Accuracy of examination of the long head of the biceps tendon in the clinical setting: a systematic review.

Key Points

1. The use of high-resolution ultrasound was found to demonstrate strong diagnostic accuracy for a complete long head of biceps tendon rupture. Despite the very large positive likelihood ratios, caution is warranted due to the large confidence intervals and uncertainty of reference standard comparison.

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BACKGROUND & OBJECTIVE

The differential diagnosis of anterior shoulder pain can be complex due to various potential pathologies and limitations in diagnostic accuracy of various clinical tests (2,3). The clinical examination of the long head of biceps specifically is limited in clinical assessment. The majority of clinical examination regarding the long head of biceps focuses on its relationship with labral pathology (2). Unfortunately, the majority of these tests are of limited diagnostic accuracy and therefore limited clinical utility (2). The aim of this study was to determine the diagnostic accuracy of orthopaedic special tests (OST) for detecting pathology related to the long head of biceps.

The differential diagnosis of anterior shoulder pain can be complex due to various potential pathologies and limitations in diagnostic accuracy of various clinical tests.

I would suggest that none of the orthopaedic special tests provide a clinically useful metric from which to base decision making.

METHODS

• Systematic review with meta-analysis utilizing a search of MEDLINE, CINAHL and EMBASE databases.

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