Acetic acid iontophoresis for the treatment of insertional Achilles tendonitis.

To cite: Kilfoil RL, Shtofmakher G, Taylor G, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014206232 DESCRIPTION Posterior heel pain is a constellation of pathologies that may include retrocalcaneal bursitis, insertional tendonitis, paratenonitis and tendonosis among others. The diagnosis of insertional Achilles tendonitis can be established clinically and radiographically and must be differentiated from retrocalcaneal bursitis and Haglund’s deformity. Patients present clinically with chronic pain of gradual onset typically relieved when the patient is unshod and it may be painful to perform a single leg raise. 4 Calcaneal exostoses of the Achilles tendon may be evident on radiograph. Exostoses composed of calcium carbonate (CaCO3) are exposed to the more chemically active acetate radical and replace the carbonate forming the blood soluble calcium acetate molecule (Ca(C3H3O2)2). 5