Background Achilles tendon ruptures are common in middle-aged athletes. Diagnosis is based on clinical examination or imaging. Although MRI is commonly used to document ruptures, there is no literature supporting its routine use and we wondered whether it was necessary. Questions/purposes We (1) determined the sensitivity of physical examination in diagnosing acute Achilles ruptures, (2) compared the sensitivity of physical examination with that of MRI, and (3) assessed care delays and impact attributable to MRI. Methods We retrospectively compared 66 patients with surgically confirmed acute Achilles ruptures and preoperative MRI with a control group of 66 patients without preoperative MRI. Clinical diagnostic criteria were an abnormal Thompson test, decreased resting tension, and palpable defect. Time to diagnosis and surgical procedures were compared with those of the control group.

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The link between increased body weight and hindfoot complaints is largely based on correlation to single foot pathology. We retrospectively reviewed 6879 patients with tibialis posterior tendonitis (TPT), plantar fasciitis (PF), or both. Among patients with either TPT or PF, 1 in 11 (9%) had both. We then compared age, gender, and body mass index among these groups. Patients with both diagnoses were neither statistically older nor more obese than patients with single diagnoses. However, they were statistically more female. Given the overall high prevalence of obesity in the study population, we feel these data support the link between obesity and multiple foot pathology. Levels of Evidence: Prognostic, Level IV: Case series

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Background: Despite the importance to patients of driving, no well-established guideline exists to help either the patient or the physician determine when it is safe for the patient to return to driving. Previous studies have recommended 6 weeks postoperatively before patients can return to driving safely. Several scientific studies have found the nationally recommended safe brake time standard to be 1.25 sec (1,250 msec), looking at brake reaction time (BRT) in all types of patients, surgical and nonsurgical. Methods: This is a prospective study assessing BRT after individuals are placed in various forms of immobilization (controlled action motion [CAM] boot, surgical shoe). The study also tested whether BRT is different when using the left foot to brake, with immobilization of the right foot. Results: All 29 male and 71 female participants in this study (mean age, 35.49 years) were capable of driving and were not currently being treated for any foot or ankle conditions. No differences were found regarding age, sex, and use of assistive devices. The mean BRT while wearing a CAM boot was 713 msec, while using the left foot to brake (CAM boot on the right foot) was 593.86 msec, and while wearing a surgical shoe was 626.32 msec. Conclusions: Although most of the study participants were below the nationally recommended safe brake time standard, it was found that not all of the participants fell within these parameters.

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