History & exam
Key factors
- acute onset of symptoms
- mechanism of injury
- severe pain
- swelling
- bruising
- palpable gap in normal position for Achilles tendon (Achilles tendon rupture)
- positive calf squeeze test (Achilles tendon rupture)
- positive Matles test (Achilles tendon rupture)
- positive biceps squeeze test (biceps tendon rupture)
- positive Hook test (biceps tendon rupture)
- pop sound
- deformity
Other diagnostic factors
- previous injury
- symptom duration more than a few days
- limited ROM
- weakness
History & exam details
Diagnostic tests
1st tests to order
- x-rays
- MRI
- ultrasound for non-ligament injuries
Tests to consider
- diagnostic arthroscopy
Diagnostic tests details
Treatment details
Acute
presenting within the first 24 to 48 hours: incomplete rupture (grade 1 or 2) suspected
- rest, ice, compression, and elevation followed by gentle mobilisation
- analgesia
- physiotherapy
presenting within the first 24 to 48 hours: confirmed complete rupture (grade 3)
- physiotherapy or surgical repair
- analgesia
Ongoing
with worse pain and/or without functional improvement at 1-week review
- further investigation + consideration of surgical referral
- analgesia
Treatment details
Last updated: Oct 25, 2012
