Thompson test

Name of test

Thompson test

What it tests

Integrity of Achilles tendon.

How to do it

The patient lays prone on the examining table. The affected leg is flexed 90, perpendicular to the table (blue lines). The examiner firmly squeezes the gastrocnemius (black arrows). The examiner examines the ankle for plantar flexion.

The normal response

When the examiner firmly squeezes the gastrocnemius, plantar flexion of the ankle is seen (second figure).

What it means if not normal

A ruptured Achilles tendon.

Comments

Active plantar flexion may be present in a patient with a ruptured Achilles tendon via the combined actions of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles. If a patient has weak plantar flexion and you suspect an Achilles rupture, the Thompson test may be useful to assess the integrity of the tendon.

A positive Thompson test has been reported to not necessarily indicate a complete rupture of the tendon, and has been seen in cases where only the gastrocnemius portion of the tendon was disrupted, with the soleus portion intact. (see reference below)

Citations

13920945, 19503640

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