The Needle Test for an Achilles tendon rupture was first described by Dr Tim O’Brien in 1984. The test is not used very often, if at all.
Procedure:
The test uses a 25 gauge needle that is inserted at a right angle to the calf muscle just medial to the midline about 10 cm proximal to the superior border of calcaneus. The tip of the needle should be inserted into the substance of Achilles tendon.
If there is no rupture then during passive dorsiflexion and plantarflexion of the foot the motion of the needle hub is in the direction opposite that of the tendon. If a rupture is present then the hub of the needle does not tilt or move.
Normal movement of the needle hub with passive dorsiflexion and plantarflexion of the foot (taken from O’Brien’s original publication in 1984).
A positive Thompson test with negative O’Brien needle test tends to indicate that there is a partial rupture of the Achilles tendon.
No information is available on the sensitivity, specificity or reliability of the test.
Reference:
O’Brien T: The Needle Test for Complete Rupture of the Achilles Tendon; J Bone and Joint Surgery; 66-a (7), 1984. (link).
Related Topics:
Achilles tendon rupture | Thompson Test for Achilles Tendon Rupture
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