A positive Ludington's test indicates a rupture of the long head of the biceps tendon, demonstrated by the absence of palpable contraction of the biceps tendon on the affected side, while the uninjured side shows a normal contraction.
Here's a more detailed explanation:
The Ludington's test is a clinical orthopedic test used to assess for a rupture of the long head of the biceps tendon. The test relies on the examiner palpating the biceps tendons while the patient performs a specific maneuver.
How the Ludington's Test is Performed:
- The patient sits or stands comfortably.
- The patient is instructed to clasp their hands behind their head with the fingers interlocked.
- The examiner palpates (feels) the long head of the biceps tendon bilaterally (on both sides) at the bicipital groove (the area on the front of the shoulder where the tendon runs).
- The patient is then instructed to alternately contract and relax their biceps muscles.
Interpreting the Results:
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Normal (Negative) Test: The examiner can feel the contraction of the long head of the biceps tendon on both sides when the patient contracts their biceps muscles.
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Positive Test: The examiner can feel the contraction of the long head of the biceps tendon on the unaffected side, but cannot feel the tendon contracting on the affected side. This absence of palpable contraction on the side being tested suggests a rupture of the long head of the biceps tendon.
Significance of a Positive Test:
A positive Ludington's test strongly suggests a tear or rupture of the long head of the biceps tendon. This is because the muscle's ability to contract is compromised when the tendon is no longer intact. Further evaluation, such as imaging studies (MRI), might be required to confirm the diagnosis and determine the extent of the injury.
