Hook test: what does inability to hook the lateral edge of the biceps tendon indicate?

Hook test: what does inability to hook the lateral edge of the biceps tendon indicate?

• A. distal biceps tendon rupture
• B. distal radius fracture
• C. lateral epicondylitis
• D. brachialis rupture

Answer: (A)

The hook test is used to assess the distal biceps tendon’s attachment at the elbow. If the distal biceps tendon is intact, its lateral edge can be felt and hooked with a finger in the antecubital fossa. If the tendon has ruptured, it retracts away from its insertion and the edge cannot be hooked. So, an inability to hook the lateral edge indicates a distal biceps tendon rupture. This injury often follows a sudden, forceful load on a flexed elbow and presents with sharp pain and weakness in elbow flexion and forearm supination. Other elbow problems like a distal radius fracture, lateral epicondylitis, or a brachialis rupture don’t specifically present with an inability to hook the distal biceps tendon, which is why the hook test is most diagnostic for rupture of that tendon.

The hook test is used to assess the distal biceps tendon’s attachment at the elbow. If the distal biceps tendon is intact, its lateral edge can be felt and hooked with a finger in the antecubital fossa. If the tendon has ruptured, it retracts away from its insertion and the edge cannot be hooked. So, an inability to hook the lateral edge indicates a distal biceps tendon rupture. This injury often follows a sudden, forceful load on a flexed elbow and presents with sharp pain and weakness in elbow flexion and forearm supination. Other elbow problems like a distal radius fracture, lateral epicondylitis, or a brachialis rupture don’t specifically present with an inability to hook the distal biceps tendon, which is why the hook test is most diagnostic for rupture of that tendon.