Question:
An athlete presents with sudden pain in the back of the ankle after a push-off, with weakness of plantarflexion. Imaging suggests Achilles tendon rupture. Which of the following is the relevant clinical finding/sign for this condition?
(Figure: Sagittal fat-saturated ankle MRI showing discontinuity of the Achilles tendon.)
An athlete presents with sudden pain in the back of the ankle after a push-off, with weakness of plantarflexion. Imaging suggests Achilles tendon rupture. Which of the following is the relevant clinical finding/sign for this condition?
(Figure: Sagittal fat-saturated ankle MRI showing discontinuity of the Achilles tendon.)
(Figure: Sagittal fat-saturated ankle MRI showing discontinuity of the Achilles tendon.)
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Achilles rupture = positive Thompson (calf-squeeze) test; McMurray is for the knee meniscus.
Updated On: Jun 25, 2026
- Positive Thompson (Simmonds) test
- Positive McMurray test
- Steroid injection
- Plaster cast immobilisation
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The Correct Option is A
Solution and Explanation
Step 1: Identify the condition.
The history (sudden posterior ankle pain, weak plantarflexion) and the MRI showing Achilles tendon discontinuity indicate an Achilles tendon rupture.
Step 2: Recall the diagnostic clinical test.
The bedside test for Achilles rupture is the Thompson (Simmonds) test: with the patient prone and the foot hanging off the table, the examiner squeezes the calf muscle. Normally this produces passive plantarflexion of the foot. If the Achilles tendon is ruptured, squeezing the calf produces no plantarflexion - a positive (abnormal) Thompson test.
Step 3: Evaluate the options.
• Positive Thompson test - correct; it is the specific clinical sign of Achilles tendon rupture.
• McMurray test - this examines for a meniscal tear of the knee, irrelevant to the Achilles tendon.
• Steroid injection - not a clinical finding; moreover steroids around the Achilles are contraindicated as they promote tendon rupture.
• Plaster cast - a treatment option, not a clinical sign/finding.
Step 4: Key fact.
Achilles tendon rupture is clinically confirmed by a positive Thompson (calf-squeeze) test - absence of passive plantarflexion on squeezing the calf.
The history (sudden posterior ankle pain, weak plantarflexion) and the MRI showing Achilles tendon discontinuity indicate an Achilles tendon rupture.
Step 2: Recall the diagnostic clinical test.
The bedside test for Achilles rupture is the Thompson (Simmonds) test: with the patient prone and the foot hanging off the table, the examiner squeezes the calf muscle. Normally this produces passive plantarflexion of the foot. If the Achilles tendon is ruptured, squeezing the calf produces no plantarflexion - a positive (abnormal) Thompson test.
Step 3: Evaluate the options.
• Positive Thompson test - correct; it is the specific clinical sign of Achilles tendon rupture.
• McMurray test - this examines for a meniscal tear of the knee, irrelevant to the Achilles tendon.
• Steroid injection - not a clinical finding; moreover steroids around the Achilles are contraindicated as they promote tendon rupture.
• Plaster cast - a treatment option, not a clinical sign/finding.
Step 4: Key fact.
Achilles tendon rupture is clinically confirmed by a positive Thompson (calf-squeeze) test - absence of passive plantarflexion on squeezing the calf.
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