Tendon rupture is a severe type of tendon injury and may involve virtually any tendon in the body. Although trauma and sports-related activities are principal mechanisms of tendon rupture, preexisting degenerative changes seem to be the most important factor for this soft tissue injury. The diagnosis is primarily made through a physical examination. Imaging studies are used to support clinical findings.
A tendon rupture is described by many reports as one of the most severe forms of tendon injury. The etiology seems to be multifactorial, as trauma and intense eccentric contractions (seen predominantly during sports activities), as well as iatrogenic causes (the use of fluoroquinolones and corticosteroids have been confirmed as risk factors for tendon rupture), seem to be equally important     . However, degenerative changes that have been histologically confirmed in many cases (particularly in those who suffered from Achilles tendon rupture) are considered as a prerequisite in order for tendons to rupture   . Various studies have described that virtually any tendon in the body could rupture, with respective differences in the clinical presentation          :
A meticulous physical examination is the essential step in recognizing tendon rupture and is supported by data obtained during history taking. Information regarding prior event that led to the injury is vital in assessing the severity and extent of tissue damage, whereas recent fluoroquinolone or corticosteroid use must be excluded, given their well-established roles in the pathogenesis of tendon ruptures  . Various probes and tests can be implemented to confirm clinical suspicion toward rupture. In the setting of Achilles tendon rupture, clinical findings include a weak strength when performing plantar flexion, a palpable and often visible defect (retraction of the tendon will produce an abnormal muscular appearance) and the absence of plantar flexion when the triceps surae muscle is mechanically compressed (known as the Thompson test) . Studies have illustrated that up to 100% of ruptures are diagnosed without the need for imaging studies if the examination is conducted properly, thus illustrating the role of a good physical exam . Weakness in the forearm and elbow accompanied by a lack of supination when compressing the biceps belly (the biceps squeeze test) and the inability to palpate the distal biceps tendon while the elbow is flexed and supinated (the hook test) are highly suggestive of a biceps tendon rupture . Quadriceps tendon ruptures are recognized by the inability of the patients to perform active knee extension . If strong clinical suspicion is raised, imaging studies may be used to confirm the diagnosis. Ultrasonography and magnetic resonance imaging (MRI) are recommended because of their ability to assess the extent of the injury  .