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Male presents with pain in the right antecubital fossa after lifting a trailer. On examination, you note ecchymosis and tenderness in the antecubital fossa. You suspect a possible distal biceps tendon rupture. Which one of the following would be most appropriate at this point?

A) A Speed's test
B) Plain radiographs of the elbow
C) MRI of the elbow
D) A local corticosteroid injection
E) Referral for physical therapy

User BlackFox
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1 Answer

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Final answer:

The most appropriate step for suspected distal biceps tendon rupture would be a Speed's test, followed by an MRI of the elbow for confirmation.

Step-by-step explanation:

Distal Biceps Tendon RuptureIf a male presents with pain, ecchymosis, and tenderness in the right antecubital fossa after lifting a trailer, and there is a suspicion of a possible distal biceps tendon rupture, the most appropriate step would be to perform a Speed's test. This test involves the patient flexing their elbow against resistance while the examiner palpates the biceps tendon in the antecubital fossa. A positive Speed's test, indicated by pain and/or weakness, would strongly suggest a distal biceps tendon rupture and further imaging may be required for confirmation.

MRI of the elbow would be the most appropriate imaging modality to confirm a distal biceps tendon rupture. It provides detailed visualization of the soft tissues, allowing for accurate assessment of the biceps tendon and its attachment to the radius.

A local corticosteroid injection or referral for physical therapy would not be appropriate at this point as they are not the primary interventions for treating a suspected distal biceps tendon rupture. These interventions may be considered later on in the management process, depending on the severity and chronicity of the injury.

User Marlhex
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