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Ludington’s Test

Source: Physiotutors

Execution

  1. 1Position the patient sitting or standing.
  2. 2Ask the patient to clasp both hands on top of or behind the head.
  3. 3Ensure the interlocked fingers support the weight of the upper limbs so the biceps tendons can relax.
  4. 4Ask the patient to alternately contract and relax both biceps muscles.
  5. 5Palpate and compare the biceps tendon and muscle contour bilaterally during contraction and relaxation.

Positive outcome

The test is positive when the biceps tendon is felt on the uninvolved side but not on the affected side. Asymmetry of the biceps muscle belly or distal retraction supports long-head biceps tendon rupture, often with a Popeye-type contour.

CommentMagee describes Ludington’s test in the shoulder chapter as a clinical observation / palpation test for long-head biceps rupture. It is not a diagnostic-accuracy test in the elbow chapter, but it is relevant when an apparent biceps contour change could be proximal rather than distal. Imaging may be needed when localization is uncertain.

Low Clinical Value