendinopathy of the Achilles tendon
- Mid portion tendinopathy of the Achilles tendon
Conditions not covered by these SOPs
- Acute Achilles tendon rupture* - Sprain and strain
* another SOP applies - the SOP has the same name unless otherwise specified
# non-SOP condition
Clinical onset
The clinical onset refers to the earliest point in time, as identified by the treating doctor, when symptoms and signs consistent with the diagnosis of Achilles tendinopathy were observed, prior to its formal confirmation.
Clinical worsening
When considering any issues concerning possible clinical worsening, it is important to ascertain whether the clinical worsening is out of keeping with the natural history of the underlying pathology. Achilles tendinopathy is usually an episodic condition but clinical worsening may occur if the condition is left without appropriate management or if aggravating factors are permitted to persist. Timely intervention (e.g. activity modification, addressing the underlying cause(s), medications, orthotics, changing footwear, physiotherapy etc) and adherence to treatment can prevent worsening and progression of Achilles tendinopathy.