The Popeye sign: a doctor's and not a patient's problem

Area of Science:

• Orthopedic Surgery
• Clinical Assessment
• Patient-Reported Outcomes

Background:

• The Popeye sign, a bulge in the upper arm, is a common finding post-long head of the biceps (LHB) surgery.
• Discrepancies exist in the detection of the Popeye sign between patients and healthcare providers.

Purpose of the Study:

• To investigate the agreement between patients and physicians in identifying the Popeye sign after LHB surgery.
• To compare physician assessments with photographic evidence and analyze factors influencing detection.

Main Methods:

• An interobserver study involving patients, consulting physicians, and non-consulting physicians (observers).
• Assessment of Popeye sign presence using clinical evaluation and digital photographs (pre- and postoperative).
• Analysis of patient demographics (age, sex, BMI) and patient satisfaction.

Main Results:

• Only 2% of patients reported a Popeye sign, compared to 40% of consulting physicians.
• Interobserver agreement was low for preoperative and moderate for postoperative assessments.
• Male sex showed a moderate correlation with Popeye sign identification; age and BMI did not.

Conclusions:

• Physicians identify the Popeye sign significantly more often than patients following LHB surgery.
• The Popeye sign appears to be a clinical finding primarily recognized by doctors, with low patient dissatisfaction.
• Sex is a factor in Popeye sign detection, while age and BMI are not.