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