RT Book, Section A1 Breed, Meghan A1 Fitch, Robert Warne A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181042164 T1 Achilles Tendon Rupture T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessmedicine.mhmedical.com/content.aspx?aid=1181042164 RD 2024/10/11 AB Rupture occurs most frequently in middle-aged males involved in athletic activities, but patients with other systemic conditions, steroid injections, or fluoroquinolone use are predisposed. Rupture occurs 2 to 6 cm above the tendon’s attachment to the calcaneus. Patients may hear or feel a pop and subsequently develop weakness when pushing off the foot; pain, edema, and ecchymosis may develop. Note that loss of plantar flexion is not necessarily seen as there are other tendons that can compensate. Thompson test can be diagnostic of an Achilles rupture; the patient is placed in a prone position or kneeling on a stool, the knee and ankle are flexed to 90 degrees, and the gastrocnemius muscle should be grasped and squeezed. If the Achilles tendon is even partially intact, then the foot will plantar flex; if ruptured, there will be no foot movement. Radiographic analysis should include a lateral view of the ankle as the Achilles tendon can sometimes be seen. Ultrasound can also be diagnostic.