Test yourself
Achilles rupture: scan long, squeeze the calf
5 questions. Pick an answer to see whether you are right and why. Your score appears at the end.
Question 1Which dynamic test helps confirm a complete Achilles rupture on ultrasound?
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Answer c. Squeezing the calf normally moves the whole tendon. In a complete rupture, the movement stops at the gap and does not pass to the tendon below.
Question 2A patient can still plantarflex the ankle after an injury. What does this mean?
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Answer a. Tibialis posterior, the peroneal muscles and the long toe flexors can still plantarflex the foot. Rely on the calf squeeze test and imaging, not active plantarflexion.
Question 3A thin, intact tendon runs along the medial side of a gap in the Achilles. What is it most likely to be?
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Answer b. The plantaris tendon is thin and runs medial to the Achilles. It often survives a rupture and can be mistaken for continuous Achilles fibres.
Question 4Where does an Achilles rupture most often occur?
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Answer d. Most ruptures occur in the middle portion of the tendon, a few centimetres above the calcaneal insertion, where the blood supply is poorest.
Question 5How do you avoid mistaking anisotropy for a tear in the Achilles tendon?
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Answer d. Tendons look dark when the beam meets them at an angle. Correcting the angle and confirming in long and short axis separates anisotropy from a true gap.
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Four or five delegates per instructor, FAMUS-accredited faculty and long, supervised time on the probe.
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