Proximal Biceps Tendon Tear

Question 1

What is the most common location of a ruptured biceps?

Answer 1

Proximal (towards upper arm)

Question 2

When is a proximal bicep tendon tear more common?

Answer 2

1. In older adults with impingement
   *due to chronic inflammation
   *the strength of the biceps will overcome the tendon

Question 3

When does a proximal bicep tendon tear occur?

Answer 3

1. During lifting

Question 4

What are the symptoms of a proximal biceps tendon tear?

Answer 4

1. Sudden pain in upper arm
2. Snap/pop
3. Muscle bulge

Question 5

During the PE what will you find?

Answer 5

1. Muscle bulge in lower biceps (Popeye muscle)
   *will be accentuated with flexion/resistance
2. Palpable defect in bicipital groove
3. Bruising

Question 6

What are the diagnostic tests?

Answer 6

1. X-ray (eval for treatment)
2. MRI will diagnosis the tear and eval for RCT

Question 7

What is the treatment?

Answer 7

1. Conservative with NSAIDS/PT

Question 8

Is surgery recommend?

Answer 8

1. Risk outweigh the benefits
   *only done if concomitant RCT