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Role of Steroids in Tendon Rupture or Disintegration Known for Decades
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The article referring to Achilles rupture and steroid use in the August 11/25, 2003, issue of the ARCHIVES1 infers that this is a newly discovered relationship, though it does not state that explicitly. My initial article on this subject published in JAMA almost 40 years ago also referred to bilateral rupture.2 I got the "bilateral" on the opposite Achilles in exactly the same maneuver—this time on the tennis court, in 1980, 15 years later and again while taking steroids.
While I don't believe this is a world-shaking experience or great scientific breakthrough, I thought it might be interesting to know that this "new relationship," if that was inferred, is not so new.
Peter Fisher, MD
Seattle, Wash
1. van der Linden PD, Sturkenboom MCJM, Herings RMC, Leufkens HMG, Rowlands S, Stricker BHCh. Increased the risk of Achilles tendon rupture with quinolone antibacterial use, especially in elderly patients on taking oral corticosteroids. Arch Intern Med. 2003;163:1801-1807.
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2. Sylbert P. Steroids and spontaneous tendon rupture. JAMA. 1964;190:475.
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Arch Intern Med. 2004;164:678.
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Increased Risk of Achilles Tendon Rupture With Quinolone Antibacterial Use, Especially in Elderly Patients Taking Oral Corticosteroids
Paul D. van der Linden, Miriam C. J. M. Sturkenboom, Ron M. C. Herings, Hubert M. G. Leufkens, Sam Rowlands, and Bruno H. Ch. Stricker
Arch Intern Med. 2003;163(15):1801-1807.
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