Exams and Tests

Tendon rupture is usually diagnosed using a physical examination. Any imaging is done to confirm the diagnosis and decide the severity of the rupture.

• Quadriceps
  
  
  • X-rays often show that your patella (kneecap) is lower than its normal position on a side view of the knee.
    
    
  • Using an MRI, your doctor can tell whether your rupture is partial or complete.
  
  
• Achilles tendon
  
  
  • Your doctor may do a Thompson test. In this test, your doctor will have you kneel on a chair and dangle your foot over the edge. The doctor will then squeeze your calf in a particular place. If the toes on your foot don't point downward when the doctor squeezes, then you probably have a ruptured Achilles tendon.
    
    
  • In a test called the blood pressure cuff test, your doctor will place a blood pressure cuff on your calf. The cuff is then inflated to 100 mm Hg. The doctor will then move your foot into a toes-up position. If your tendon is intact, it will cause the pressure to rise to about 140 mm Hg. If you have a tendon rupture, the pressure will increase only a small amount.
    
    
  • You may be able to flex your foot downward because your supporting muscles are intact. You will be unable to support yourself on your tiptoes on the affected side however.
    
    
  • X-rays taken from the side may show darkening of the triangular fatty tissue-filled space in front of the Achilles tendon or a thickening of the tendon.
    
    
  • MRI or ultrasound may be used to decide how severe your rupture is, although these tests are usually not needed to make the diagnosis.
  
  
• Rotator cuff
  
  
  • You will be unable to initiate bringing your arm out to the side.
    
    
  • Your doctor may do a drop arm test. In this test, your arm is passively raised to 90°, and you are asked to hold your arm at this position. If you have rotator cuff rupture, slight pressure on the forearm will cause you to suddenly drop the arm.
    
    
  • X-rays may show that the long bone in your upper arm (the humerus) is slightly out of place.
    
    
  • Shoulder arthrography is most helpful in identifying a suspected rotator cuff tear. In this test, a dye that shows up on x-rays is injected directly into the shoulder joint, and the joint is then moved around. Then an x-ray of the shoulder is taken. If any dye is seen leaking from the joint, then it is highly likely that you have a ruptured rotator cuff.
    
    
  • MRI provides a noninvasive means of assessing the integrity of the rotator cuff although it is more costly and not as specific as arthrography.
  
  
• Biceps
  
  
  • X-rays may show that your upper arm bone is out of place or that the place where the muscle attaches has changed.
    
    
  • If your biceps tendon is completely ruptured, the biceps retracts toward the elbow causing a swelling just above the crease in your arm. This is called the Popeye deformity.
    
    
  • You will experience decreased strength of elbow flexion and arm supination (moving the hand palm up).
    
    
  • You will have decreased ability to raise the arm out to the side when the hand is turned palm up.