Biceps tendonitis and rupture

1. Where is the most common site of biceps tendon rupture? What other shoulder condition is it associated with?
2. What are the symptoms of bicipital tendonitis? Biceps rupture.
3. What tests are done to diagnose biceps tendonitis?
4. What test is done to diagnose biceps rupture?
5. What is the treatment for biceps tendonitis/rupture?

Answers:
1. Most common site of rupture is long head of biceps proximally, often secondary to impingement syndrome or rotator cuff tears.
2. Point tenderness in bicipital groove, positive impingement signs. If there is rupture, there will be sharp pain, audible snap, ecchymosis, and visible bulge in lower arm.
3. Yergason's test (pain with supination of wrist against resistance) and Speed's test (pain with shoulder flexed, elbow extended, supination against resistance).
4. Ludington's test: deformity with flexion of biceps muscle.
5. For tendonitis, can do ROM, strengthening, modalities, or injection into tendon sheath. For rupture, reattachment isn't indicated except in young people who do heavy lifting.