Patients with bicipital tendinitis present with acute, intense, localized pain at the anterior aspect of the shoulder. Palpation of the tendon within the bicipital groove reproduces the intense pain. Forearm supination, one of the main actions of the biceps, will also reproduce pain, especially when resistance is applied.
The tendon may sublux or momentarily dislocate from the bicipital groove if the transhumeral ligament, which forms the roof of the groove, tears from degeneration or acute trauma. Resisted forearm supination may cause subluxation that is palpable and accompanied by a painful popping sensation as the tendon subluxes.
In younger patients, mild trauma may cause complete rupture of the bicepts tendon. In older patients, chronic impingement and degeneration may lead to rupture. On examination, the classic finding is described as a "popeye" deformity caused by contraction of the muscle from the side of the tear proximally.
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