The diagnostic possibilities include a bone or soft tissue injury.
A bony injury was excluded because there was no bone tenderness.
The patient had a significant soft tissue injury. On examination he had significant swelling of the ankle with a subcutaneous hematoma. He was unable to stand on tiptoe on the right leg, and in the prone position a palpable defect was demonstrated within the calcaneal tendon.
A diagnosis of calcaneal tendon rupture was made.