Spontaneous Achilles tendon Rupture in Calcaneus Osteomyelitis

Background: Achilles tendon is the most common injured tendon in the lower limb. Spontaneous rupture is attributed to some intrinsic and extrinsic factors in which medications side effect (e.g. corticosteroids and quinolones) is the most common reported cause in the literature. Case presentation: we present a case of 76-year-old female known case of uncontrolled type II diabetes and hypertrophic right Charcot foot. She was diagnosed with chronic foot osteomyelitis for which she received long course of ceftriaxone. Six month following completing the antibiotic course, she presented with fever and malaise with decreased right foot range of motion in the absence of traumatic event. Upon requesting multiple imaging modalities, she was diagnosed with acute Achilles tendon rupture in the setting of acute on top of chronic calcaneus osteomyelitis. Conclusion: AT rupture in the setting of osteomyelitis is a rare entity and has not been reported previously in the literature. This case will bring the attention in evaluating the tendons thoroughly in cases of osteomyelitis.