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 accessemergencymedicine.mhmedical.com/content.aspx?aid=1181042164
RD 2024/04/20
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.