Execution
- 1Position the patient sitting with the elbow flexed to 90°.
- 2Identify the radial tuberosity approximately 2.5 cm distal to the radial head.
- 3Firmly palpate the radial tuberosity region.
- 4Supinate and pronate the forearm while maintaining palpation.
- 5Note whether focal tenderness occurs only when the arm is fully pronated.
Positive outcome
Tenderness over the lateral or radial aspect of the radial tuberosity only in full pronation is positive. Magee states that this indicates a partial tear of the distal biceps tendon.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Shim & Strauch (2018) | NA | NA | NA | NA | NA |
CommentTILT is designed for partial distal biceps tears, not complete avulsions. Magee notes that the radial tuberosity is realistically palpable only in full pronation, which is central to the test. Published diagnostic-accuracy estimates are not well established, so value remains low despite a plausible mechanism.
Low Clinical Value