[Spontaneous bilateral rupture of the Achilles tendon in an elderly woman undergoing prednisone pulse therapy with a history of polymyalgia rheumatica].

An 83-year-old woman presented at the neurology out-patient clinic with acute bilateral weakness of the calf muscles that had lasted for a few weeks. Ultrasound and MRI evaluation of the Achilles tendons revealed bilateral ruptures. Possible predisposing factors included treatment with prednisone pulse therapy for obstructive pulmonary disease and prior polymyalgia rheumatica. Surgical reconstruction of the tendons resulted in a major clinical improvement. Rupture of the Achilles tendons can occur spontaneously, and sometimes bilaterally. A predisposing factor is present in nearly every case of spontaneous bilateral rupture of the Achilles tendons. As in spontaneous unilateral ruptures, the most frequently described predisposing factor is the use of corticosteroids or quinolones.