Biceps tendinitis: Difference between revisions
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==Background== | ==Background== | ||
[[File:1120 Muscles that Move the Forearm Humerus Flex Sin.png|thumb|Biceps tendon anatomy.]] | |||
*Results from progressive impingement or isolated tendon injury | *Results from progressive impingement or isolated tendon injury | ||
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==Management== | ==Management== | ||
*Analgesia | *[[Analgesia]] | ||
**[[NSAIDs]] | **[[NSAIDs]] | ||
*Relative rest | *Relative rest | ||
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==See Also== | ==See Also== | ||
*[[Shoulder diagnoses]] | *[[Shoulder diagnoses]] | ||
*[[Biceps tendon rupture]] | |||
==References== | ==References== | ||
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[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
[[Category:Sports Medicine]] | |||
Latest revision as of 04:22, 24 September 2019
Background
- Results from progressive impingement or isolated tendon injury
Clinical Features
- Pain
- Acute, intense, localized to anterior aspect of shoulder
- May occur at rest and be worse at night
Evaluation
- Palpation of tendon within bicipital groove reproduces pain
- Forearm supination, especially against resistance, reproduces pain
- Clinical exam tests below do not perform consistently, are only moderately specific, and do not change the post-test probability significantly[1]
- Yergason Test
- Flex patient's elbow to 90⁰
- Palpate bicipital groove as patient patient attempts forearm supination against resistance
- Pain/instability at prox bicipital groove indicates tendinitis or tendon subluxation
- Speed's test
- Shoulder raised 60⁰ in front flexion
- With forearm supinated and elbow fully extended
- Examiner presses down on forearm and patient resists pressure
- Pain/instability at bicipital groove where long head inserts indicates tendinitis or instability
Differential Diagnosis
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
Management
Disposition
- Follow-up with primary care provider within 1wk
See Also
References
- ↑ Holtby R and Razmjou H. Accuracy of the Speed's and Yergason's tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. Arthroscopy. 2004 Mar;20(3):231-6.