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6. Shoulder And Arm > Biceps Tendinopathy > Flashcards

Biceps Tendinopathy Flashcards

1
Q

What is meant by tendinopathy

A

variety of pathological changes that occur in tendons, typically due to overuse

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2
Q

what does tendinopathy result in

A

painful, swollen, and structurally weaker tendon that is at risk of rupture

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3
Q

In which people is biceps tendinopathy common in

A

Young individuals

Active - due to sport

Older people - degenerative tendinopathy

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4
Q

What are the clinical features of a patient with biceps tendinopathy

A

Pain - worse on stressing the tendon - Better with ice and rest

Weakness on flexion and supination

Stiffness

Examinations: tenderness over the tendon, loss of muscle bulk to to disuse atrophy

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5
Q

Which specific tests can be performed for biceps tendinopathy

A

Speed test - proximal biceps tendon

Yergasons test - distal biceps tendon

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6
Q

What is the speed test

A

Pt stands with elbows extended and forearm supination, then forward flex shoulders
against resistance

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7
Q

what is yergasons test

A

Pt stands with elbows fled at 90 degrees, forearm pronation. Active supination is then performed against resistance

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8
Q

what are the differential diagnoses of biceps tendinopathy

A

Inflammatory arthropathy

Radiculopathy

OA

Rotator cuff disease

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9
Q

How is biceps tendinopathy diagnosed

A

Largely clinical diagnosis

Blood tests - FBBC, CRP

Plain radiographs - first line often to exclude other things

USS

MRI

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10
Q

What is the management of biceps tendinopathy

A

Conservative using analgesia - NSAIDS

Ice therapy

Physiotherapy

USS guided steroid injections in cases that are unresponsive to conservative treatment

Surgical:
- Arthroscopic tenodesis (tendon is severed and reattached) or tenotomy (division of the tendon) for decompression

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11
Q

What are the complications

A

Most recover with no complications but a small number may get chronic pain

Higher risk of biceps tendon rupture

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12
Q

Is biceps tendon rupture common or uncommon

A

Uncommon

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13
Q

What are the classifications of biceps tendon rupture

A

Complete - through entire tendon

Partial - tendon rupture is partly intact

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14
Q

What is the MOA of biceps tendon rupture

A

sudden forced extension of a flexed elbow.

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15
Q

What are the risk factors for biceps tendon rupture

A

biceps tendinopathy

Steroid use

Smoking

CKD

Fluoroquinolones abx

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16
Q

What are the clinical features of biceps tendon rupture

A

Sudden onset pain and weakness

Feeling of a pop

Marked swelling and bruising in antecubital fossa

Reverse popeye sign

17
Q

what test can be done to identify a distal tendon rupture

A

Hook test

18
Q

What is the hook test

A

90 degree flexion of elbow with supination

examiner attempts to ‘hook’ their index finger underneath the lateral edge of the biceps tendon

19
Q

What are the investigations of biceps tendon rupture

A

Diagnosed clinically but confirmed using USS

If USS inconclusive then MRI

20
Q

What is the conservative management of biceps tendon rupture

A

Conservative - analgesia and physiotherapy

21
Q

What is the surgical management of biceps tendon rupture

A

Anterior single incision

Dual incision technique

22
Q

what is the anterior single incision

A

Involves single incision in the antecubital fossa

23
Q

What is the dual incision therapy

A

dual incision technique involves a smaller anterior incision in the antecubital fossa and a posterolateral elbow incision (between the ECU and EDC).

24
Q

When should surgery occur if that is the option to be considered

A

Within a few weeks of the rupture as the tendon with retract and scar

25
Q

what are the main complications of biceps tendon rupture surgery

A

Injury to the lateral ante brachial cutaneous nerve

posterior interosseous nerve, or radial nerve (rare).

6. Shoulder And Arm (7 decks)

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