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Biceps Rupture

What is it?

  • It is rupture of the biceps tendon 

Epidemiology

  • More prevalent in men then women
  • Patients generally aged between 40 and 60 years old
  • Most commonly affects the dominant arm.

Aetiology

  • Most commonly affects the long head of the biceps tendon
  • Tears can be partial or full thickness
  • Vast majority of ruptures occur at its origin at the supraglenoid tubercle 
  • Caused by:
    • Inflammatory and degenerative changes over time
    • Sudden trauma e.g. weight lifting
  • Associated with rotator cuff tears in the elderly population.

History

  • Pain
    • Sudden, sharp pain in upper arm while doing activity
    • Or may complain of repetitive pain on performing overhead activities
  • Hearing a sudden snapping or popping sensation at the time of pain
  • Visualising a lump in the upper arm.

Clinical Features / Examination

  • Flexion of the arm at the elbow produces a 'popeye' sign or lump in the upper limb
  • Bruising of the upper arm
  • Localised tenderness
  • Indentation at the bicipital groove
  • Positive Speed's or Yergason's test.

Figure 1 - 'Popeye' sign associated with Biceps rupture (right biceps)



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