What is the best clinical test for Achilles tendinopathy?

BackgroundDifferential diagnosis of Achilles pathology is demanding. This study evaluates the diagnostic accuracy of clinical tests identified for a chronic mid body Achilles tendinopathy. Ultrasound scanning provides the reference standard.MethodsTwenty-one participants with, and without, an Achilles tendinopathy, had an ultrasound scan followed immediately by the application of ten clinical tests. The accuracy and reproducibility of each test was determined.ResultsThe most valid tests are; pain on palpation of the tendon (sensitivity 84%, specificity 73%, kappa 0.74–0.96) and the subjective reporting of pain 2–6 cm above the insertion into the calcaneum (sensitivity 78%, specificity 77%, kappa 0.75–0.81).ConclusionOnly location of pain and pain on palpation were found to be sufficiently reliable and accurate, to be recommended for use.