Thompson's Test

Aka: Thompson's Test, Thompson Test, Calf Squeeze Test

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II. Indications

  1. Achilles Tendon Rupture suspected

III. Exam: Standard Thompson Test

  1. Technique
    1. Patient lies prone
      1. Knee flexed at 90 degrees OR Feet and ankles projecting off the end of the exam table
    2. Examiner squeezes calf
    3. Observe for plantar flexion of foot
  2. Interpretation: Standard Thompson Test
    1. Normal Response: Plantar flexion as reflex response
    2. Achilles Tendon Rupture: Plantar flexion absent
  3. Efficacy
    1. Test Sensitivity: 96%
    2. Test Specificity: 93%
    3. Positive Likelihood Ratio: 13.47
    4. Negative Likelihood Ratio: 0.04
    5. Maffulli (1998) Am J Sports Med 26(2): 266-70 [PubMed]
  4. False Negative test causes
    1. Accessory Muscles are squeezed
    2. Incomplete Achilles Tendon Rupture

IV. Technique: Confirmatory Test

  1. Indications
    1. Standard Thompson Test equivocal
  2. Technique
    1. Patients foot allowed to rest
    2. Sphygmomanometer applied to affected calf
      1. Inflate sphygmomanometer to 100 mmHg
    3. Dorsiflex foot and observe pressure gauge
  3. Interpretation
    1. Normal response: Pressure rises and stays at 140 mmHg
    2. Achilles Tendon Rupture: Only flicker of movement

V. References

  1. Greene (2001) Musculoskeletal Care p.420-1
  2. Mazzone (2002) Am Fam Physician 65(9):1805-10 [PubMed]

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