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The hook test for distal biceps tendon avulsion.

Shawn W O'Driscoll¹, Lucas B J Goncalves, Patricio Dietz

¹Mayo Clinic, 200 1st Street SW, MSB 3-69, Rochester, MN 55905, USA. odriscoll.shawn@mayo.edu

The American Journal of Sports Medicine

|August 10, 2007

Summary

The Hook test accurately diagnoses complete distal biceps tendon avulsions, showing 100% sensitivity and specificity. This clinical examination is more reliable than MRI for detecting these injuries.

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Area of Science:

Orthopedic Surgery
Diagnostic Imaging
Musculoskeletal Disorders

Background:

Complete biceps tendon avulsions are often missed during clinical evaluation.
There is a need for a dependable diagnostic method for these injuries.

Purpose of the Study:

To determine if the Hook test can reliably detect complete distal biceps tendon avulsions.
To compare the diagnostic accuracy of the Hook test with MRI.

Main Methods:

A cohort of 45 patients undergoing distal biceps tendon surgery were evaluated using the Hook test.
The test involves assessing the ability to hook a finger under the biceps tendon during active supination with the elbow flexed.
Diagnostic accuracy was compared to surgical findings and MRI results.

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Main Results:

The Hook test demonstrated 100% sensitivity and specificity for complete distal biceps avulsions (33/33 patients).
The test was normal in all patients with partial tears (12/12) and healthy controls (45/45).
MRI showed lower sensitivity (92%) and specificity (85%) compared to the Hook test.

Conclusions:

The Hook test is a highly sensitive and specific clinical diagnostic tool for distal biceps tendon avulsions.
It offers superior diagnostic accuracy compared to MRI for these specific injuries.