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Achilles tendinopathy — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareAchilles tendinopathyUSMLE Step 3

A 50-year-old recreational tennis player has posterior heel pain that worsens with running and improves with rest. Examination shows tenderness 4 cm proximal to the calcaneal insertion and pain with resisted plantar flexion. Thompson test is normal. Which of the following is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Achilles tendinopathy

Localized posterior tendon pain with a normal Thompson test suggests Achilles tendinopathy rather than rupture.

Reference: AAOS foot and ankle guidance: https://www.aaos.org/