Royal London Hospital Test Special Test

What is it used for?

• Diagnosing Achilles Tendinopathy.

How to Perform

• Position: Patient lies prone (on stomach) with feet hanging off the table.
• Step 1: Palpate the Achilles tendon for a tender lump while the foot is relaxed (slightly plantar flexed).
• Step 2: Ask the patient to actively dorsiflex the foot (pull toes up) to stretch the tendon, and palpate the tender spot again.

Interpretation of Results

• Positive Test: The tenderness significantly decreases or disappears when the tendon is stretched (dorsiflexed). If pain remains constant, it may indicate paratendonitis rather than tendinopathy.

Diagnostic Accuracy

• Sensitivity: 54%
• Specificity: 91%

References

• Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.