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.)

• A. Positive Thompson (Simmonds) test
• B. Positive McMurray test
• C. Steroid injection
• D. Plaster cast immobilisation

Hint:

Achilles rupture = positive Thompson (calf-squeeze) test; McMurray is for the knee meniscus.

Answer 1

The Correct Option is A

The clinical picture - sudden posterior-ankle pain on push-off, loss of plantarflexion power, and an MRI showing a gap in the Achilles tendon - defines an Achilles tendon rupture.

The confirmatory bedside manoeuvre is the Thompson (Simmonds) calf-squeeze test. With the patient prone and feet over the edge of the couch, the examiner compresses the gastrocnemius-soleus. In an intact tendon the foot plantarflexes; when the tendon is torn, the foot stays still - recorded as a positive test, indicating discontinuity of the musculotendinous unit.

The other choices do not fit:
$\bullet$ McMurray test is for knee meniscal pathology.
$\bullet$ Steroid injection is a management item and is actually risky near the Achilles.
$\bullet$ Plaster cast is a treatment, not a diagnostic sign.
\[\boxed{\text{Positive Thompson (Simmonds) test}}\]