Total Rupture of Achilles Tendon: Clinical Examination and Ultrasonography

A 67-year-old man stepped on the edge of stairs so that full body weight was loaded on the achilles tendon. A snap was heard, and active flexion of the ankle was not possible. A defect can be felt in the proximal part of the tendon. Squeezing the calf did not elicit plantar flexion of the ankle (Thompson's test) on the affected side. Ultrasonography shows a thin section of the tendon where hypoechogenic haemorrhage is seen instead of normal tendon tissue. In the longitudinal image the ruptured ends of the tendon can be seen moving (more clearly on the right) when the calf is squeezed. Even a total rupture of the proximal part of the tendon can be treated with cast, immobilizing the ankle in slight planter flexion (equinus cast).

Total Rupture of Achilles Tendon: Clinical Examination and Ultrasonography