RESUMO
El 0,5 % de la población precisa tratamiento con glucocorticoides. A pesar de su indiscutible utilidad, pueden originar múltiples efectos secundarios, entre ellos los musculoesqueléticos como la osteoporosis, la ruptura tendinosa, que es excepcional, la osteonecrosis y la miopatía. Presentamos el caso de una paciente de 72 años con antecedente de asma bronquial que, tras una reagudización de la misma que requirió tratamiento con 5 mg/día de prednisona, presentó dolor y dificultad para la marcha. La exploración hizo sospechar una ruptura bilateral de tendones aquíleos, que se confirmó mediante ecografía y resonancia magnética nuclear (RMN). La incapacidad era grave. Realizando marcha en el domicilio con andador, la puntuación según la escala FIM pasó desde 112 a 120 tras tratamiento quirúrgico y rehabilitador. Ante un paciente en tratamiento crónico con corticoides y patología musculoesquelética es preciso descartar que dicha patología sea consecuencia del consumo de estos fármacos. La ruptura tendinosa espontánea y bilateral es excepcional y muy incapacitante, su tratamiento es quirúrgico y/o rehabilitador
A total of 0.5 % of the population requires treatment with glucocosteroids. In spite of their unquestionable utility, they can cause multiple side effects, among the musculoskeletal ones such as osteoporosis, tendinous rupture which is rare, osteonecrosis and myopathy. 72 year old patient with bronchial asthma background who after its deterioration that required treatment with 5 mg/day of prednisone, subsequently had pain and walking difficulty. The examination led to the suspicion of bilateral rupture of Achilles tendons, that was confirmed by ultrasonography and MRI. The incapacity was serious, having to use a walker at home to walk, the score according to the FIM scale went from 112 to 120 after surgical and rehabilitation treatment. Faced with a patient under chronic treatment with corticosteroids and musculoskeletal disease, it must be ruled out that this disease is due to the consumption of these drugs. Spontaneous and bilateral tendinous rupture is rare and very incapacitating and its treatment is surgical and/or rehabilitation
