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Special Test

Yergason Test Procedure | Biceps Tendon Pathology

Yergason test identifies the presence of pathology to the long head of the biceps tendon within the bicipital groove or the presence of a SLAP lesion. It’s also a Biceps tendonitis test.

Palpate the tendon as it passes through the bicipital groove to identify lesions involving this area. It assesses the ability of the transverse humeral ligament to hold the biceps tendon in the bicipital groove.

See Also: Slap Lesion

How do you perform the Yergason Test?

  • The patient is Sitting or standing, the GH joint in the anatomical position and the elbow is flexed to 90°. The forearm is positioned so that the lateral border of the radius faces upward (neutral position).
  • One of the examiner’s hands stabilizes the elbow while the other hand grasps the patient’s forearm as if to shake hands.
  • The patient is asked to supinate the forearm against the examiner’s resistance. This places isolated tension on the long head of the biceps tendon.
  • Palpate the biceps tendon in the bicipital groove 7–8 cm below the glenohumeral joint during the maneuver with the other hand and feel for any popping out of the tendon. This will happen if the transverse humeral ligament is torn. Tenderness alone without pop-out sensation may be indicative of bicipital paratenonitis/ tendinosis.
See Also: Speed Test of the Shoulder
Yergason Sign

What does a positive Yergason Sign mean?

  • Snapping or popping in the bicipital groove indicates a tear or laxity of the transverse humeral ligament. This pathology prevents the ligament from maintaining the long head of the tendon in its groove
  • Pain in the bicipital groove is a sign of a lesion of the biceps tendon, its tendon sheath, or its ligamentous connection via the transverse ligament.
  • The typical provoked pain can be increased by pressing on the biceps tendon in the bicipital groove.
  • This test may be negative with partial or complete rupture of the supraspinatus tendon.

False-positive findings may be the result of rotator cuff impingement. Pain in the superior glenohumeral region is weakly predictive of SLAP lesions.

See Also: Biceps Tendonitis

Sensitivity & Specificity

A Prospective blinded study by Richard Holtby , on 152 subjects with shoulder pain scheduled to undergo surgery, to assess the accuracy of the Speed’s test and Yergason test in detecting biceps pathology, he found that the sensitivity and specificity of Yergason test was as following:

  • Sensitivity: 43 %
  • Specificity: 79 %

The likelihood ratios were 1.28 and 0.91 for Speed’s test and 2.05 and 0.72 for Yergason’s test.

Another study on 68 patients with type II SLAP lesions and 78 age-matched controls who underwent shoulder arthroscopy the sensitivity and specificity of Yergason test was 12% and 87%, respectively.

Related Anatomy

Biceps brachii Muscle

Biceps brachii Muscle had two heads (Short head and long head)

  • The Short head originates from the Coracoid process, while the long head originates from Supraglenoid rim of the shoulder.
  • It inserts onto Radial tuberosity.
  • Its action includes Supination and flexion of the forearm.
  • It’s innervated by the Musculocutaneous nerve.

Reference

  1. Richard Holtby, Helen Razmjou: Accuracy of the Speed’s and Yergason’s tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. 2004 Mar;20(3):231-6. doi: 10.1016/j.arthro.2004.01.008. PMID: 15007311.
  2. Oh JH, Kim JY, Kim WS, et al. The evaluation of various physical examinations for the diagnosis of type II superior labrum anterior and posterior lesion. Am J Sports Med. 2008;36:353-359.
  3. Gismervik SØ, Drogset JO, Granviken F, Rø M, Leivseth G. Physical examination tests of the shoulder: a systematic review and meta-analysis of diagnostic test performance. BMC Musculoskelet Disord. 2017 Jan 25;18(1):41. doi: 10.1186/s12891-017-1400-0. PMID: 28122541; PMCID: PMC5267375.
  4. Calis ¸, M, et al: Diagnostic values of clinical diagnostic tests in subacromial impingement syndrome. Ann Rheum Dis, 59:44, 2000.
  5. Holtby, R, and Razmjou, H: Accuracy of the Speed’s and Yergason tests in detecting biceps pathology and SLAP lesions: comparison with arthroscopic findings. Arthroscopy, 20:231, 2004.
  6. Campbel’s Operative Orthopaedics 13th Book
  7. Clinical Tests for the Musculoskeletal System 3rd Edition.
  8. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.
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