II. History

  1. Repetitive motion injury
    1. Repeated elbow flexion AND
    2. Supination or pronation

III. Symptoms

  1. Vague, anterior Elbow Pain developing gradually with overuse

IV. Signs: Distal Biceps Tendinopathy

  1. Anterior Elbow Pain (in antecubital fossa) exacerbating factors
    1. Elbow flexion against resistance
    2. Forearm supination against resistance

V. Signs: Distal Biceps Tendon Rupture

  1. Distal biceps tendon fails to demonstrate typical movement
    1. Elbow flexed to 90 degrees
    2. Passive supination and pronation
  2. Hook Test
    1. Examiner hooks the distal biceps tendon by pinching underneath the tendon, between the index finger and thumb
    2. A failed Hook Test suggests a Distal Biceps Tendon Rupture

VI. Imaging

  1. Elbow MRI
  2. Elbow Musculoskeletal Ultrasound (MSK)

VII. Differential Diagnosis

VIII. Management

  1. RICE-M
  2. NSAIDs
  3. Physicial Therapy for directed Stretching and strengthening

IX. Complications

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