Thompson Test in Achilles Tendon Rupture
HPI: A 26-year old male presented to the emergency department after experiencing the acute onset of left ankle pain while playing basketball. Upon jumping, he felt a “pop” in his left posterior ankle, followed by pain and difficulty ambulating. His exam was notable for a defect at the left Achilles...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2016-07-01
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| Series: | Journal of Education and Teaching in Emergency Medicine |
| Subjects: | |
| Online Access: | http://jetem.org/thompson-test-achilles-tendon-rupture/ |
| _version_ | 1819229410354528256 |
|---|---|
| author | Spencer Albertson Megan Boysen Osborn |
| author_facet | Spencer Albertson Megan Boysen Osborn |
| author_sort | Spencer Albertson |
| collection | DOAJ |
| description | HPI:
A 26-year old male presented to the emergency department after experiencing the acute onset of left ankle pain while playing basketball. Upon jumping, he felt a “pop” in his left posterior ankle, followed by pain and difficulty ambulating. His exam was notable for a defect at the left Achilles tendon on palpation. The practitioner performed a Thompson test, which was positive (abnormal) on the left.
Significant Findings:
The left Achilles tendon had a defect on palpation, while the right Achilles tendon was intact. When squeezing the right (unaffected) calf, the ankle spontaneously plantar flexed, indicating a negative (normal) Thompson test. Upon squeeze of the left (affected) calf, the ankle did not plantar flex, signifying a positive (abnormal) Thompson test. The diagnosis of left Achilles tendon rupture was confirmed intraoperatively one week later.
Discussion:
The Achilles tendon (also: calcaneal tendon or heel cord) is derived from the medial and lateral heads of the gastrocnemius muscle, as well as the soleus muscle. Rupture of the Achilles tendon most commonly occurs in the distal tendon, approximately 2-6 cm from its attachment to the calcaneal tuberosity, in an area of hypovascularity known as the “watershed” or “critical” zone.1-3 The Thompson test (also: Simmonds-Thompson test), described by Simmonds in 1957 and Thompson in 1962, is done while the patient is in the prone position, with feet hanging over the end of a table/gurney, or with the patient kneeling on a stool or chair.4-5 Squeezing the calf of an unaffected limb will cause the ankle to plantar flex, but squeezing the calf of a limb with an Achilles tendon rupture will cause no motion. The sensitivity of the Thompson’s test for the diagnosis of a complete Achilles tendon rupture is 96-100% and the specificity is 93-100%, but data is limited.6-8 |
| first_indexed | 2024-12-23T11:12:44Z |
| format | Article |
| id | doaj.art-03aaab2ca4bb4fdb943f9858593c398a |
| institution | Directory Open Access Journal |
| issn | 2474-1949 2474-1949 |
| language | English |
| last_indexed | 2024-12-23T11:12:44Z |
| publishDate | 2016-07-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Journal of Education and Teaching in Emergency Medicine |
| spelling | doaj.art-03aaab2ca4bb4fdb943f9858593c398a2022-12-21T17:49:18ZengeScholarship Publishing, University of CaliforniaJournal of Education and Teaching in Emergency Medicine2474-19492474-19492016-07-0111V5V6doi:10.21980/J8VC7SThompson Test in Achilles Tendon RuptureSpencer Albertson0Megan Boysen Osborn1University of California, IrvineUniversity of California, IrvineHPI: A 26-year old male presented to the emergency department after experiencing the acute onset of left ankle pain while playing basketball. Upon jumping, he felt a “pop” in his left posterior ankle, followed by pain and difficulty ambulating. His exam was notable for a defect at the left Achilles tendon on palpation. The practitioner performed a Thompson test, which was positive (abnormal) on the left. Significant Findings: The left Achilles tendon had a defect on palpation, while the right Achilles tendon was intact. When squeezing the right (unaffected) calf, the ankle spontaneously plantar flexed, indicating a negative (normal) Thompson test. Upon squeeze of the left (affected) calf, the ankle did not plantar flex, signifying a positive (abnormal) Thompson test. The diagnosis of left Achilles tendon rupture was confirmed intraoperatively one week later. Discussion: The Achilles tendon (also: calcaneal tendon or heel cord) is derived from the medial and lateral heads of the gastrocnemius muscle, as well as the soleus muscle. Rupture of the Achilles tendon most commonly occurs in the distal tendon, approximately 2-6 cm from its attachment to the calcaneal tuberosity, in an area of hypovascularity known as the “watershed” or “critical” zone.1-3 The Thompson test (also: Simmonds-Thompson test), described by Simmonds in 1957 and Thompson in 1962, is done while the patient is in the prone position, with feet hanging over the end of a table/gurney, or with the patient kneeling on a stool or chair.4-5 Squeezing the calf of an unaffected limb will cause the ankle to plantar flex, but squeezing the calf of a limb with an Achilles tendon rupture will cause no motion. The sensitivity of the Thompson’s test for the diagnosis of a complete Achilles tendon rupture is 96-100% and the specificity is 93-100%, but data is limited.6-8http://jetem.org/thompson-test-achilles-tendon-rupture/Thompson testSimmonds-Thompson testorthopedicsAchilles tendon rupturecalcanea tendon ruptureankle paincalf pain |
| spellingShingle | Spencer Albertson Megan Boysen Osborn Thompson Test in Achilles Tendon Rupture Journal of Education and Teaching in Emergency Medicine Thompson test Simmonds-Thompson test orthopedics Achilles tendon rupture calcanea tendon rupture ankle pain calf pain |
| title | Thompson Test in Achilles Tendon Rupture |
| title_full | Thompson Test in Achilles Tendon Rupture |
| title_fullStr | Thompson Test in Achilles Tendon Rupture |
| title_full_unstemmed | Thompson Test in Achilles Tendon Rupture |
| title_short | Thompson Test in Achilles Tendon Rupture |
| title_sort | thompson test in achilles tendon rupture |
| topic | Thompson test Simmonds-Thompson test orthopedics Achilles tendon rupture calcanea tendon rupture ankle pain calf pain |
| url | http://jetem.org/thompson-test-achilles-tendon-rupture/ |
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