ThompsonTest

Thompson test, also known as the Simmonds–Thompson test, is a clinical examination used to assess suspected rupture of the Achilles tendon. It is commonly performed in emergency departments and orthopedic clinics and can help distinguish complete rupture from an intact tendon.

In the standard test, the patient lies prone with the foot hanging over the edge of the examination table. The examiner grasps the mid-calf and squeezes the calf muscle (gastrocnemius). With an intact Achilles tendon, this squeeze causes plantarflexion of the foot. If the Achilles tendon is ruptured, there is little or no plantarflexion of the foot.

Interpretation: A positive test—little or no plantarflexion—suggests complete rupture of the Achilles tendon and often prompts urgent imaging or operative consultation. A negative test—visible plantarflexion—suggests an intact tendon, though imaging may still be used if clinical suspicion remains high or to assess for partial rupture.

Limitations: False negatives can occur with partial ruptures, significant swelling, or pain limiting muscle contraction; false positives are uncommon but can arise from alternative causes of reduced plantarflexion. The test is a rapid bedside assessment and should be integrated with imaging (ultrasound or MRI) and clinical examination when Achilles rupture is suspected.

History: The test is commonly attributed to Simmonds and Thompson, and is also referred to as the Simmonds–Thompson test. It has become a standard part of evaluation for suspected Achilles tendon injuries.