Department of Orthopedic Surgery, AZ Monica, Antwerp; Department of Orthopaedic Surgery and Traumatology, Ziekenhuis Oost-Limburg, Genk.
Department of Orthopedic Surgery, AZ Monica, Antwerp.
J Hand Surg Am. 2021 Aug;46(8):710.e1-710.e4. doi: 10.1016/j.jhsa.2020.12.012. Epub 2021 Mar 20.
To describe and study a test for distal biceps tendon pathology other than complete tears.
In this prospective study, the biceps provocation test (BPT) was performed in a cohort of 30 patients with suspected distal biceps tendon pathology and 30 patients with another elbow pathology. Patients with a complete tear were excluded. Diagnosis was confirmed on magnetic resonance imaging or from surgical findings. The BPT is a 2-part test. The elbow is flexed to 70° with the forearm supinated. The examiner's hands are placed on the patient's forearm and the patient is asked to flex the elbow against resistance (BPTs). The forearm is then pronated and the test is repeated (BPTp). Pain is documented for both supination and pronation using a visual analog scale from 0 to 10. The test is positive when the patient indicates an increase in pain with BPTp compared with BPTs.
The BPT was positive in all patients with distal biceps tendon pathology. The average visual analog scale score in this group was 1 (range, 0-7) for the supinated part of the test (BPTs) and 7 (range, 4-10) with the forearm in pronation (BPTp), with an average increase of 5 points (range, 2-8). This difference was significant. No significant difference was found in the control group. Among the controls, BPTp and BPTs were rated as equally painful by 27 patients, and BPTp was less painful than BPTs in 3. Sensitivity and specificity were both 100% in this small group of 60 patients, with a high prevalence of distal biceps tendon pathology.
The BPT appears to be highly sensitive and specific for distal biceps partial injury or tendinitis.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.
描述并研究一种用于诊断非完全性肱二头肌长头肌腱断裂的试验。
在这项前瞻性研究中，对 30 例疑似肱二头肌长头肌腱病变和 30 例其他肘部病变的患者进行了二头肌激发试验（BPT）。排除完全性撕裂的患者。诊断依据磁共振成像或手术结果确定。BPT 包括两部分测试。将肘部弯曲至 70°，同时将前臂旋后。检查者的手放在患者的前臂上，嘱患者对抗阻力弯曲肘部（BPTs）。然后将前臂旋前，并重复该测试（BPTp）。使用 0 到 10 的视觉模拟评分记录旋后和旋前时的疼痛。当患者在旋前位时感到疼痛比旋后位时明显增加（BPTp 与 BPTs 相比）时，试验结果为阳性。
所有肱二头肌长头肌腱病变患者的 BPT 均为阳性。该组的平均视觉模拟评分在旋后位时为 1（范围 0-7），在旋前位时为 7（范围 4-10），平均增加 5 分（范围 2-8）。这种差异具有统计学意义。对照组无明显差异。在对照组中，27 例患者认为 BPTp 和 BPTs 同样疼痛，3 例患者认为 BPTp 比 BPTs 疼痛程度更轻。在这 60 例患者的小样本中，BPT 的敏感性和特异性均为 100%，肱二头肌长头肌腱病变的患病率较高。
BPT 似乎对肱二头肌长头肌腱部分损伤或肌腱炎具有高度的敏感性和特异性。
研究类型/证据等级：诊断 II 类。
