What is the clinical significance of the Thompson test?

• A. Ankle sprain
• B. Achilles tendon rupture
• C. Plantar fasciitis
• D. Calcaneal fracture

Answer: (B)

The Thompson test checks the Achilles tendon’s integrity. When the calf is squeezed, a functioning gastrocnemius-soleus complex should cause the foot to plantarflex. If the Achilles tendon is ruptured, there is little or no plantarflexion because the force can’t be transmitted through the tendon.

Clinically, a positive Thompson test (no plantarflexion with a calf squeeze) points to an Achilles tendon rupture. This injury often presents with a sudden snap or jump sensation in the back of the ankle, acute heel or posterior calf pain, and difficulty or inability to push off the foot. It typically requires prompt orthopedic evaluation to determine treatment, which may be immobilization and nonoperative management in some partial tears or low-demand patients, or surgical repair in complete ruptures for active individuals. Imaging (ultrasound or MRI) can help confirm the diagnosis and guide management.