Presentation
Recurrent pain and swelling of the big toe.
Patient Data
Thickened distal end of the Achilles tendon with a large osseous structure inside the Achilles tendon insertion, in keeping with Achilles tendon ossification.
Osteoarthritic changes of the metatarsophalangeal, interphalangeal and metatarso-sesamoid joints of the big toe seen as narrowed joint spaces and marginal osteophytes.
Case Discussion
Achilles tendon ossification appears as bone formation within the substance of Achilles tendon, much uncommon than the similar-appearing Achilles calcific tendinopathy. It can occur in any part of Achilles tendon. In this case, it occurs at its insertion site.
The first metatarsophalangeal joint is the commonest site for erosive osteoarthritis in the foot, responsible for pain in this region. Osteoarthritis also can affect metatarso-sesamoid articulation and interphalangeal joint.
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