Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy

Baumann, Quentin; Hue, Antoine-Guy; Lutz, Patricia M.; Hardy, Alexandre; Mertl, P.; Courage, Olivier

doi:10.1016/j.jseint.2020.06.005

Cited by 3 publications

(3 citation statements)

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“…The systematic search returned 2010 records, of which 487 were duplicates, leaving 1523 for screening. A total of 1480 studies were excluded by examining their titles and/or abstracts, and a further 28 studies were excluded after full‐text review [3, 5, 7, 8, 10, 14, 16, 18, 20, 21, 27, 28, 32, 36, 38, 39, 41, 45, 46, 49, 51, 53, 54]. This left 15 eligible studies [4, 6, 8, 9, 11–13, 17, 19, 22, 26, 30, 31, 33–35, 40, 43, 44, 47, 48] that reported on a total of 2734 patients (Tables 1, 2).…”

Section: Resultsmentioning

confidence: 99%

3D imaging has good specificity but poor sensitivity for the diagnosis of pathologies of the long head of the biceps: a systematic review and meta-analysis

Lalevée

Rooij

Nover

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo systematically review and meta‐analyse the literature to determine which three‐dimensional (3D) imaging modality provides the best diagnostic accuracy to detect pathologies of the long head of the biceps tendon (LHBT). Materials and methodsA search was performed on PubMed, Embase®, and Cochrane. Studies that compared the diagnostic accuracy of 3D imaging modalities versus arthroscopy for the assessment of LHBT pathologies were included. Studies assessing superior labral anterior posterior (SLAP) lesions were excluded. ResultsFifteen studies were included; nine were eligible for meta‐analysis. Six studies on instability indicated a sensitivity of 0.68 (CI 0.46–0.84) and specificity of 0.76 (CI 0.68–0.82). Four studies on full‐thickness tears indicated a sensitivity of 0.56 (CI 0.28–0.81) and specificity of 0.97 (CI 0.93–0.99). Four studies on partial‐thickness tears indicated a sensitivity of 0.52 (CI 0.20–0.82) and specificity of 0.64 (CI 0.25–0.91). Two studies on any tear indicated a sensitivity of 0.58 (CI 0.28–0.83) and specificity of 0.99 (CI 0.93–1.00). Only one study on other pathologies indicated a sensitivity of 0.61 and specificity of 0.84. ConclusionTo diagnose LHBT pathologies, 3D imaging modalities overall have low‐to‐moderate sensitivity, but high‐to‐excellent specificity. The consistency in reported sensitivity is generally poor, while the consistency and reported specificity is good for the detection of instability, full‐thickness tears and any tear, but poor for the detection of partial‐thickness tears. 3D imaging may be adequate to rule out LHBT pathologies, but are not sufficiently reliable to confirm the presence of such pathologies. Level of evidenceIII.

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Section: Resultsmentioning

confidence: 99%

3D imaging has good specificity but poor sensitivity for the diagnosis of pathologies of the long head of the biceps: a systematic review and meta-analysis

Lalevée

Rooij

Nover

et al. 2022

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

show abstract

“…The systematic search returned 2010 records, of which 487 were duplicates, leaving 1523 for screening. A total of 1496 studies were excluded by examining their titles and/or abstracts, and a further 20 studies were excluded after full‐text review [3, 5, 7, 10, 13, 15, 17–19, 26, 29, 32, 34–36, 38, 43–46]. This left 7 eligible studies (30 datasets) [4, 11, 20, 25, 27, 30, 41] that reported on a total of 448 patients (Table 1; Fig.…”

Section: Resultsmentioning

confidence: 99%

Ultrasound is more reliable than clinical tests to both confirm and rule out pathologies of the long head of the biceps: a systematic review and meta-analysis

Courage

Rooij

Saffarini

2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To synthesize the literature and critically appraise current evidence to determine the most accurate physical examination (clinical test or ultrasound) to detect pathologies of the long head of the biceps tendon (LHBT). Methods A search was performed on PubMed, Embase®, and Cochrane. Studies that compared the diagnostic accuracy of clinical tests or ultrasound versus arthroscopy for the assessment of LHBT pathologies were included. Results Seven studies were included reporting on a total of 448 patients. One study on instability using ultrasound reported sensitivity and speciicity of 1.00 and 0.96, respectively. Two studies on full-thickness tears using ultrasound reported sensitivity and speciicity of 0.88-0.95 and 0.71-0.98, respectively. Four studies on partial-thickness LHBT tears reported sensitivity and speciicity of 0.17-0.68 and 0.38-0.92, respectively, for clinical tests, versus 0.27-0.71 and 0.71-1.00, respectively, for ultrasound. Three studies on other LHBT pathologies reported sensitivity and speciicity of 0.18-0.79 and 0.53-0.85, respectively, for clinical tests, versus 0.50 and 1.00, respectively, for ultrasound. Conclusion To detect LHBT pathologies, sensitivity is high-to-excellent using ultrasound, and moderate using Neer's sign and Speed's test, while speciicity is high-to-excellent also using ultrasound, as well as the belly press, lift-of and Kibler's tests. The clinical relevance of these indings is that clinical tests are only reliable either to conirm or rule out LHBT pathologies, whereas ultrasound is reliable both to conirm and rule out LHBT pathologies. While diagnostic imaging cannot substitute for patient history and physical examination, the reliability and accessibility of ultrasound render it practical for routine use, particularly if clinical tests render unclear or contradictory indings. Level of evidence Level III.

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“… 3 As a result, the size difference between the LHBT and the bicipital groove prevents normal gliding during shoulder motion, leading to incarceration of the tendon in the joint. 3 , 4 This entrapment of the LHBT can potentially lead to pain and dysfunction. 3 , 4 …”

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confidence: 99%

Arthroscopic Identification and Management of Hourglass Biceps

Field

2022

Arthroscopy Techniques

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Diagnostic value of the hourglass biceps test for the detection of intra-articular long head of the biceps hypertrophy

Cited by 3 publications

References 20 publications

3D imaging has good specificity but poor sensitivity for the diagnosis of pathologies of the long head of the biceps: a systematic review and meta-analysis

3D imaging has good specificity but poor sensitivity for the diagnosis of pathologies of the long head of the biceps: a systematic review and meta-analysis

Ultrasound is more reliable than clinical tests to both confirm and rule out pathologies of the long head of the biceps: a systematic review and meta-analysis

Arthroscopic Identification and Management of Hourglass Biceps

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