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The Thompson test (also called Simmonds' test or Simmonds-Thompson test) is used in lower limb examination to test for the rupture of the Achilles tendon. [1] [2] The patient lies face down with feet hanging off the edge of the bed.
In chronic venous insufficiency, sonographic examination is of most benefit; in confirming varicose disease, making an assessment of the hemodynamics, and charting the progression of the disease and its response to treatment. It has become the reference standard for examining the condition and hemodynamics of the lower limb veins.
Involuntary extension of the "normal" leg occurs when flexing the contralateral leg against resistance. To perform the test, the examiner should hold one hand under the heel of the "normal" limb and ask the patient to flex the contralateral hip against resistance (while the patient is supine), asking the patient to keep the weak leg straight while raising it.
The clinician exposes the lower limb. A tap is made on the lower part of the leg on the long saphenous varicose vein with one hand. If an impulse can be felt at the saphenous opening with the other hand, Schwartz's test is positive. [2]
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On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
Buerger's test is performed in an assessment of arterial sufficiency. It is named after Leo Buerger.The vascular angle, which is also called Buerger's angle, is the angle to which the leg has to be raised before it becomes pale, whilst lying down.
If the iliopsoas muscle is shortened, or a contracture is present, the lower extremity on the involved side will be unable to fully extend at the hip. This constitutes a positive Thomas test. [2] Sometimes, with a very flexible patient, the Thomas test will be normal despite a psoas dysfunction being present.
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