THURSDAY, March 30 (HealthDay News) -- Achilles tendon pain caused by tendon xanthomata can be a sign of heterozygous familial hypercholesterolemia (HeFH), according to a report in the March issue of Annals of the Rheumatic Diseases. However, health care providers often miss the connection, the authors say.
High serum cholesterol can cause the accumulation of deposits around the tendon leading to inflammation and a fibrous reaction. To determine the prevalence of tendon pain before diagnosis of HeFH, Peter Durrington, M.D., from the University of Manchester, U.K., and colleagues surveyed 87 controls and 133 HeFH patients attending a lipid clinic about Achilles tendon pain lasting longer than three days.
The authors found that 46.6 percent of patients had experienced one or more episodes of pain, often severe, compared with 6.9 percent of controls who reported moderate pain at most. Only 5 percent of patients were recognized as having tendon xanthomata by the referring physician, however.
When detected early, HeFH can be managed efficiently with medication and lifestyle changes, but unless serum cholesterol is measured directly, few warning signs are available. HeFH is usually recognized when cardiovascular symptoms have already occurred. "Measurement of serum cholesterol in patients presenting with painful Achilles tendon could lead to early diagnosis of HeFH," the authors concluded.
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