Execution
- 1Position the patient standing with both shoulders abducted to 90°.
- 2Flex both elbows to approximately 60° to 70°.
- 3Stand in front of the patient and observe both biceps contours.
- 4Ask the patient to actively supinate and pronate both forearms.
- 5Compare whether the biceps muscle migrates proximally during supination and distally during pronation.
Positive outcome
Lack of normal biceps muscle migration during supination and pronation is positive for distal biceps tendon rupture. Magee notes that similar findings may occur with a passive forearm pronation version.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Metzman & Tivener (2015) | NA | NA | NA | NA | NA |
| Devereaux & ElMaraghy (2013) | NA | 9 | 100 | NA | 0.91 |
CommentMagee describes the contour-migration version and note the passive forearm pronation variant. Devereaux’s passive pronation data had very low sensitivity despite perfect specificity, so the test is not a good screen. Use it as a visual adjunct to the hook test, BCI, and biceps squeeze rather than alone.
Low Clinical Value