Biceps Rupture

What is it?

• It is rupture of the biceps tendon 

Epidemiology

• More prevalent in men then women
• Patients generally aged between 40 and 60 years old
• Most commonly affects the dominant arm.

Aetiology

• Most commonly affects the long head of the biceps tendon
• Tears can be partial or full thickness
• Vast majority of ruptures occur at its origin at the supraglenoid tubercle 
• Caused by:
  • Inflammatory and degenerative changes over time
  • Sudden trauma e.g. weight lifting
• Associated with rotator cuff tears in the elderly population.

History

• Pain
  • Sudden, sharp pain in upper arm while doing activity
  • Or may complain of repetitive pain on performing overhead activities
• Hearing a sudden snapping or popping sensation at the time of pain
• Visualising a lump in the upper arm.

Clinical Features / Examination

• Flexion of the arm at the elbow produces a 'popeye' sign or lump in the upper limb
• Bruising of the upper arm
• Localised tenderness
• Indentation at the bicipital groove
• Positive Speed's or Yergason's test.

Figure 1 - 'Popeye' sign associated with Biceps rupture (right biceps)