Revista de Medicina Desportiva (English) July 2018 | Page 10

Figures 2 and 3 – Hook and Ruland tests to look for avulsion (or rupture) of the distal
biceps tendon
Source: http://www.orthobullets.com/shoulder-and-elbow/3081/distal-biceps-avulsion?expandLeftMenu=true
positive and is also almost a pathog-
nomonic signal of distal bicipital
tendon avulsion or rupture (96%
sensitivity). 6,7 If there is a partial rup-
ture, a supination movement may
occur, but the test é painful. 7
The X-ray may show a bone avul-
sion or a small stain at the radial
tuberosity. The CT scan shows the
localization of an ectopic ossifica-
tion and also helps on the surgical
approach 6,9 . The MRI can be useful
to clarify between partial and total
rupture and the pathological loca-
tion (rupture in the tendon or in the
muscle) and to see how big is the
tendon retraction 8,9. However, the
diagnosis is definitely clinical. 6,9
Clinical case
The male patient was 31 years old
and a bodybuilding athlete. He went
to the medical emergency of a hos-
pital complaining of intense pain in
his left elbow and inability to bend it
after an unexpected sudden exten-
sion movement of t