Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic 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

Risk factors

  • type of sports (basketball, ice skating, football, contact sports)
  • anatomical variation
  • eccentric exercise
  • pennate muscle architecture and type II muscle fibres (fast twitch)
  • muscle-tendon units that span 2 joints
  • previous history ankle sprain

Diagnostic investigations

1st investigations to order

  • x-rays
  • MRI
  • ultrasound for non-ligament injuries
Full details

Investigations to consider

  • diagnostic arthroscopy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Staff Orthopaedic Surgeon

Department of Orthopaedics

VA Medical Center

Cheyenne

WY

Disclosures

SNS declares that he has no competing interests.

Assistant Professor

Department of Orthopaedic Surgery

Virginia Commonwealth University

Richmond

VA

Disclosures

VM is an editorial board member, European Journal of Orthopaedic Surgery & Traumatology.

Spinal Clinical Research Fellow

Queens Medical Centre

Nottingham

UK

Disclosures

SRM declares that he has no competing interests.

Dr Senthil N. Sambandam, Dr Varatharaj Mounasamy, and Dr Sakthivel Rajaram Manoharan would like to gratefully acknowledge Dr Issada Thongtrangan, a previous contributor to this monograph. IT declares that he has no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Department of Orthopaedics

University of Virginia

Charlottesville

VA

Disclosures

QC declares that he has no competing interests.

Professor of Trauma and Orthopaedic Surgery

University Hospital of North Staffordshire

Keele University School of Medicine

Stoke on Trent

UK

Disclosures

NM is an author of a study referenced in this monograph.

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