You are probably familiar with the popeye sign that’s characteristic of proximal ruptures of the long head of the biceps tendon. But what may be a clinical sign of injury to the distal biceps tendon? O’Driscoll et al. (2007) proposed the Hook Test and report a sensitivity and specificity of both 100% in their diagnostic cohort study. Devereaux et al. (2013) could replicate the specificity of 100% but report a slightly lower sensitivity of 81%. While the sample sizes were rather small in both studies at 45 patients each, the sound reference standard and setup plus the findings give it a high clinical value in our opinion.
To conduct the test, the patient is either standing or sitting. Then the patient is asked to actively flex the elbow to 90° and to fully supinate the forearm. In the case of the left elbow, use your right index finger and try to hook it under the biceps tendon by bringing it in laterally of the antecubital fossa.
In a normal tendon, you should be able to insert the finger approximately 1cm beneath the tendon or even until the distal interphalangeal joint and be able to pull the tendon forward vigorously.
If the distal biceps tendon is avulsed, you won’t be able to hook your index finger under the tendon, which indicates a positive test.
In a second scenario, pain may be elicited when pulling the intact tendon forward which may suggest a partial tear or other injuries of the tendon or sheath.
Other common orthopedic tests to assess for distal biceps tendon ruptures are:
What customers have to say about the Assessment E-Book
The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!
The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
Great work, guys
The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!
The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.
The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
Congrats guys you’ve done an incredible job.
I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
In one word: amazing. Keep going guys ! Best wishes from france.
This content is for members
Create your free account to gain access to this exclusive content and more!
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.