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BICEPS TENDON PROBLEM

This _ presents with upper arm pain and exam findings suspicious for a biceps tendon rupture. Differential includes bursitis, muscle strain, partial tear, fracture, and elbow pathology. Neurovascularly intact distal to the injury.



Plan: plain films, urgent orthopedic referral, pain control, reassessment, anticipating discharge







PEARLS:

– Classic mechanism for biceps tendon rupture:

— FOOSH – proximal rupture

— Elbow forced straight against resistance – distal

– Exam: “popeye’s sign” from rupturing of the long head of the biceps. Probably will be able to still flex a little if it’s proximal.

– If they have a distal rupture, they will have marked ecchymosis over the AC and marked weakness on flexion

– Hook test: you should be able to get about 1 cm under the biceps tendon with your finger as a ‘hook’



Proximal ruptures are usually managed nonop; distal ruptures require near-term urgent ortho f/u.



from natedotphrase.com

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