Distal biceps tendon ruptures: more efficient diagnostics for a better outcome

Area of Science:

• Orthopedic Surgery
• Diagnostic Imaging
• Musculoskeletal Disorders

Background:

• Distal biceps tendon ruptures are uncommon but cause significant functional impairment.
• Prompt diagnosis and treatment are vital for optimal patient outcomes.
• Diagnostic challenges can arise during the evaluation of these injuries.

Purpose of the Study:

• To identify the most sensitive and specific clinical tests for diagnosing distal biceps tendon ruptures.
• To explore methods for optimizing ultrasound evaluation of the distal biceps tendon.
• To compare the diagnostic efficacy of ultrasound versus MRI for distal biceps tendon injuries.

Main Methods:

• An extensive literature search was conducted using PubMed and Embase databases.
• Systematic search strategy developed in the Medline database (PubMed interface).
• Inclusion of medical subject headings and free text words for comprehensive search.

Main Results:

• A standardized clinical examination including the Hook test, Passive Forearm Pronation Test, and Biceps Crease Interval test demonstrates high accuracy for full-thickness ruptures.
• Specific ultrasound views (Cobra sign, Supinator view, Pronator view) enhance diagnostic value.
• Ultrasound is a trustworthy and cost-effective alternative to MRI for diagnosing distal biceps tendon ruptures.

Conclusions:

• Standardized clinical examination is highly accurate for diagnosing distal biceps tendon ruptures.
• Optimized ultrasound techniques improve diagnostic capabilities.
• Ultrasound serves as a reliable and cost-effective imaging modality for distal biceps tendon injuries, comparable to MRI.