Calf injuries: tennis leg: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Calf injuries: tennis leg

Sample item

A 45-year-old recreational tennis player feels a sudden sharp pain as if struck in the mid-calf while lunging forward. The Thompson test is negative and there is a tender medial calf swelling. Which structure is most often injured?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Medial head of the gastrocnemius at the musculotendinous junction

Tennis leg is a partial tear of the medial head of the gastrocnemius at the musculotendinous junction, from forceful push-off with the knee extended. The Achilles tendon is intact, so the Thompson test is negative. Treatment is rest, compression, a heel raise and gradual rehabilitation, and ultrasound can exclude a deep vein thrombosis.

Option by option

  • A. Soleus origin

    The soleus origin is not the typical site.

  • B. Medial head of the gastrocnemius at the musculotendinous junction (correct)

    Correct. The medial gastrocnemius head is the usual site.

  • C. Plantaris tendon only

    Plantaris rupture is rare and was formerly blamed for tennis leg.

  • D. Achilles tendon

    An Achilles rupture would give a positive Thompson test.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Medial head of the gastrocnemius at the musculotendinous junction. Tennis leg is a partial tear of the medial head of the gastrocnemius at the musculotendinous junction, from forceful push-off with the knee extended.

Why is "Soleus origin" not the answer?

The soleus origin is not the typical site.

Why is "Plantaris tendon only" not the answer?

Plantaris rupture is rare and was formerly blamed for tennis leg.

Why is "Achilles tendon" not the answer?

An Achilles rupture would give a positive Thompson test.

What concept does this question test?

It tests Calf injuries: tennis leg in Orthopaedics. The Achilles tendon is intact, so the Thompson test is negative. Treatment is rest, compression, a heel raise and gradual rehabilitation, and ultrasound can exclude a deep vein thrombosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Calf injuries: tennis leg?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.