A 38-year-old recreational runner develops acute onset sharp pain in the posterior heel during a sprint race and notices a palpable gap above the calcaneum. Thompson's test is positive (no plantar flexion on calf squeeze). The Thompson test assesses the integrity of which anatomical structure?

• A Peroneus longus tendon at the lateral malleolus
• B Gastrocnemius-soleus complex continuity via the Achilles tendon ✓
• C Plantar fascia at the calcaneal attachment
• D Posterior tibial tendon medial to the medial malleolus

Explanation

Thompson's (Simmonds') test assesses the continuity of the gastrocnemius-soleus-Achilles tendon complex. With the patient prone and knee at 90°, squeezing the calf should produce passive plantar flexion of the ankle if the Achilles is intact. Absence of plantar flexion (positive Thompson test) confirms complete Achilles tendon rupture. The gap above the heel and acute onset during exertion are classic. Management is debated (operative vs conservative with functional bracing); operative repair has lower re-rupture rate but carries surgical complications. Thompson test is specific and sensitive (>95%) for complete Achilles rupture.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.