Physical examination for partial tears of the biceps tendon

H Gill, G Rassi, M Bahk, R Castillo and E McFarland

The physical examination for suspected tears to long head of biceps (LHB) remains controversial.  The aims of this study were to establish the occurance of partial tears of LHB and to analyse the diagnostic value of various clinical tests.  Of 847 patients who underwent shoulder arthroscopy, 40 were found to have partial LHB tears.  Pre-op examination had included 9 common tests used in shoulder assessments.  The results showed that the prevalence of partial LHB tears was 5% of all arthroscopic procedures.  The most commonly associated conditions included rotator cuff tears (85%) and anterior instability (7.5%).  Tenderness on palpation of LHB had a sensitivity of 53% and specificity of 54%.  Speed's test showed senitivity of 50% and specificity of 67%.  The authors concluded that a diagnosis of LHB tear cannot be made reliably with existing physical examination techniques.  Diagnostic arthroscopy is recommended if clinically indicated.

The American Journal of Sports Medicine, 2007, 35, 1334-1340

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