Bilateral Calcification of Achilles’ Tendons, and Acetic Acid Iontophoresis Plus Ultrasound Effectivenness

Marcos Edgar Fernandez-Cuadros,1,2,* Olga Susana Perez-Moro,1 Maria Jesus Albaladejo-Florin,1 Luz
Otilia Casique-Bocanegra
,2 and Ruben Algarra-Lopez1
1Rehabilitacion y Medicina Fisica, Hospital Universitario Santa Cristina, Madrid, Spain
2Rehabilitacion y Medicina Fisica, Fundacion Hospital de la Santisima Trinidad, Salamanca, Spain
*Corresponding author: Marcos Edgar Fernandez-Cuadros, Calle del Ansar 44, piso Segundo, CP 28047, Madrid, Spain. Tel: +34-620314558, E-mail:

Introduction: Calcifying tendonitis is the deposition of hydroxyapatite within tendons. It could affect different tendons. In the current case report, bilateral Achilles’ tendons were affected. The etiology is multifactorial. The treatment is conservative and surgical. Iontophoresis is a conservative technique that favors the penetration of 5% acetic acid, based on the attraction and repulsion of charges with the help of continuous electric current.
Case Presentation: A 57-year-old female presented a 12-month experience of bilateral Achilles’ tendon pain. Conservative treatment (nonsteroidal anti-inflammatory drugs (NSAIDs), laser therapy, and physiotherapy) and advanced treatment (shock waves) did not alleviate her pain. Radiography and ultrasound scan showed bilateral insertional formative calcification on both Achilles’ tendons, 9.3mmon left Achilles’ tendon and 6.6mmon right one. After 15 sessions of 5% acetic acid iontophoresis (2 mL, 4.7 mA10 minutes) and continuous ultrasound (1 W/cm2,1 MHz5 minutes) over the calcification area, calcification sizes decreased from 9.3 to 4.3 mm (left
Achille’s tendon) and disappeared on right Achille’s tendon. Pain also decreased from 9/10 to 4/10 on left Achille’s tendon and from 5/10 to nothing on right tendon.
Conclusions: Based on the authors‘ best knowledge, the current study was the first case report that confirmed the effectiveness of 5% acetic acid iontophoresis plus ultrasound to treat bilateral Achilles’ calcifying tendonitis.

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