PT tests for Dx Achilles Tendon Rupture
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Upon reading the newest edition of JOSPT’s Musculoskeletal Imaging section, it came to me (and my current intern) that we have never heard of the Matles test! So, in sake of learning; I went searching for answers.
The Matles test assesses the integrity of the Achilles Tendon (a rupture) through tension in the tendon in a prone position with knee bent to 90 degrees, as shown in the photograph below.
A positive test for an Achilles’ tendon rupture is defined as the the ankle in neutral or dorsiflexed position in resting position, instead of a 20 to 30 degree plantar flexion position in asymptomatics.
I couldn’t find a lot of information on the diagnostic data other than the reference included in the article here. Nevertheless, the statistics are:
Matles Test: specificity is .85 and sensitivity of .88.
This is not as good, but comparable to the usual Thompson or calf squeeze test with specificity of .98 and sensitivity of .96 as available by the CORE application screenshot below.
In short, I would supplement the Matles test with the Thompson test in your examination criteria but not use it solely, if there is an assumption of Achilles Tendon Rupture. Use this data alongside your observation of an antalgic gait, the mechanism of injury and palpation of a defect. All of these will assist in your clinical decision making process to make the most appropriate intervention.
Filed under: Differential Diagnosis http://intouchpt.wordpress.com/
2013-02-19 13:46:35
Source: http://intouchpt.wordpress.com/2013/02/18/pt-tests-for-dx-achilles-tendon-rupture/
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