Purpose
A magnetic resonance imaging (MRI) scan of the elbow is often obtained to confirm
the clinical suspicion of a distal biceps tendon rupture. The goal of this study was
to evaluate the effectiveness of MRI in diagnosing partial and complete distal biceps
tendon ruptures as determined at the time of surgery.
Methods
We identified 22 partial and 24 complete distal biceps tendon ruptures operated on
by a single surgeon. The preoperative MRIs of these patients were obtained, along
with MRIs of the elbow in 10 asymptomatic individuals. Two musculoskeletal radiologists
read each MRI without knowledge of the diagnosis or the surgical findings. Their interpretations
were compared with the intraoperative findings and the results were statistically
analyzed.
Results
The overall sensitivity and specificity of MRI were 92.4% and 100%, respectively,
in detecting distal biceps tendon ruptures. The sensitivity and specificity of MRI
for complete tears were 100% and 82.8%, respectively. The sensitivity and specificity
of MRI for partial tears were 59.1% and 100%, respectively.
Conclusions
Magnetic resonance imaging is an effective tool for diagnosing distal biceps tendon
ruptures. Although MRI is extremely sensitive in diagnosing complete tears, it is
substantially less sensitive in diagnosing partial tears.
Type of study/level of evidence
Diagnostic II.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Rupture of the distal insertion of the biceps brachii tendon.Clin Orthop Relat Res. 1988; 234: 34-38
- Rupture of the distal tendon of the biceps brachii: operative versus non-operative treatment.J Bone Joint Surg. 1985; 67A: 414-417
- Partial rupture of the distal biceps tendon.Clin Orthop Relat Res. 1991; 271: 143-148
- Rupture of biceps brachii: a conservative method of treatment.J Bone Joint Surg. 1967; 49A: 1016
- Repair of distal biceps tendon ruptures in athletes.Am J Sports Med. 1993; 21: 114-119
- Surgical treatment of partial biceps tendon ruptures at the elbow.J Shoulder Elbow Surg. 2006; 15: 215-217
- Avulsion of the lower biceps brachii tendon: analysis of fifty-one unreported cases.Am J Surg. 1941; 51: 662-683
- Partial rupture of the distal biceps tendon.Clin Orthop Relat Res. 2000; 374: 195-200
- Rupture of the distal biceps brachii tendon: report on 13 cases.JAMA. 1963; 184: 60-63
- Avulsion of the distal biceps brachii tendon.Am J Surg. 1954; 88: 657-659
- Traumatic avulsion of tendon of insertion of biceps brachii.Am J Surg. 1951; 82: 290-292
- Distal biceps brachii repair: results in dominant and nondominant extremities.Clin Orthop Relat Res. 1995; 317: 114-121
- Repair of the distal biceps tendon using suture anchors and an anterior approach.Clin Orthop Relat Res. 1996; 322: 116-119
- Distal biceps brachii tendon avulsion: a simplified method of operative repair.Am J Sports Med. 1986; 14: 234-236
- Distal biceps tendon injuries: diagnosis and management.J Am Acad Orthop Surg. 1999; 7: 199-207
- Partial rupture of the distal biceps tendon.J Shoulder Elbow Surg. 1996; 5: 73-75
- Partial rupture of the distal biceps tendon.J Shoulder Elbow Surg. 2001; 10: 377-379
- Cubital bursitis.J Bone Joint Surg. 1988; 70B: 832-833
- Management of acute and chronic biceps tendon rupture.Hand Clin. 2000; 16: 497-503
- Repair of chronic distal biceps brachii tendon rupture using free autogenous semitendinosus tendon.Clin Orthop Relat Res. 1996; 323: 188-191
- Repair of chronic ruptures of the distal biceps tendon using flexor carpi radialis tendon graft.Am J Sports Med. 2000; 28: 538-540
- Rupture of the distal tendon of the biceps brachii: a biomechanical study.J Bone Joint Surg. 1985; 67A: 418-421
- Reconstruction of chronic ruptures of the distal biceps tendon with use of an Achilles tendon allograft.J Bone Joint Surg. 2002; 84A: 999-1005
- Rupture of the distal biceps tendon: evaluation with MR imaging.Radiology. 1994; 190: 659-663
- Distal biceps tendon injury: MR imaging diagnosis.Radiology. 1994; 191: 203-206
- Partial tears of the distal biceps tendon: MR appearance and associated clinical findings.Skeletal Radiol. 2001; 30: 560-564
- The hook test for distal biceps tendon avulsion.Am J Sports Med. 2007; 35: 1865-1869
- Optimal positioning for MRI of the distal biceps brachii tendon: flexed abducted supinated view.AJR Am J Roentgenol. 2004; 182: 944-946
Article info
Publication history
Published online: November 27, 2009
Accepted:
August 26,
2009
Received:
November 4,
2008
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Effectiveness of Magnetic Resonance Imaging in Detecting Partial and Complete Distal Biceps Tendon RuptureJournal of Hand SurgeryVol. 35Issue 5
- PreviewThe data published by Festa and colleagues provide an important opportunity to better understand enthesopathy of the distal biceps tendon insertion.1 As pointed out by Hobbs and colleagues in a recent evidence-based medicine review,2 the concepts of acute and chronic, partial and complete, and tendinopathy versus partial rupture have been used in imprecise and confusing ways when addressing so-called “tears” of the distal biceps tendon. My understanding of the best available evidence in the context of my experience treating patients is that normal tendons do not rupture, that acute tears (ecchymosis, swelling, and pain) are always complete, and that the so-called “partial tear” is just distal biceps tendinopathy without acute rupture.
- Full-Text
- Preview
