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The Hook Test diagnoses a distal biceps tendon rupture, avulsion, or tear. The biceps tendon inserts into the proximal radius at the radial tuberosity at the elbow. When the biceps tendon ruptures, it will cause pain at the elbow. It is a single traumatic event with eccentric force on the flexed elbow. The patient will experience a sharp, sudden, painful “pop” at the elbow from unexpected extension force when the elbow is at 90 degrees of flexion. The condition occurs in middle-aged men, usually involving the dominant extremity. There might be ecchymosis at the elbow and weakness of supination and flexion of the elbow. There may be a palpable defect with proximal retraction of the biceps muscle belly. If rupture of the tendon is not diagnosed and repaired, there will be a loss of 40–50% of supination and 30% of elbow flexion.
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