Execution
- 1Position the patient with the shoulder abducted to 90° and the elbow flexed to 90°.
- 2Position the forearm in supination so the thumb faces upward.
- 3Ask the patient to actively supinate against the examiner’s resistance.
- 4Use the index finger of the other hand to hook underneath the distal biceps tendon from lateral to medial.
- 5Determine whether a cordlike distal biceps tendon can be hooked.
Positive outcome
The test is positive for distal biceps tendon rupture when no cordlike structure can be hooked. Magee emphasizes hooking from lateral to medial.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| O’Driscoll et al. (2007) | NA | 100 | 100 | infinity | 0.0 |
| Devereaux & ElMaraghy (2013) | NA | 81 | 100 | infinity | 0.19 |
CommentThe original Hook Test values are impressive, but the 100% specificity gives an infinite LR+ that is unstable in small samples. Devereaux and ElMaraghy found lower sensitivity, especially when using a nuanced approach across complete tears and related tests. A negative hook test does not reliably exclude partial or chronic distal biceps pathology.
High Clinical Value