Proximal Biceps Tendon Tear: Likelihood Ratios

Introduction: aka tear of the Long Head of the Biceps (brachii). The tendon of the long head passes along the intratubercular groove of the humerus into the joint capsule at the head of the humerus, and attaches to the scapula at the supraglenoid tubercle.

Physical exam tends to be of limited specificity, as many times Rotator Cuff Tear elicits positive tests.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Arthroscopic Shoulder Surgery patients	5%	Am J Sports Med. 2007 Aug;35(8):1334-40. PMID: 17369556
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The likelihood ratios of findings for Proximal Biceps Tendon Tear are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Yergason's Test	+ 0 -	2	0.7
for biceps tendon pathology OR Superior Labral Anterior Posterior Lesion In this test, the patient's elbow is flexed to 90 degrees with the thumb up. The examiner grasps the wrist, resisting attempts by the patient to actively supinate the arm and flex the elbow. Pain with this maneuver indicates biceps tendonitis. Study: Arthroscopy. 2004 Mar;20(3):231-6. PMID: 15007311

Poorly Diagnostic Findings
Finding	Result	+LR	-LR
[ + ] Speed Test	+ 0 -	1.5	0.7
The patient's elbow is flexed 20 to 30 degrees with the forearm in supination and the arm in about 60 degrees of flexion. The examiner resists forward flexion of the arm while palpating the patient's biceps tendon over the anterior aspect of the shoulder. Study: Am J Sports Med. 2007 Aug;35(8):1334-40. PMID: 17369556
[ + ] Tenderness to Palpation	+ 0 -	1.2	0.9
(of the tendon) Study: Am J Sports Med. 2007 Aug;35(8):1334-40. PMID: 17369556