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.
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.
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.
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
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Published online: November 27, 2009
Accepted: August 26, 2009
Received: November 4, 2008
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
© 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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- 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.