A 42-year-old man feels a sudden snap in his left calf while lunging during badminton, followed by pain and inability to push off. On examination there is a palpable gap 4 cm above the heel and squeezing the calf does not produce any plantar flexion of the foot. The most likely diagnosis is:

• A Rupture of the plantaris tendon
• B Complete rupture of the Achilles tendon ✓
• C Rupture of the gastrocnemius medial head (tennis leg)
• D Deep vein thrombosis of the calf veins

Explanation

A positive Simmonds (Thompson) test, absence of plantar flexion on calf squeeze, with a palpable tendon gap and loss of push-off confirms complete Achilles rupture. Tennis leg and plantaris rupture cause calf pain and swelling but the Thompson test remains normal because the intact Achilles still transmits the squeeze force to plantar flex the foot. Deep vein thrombosis causes diffuse swelling without a tendon defect.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.