Tendon Injuries

Key considerations

The lecture duration is 11min.

0.25 CPD Points, 0.25 CEUs, 0.25 CME credits approval pending.
Accredited by CPDUK, CBRN and Provider Pending.

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Vanessa Franco
Emergency medicine physician in Santa Monica, California, USA
Lecture Summary

Tendon injuries in the EM are often overlooked, but many are surgically urgent and time sensitive diagnoses that can be made quickly and easily on physical exam. Proper identification of these injuries will lead to better outcomes for patients. Missing these injuries may cause permanent weakness or dysfunction if they identified too late. Proximal biceps tendon injuries are usually treated non-operatively and not surgically urgent. In contrast, distal biceps tendon ruptures are surgically urgent because the tendon retracts quickly after injury (over the first few weeks), making surgical repair difficult with time. The hook test can be used to evaluate for distal biceps tendon injuries. Like distal biceps tendon injuries, patellar and quadriceps tendon injuries are surgically urgent. The ability to perform an active straight leg raise rules out a patellar or quadriceps tendon injury. To evaluate for extensor tendon injuries of the finger, having the patient perform simple flexion and extension of the entire finger is not sufficient, as a central slip injury can be easily missed. The Elson's test allows the isolation of a central slip injury, which can otherwise lead to a Boutonniere's deformity.

Target Audience

Emergency Medicine Doctors
Emergency Medicine Nurses
Paramedics
Rural GP's

Learning Objectives:

Upon completion of this activity, you should be able to:

  • Understand that distal biceps, patellar, and quad tendon ruptures are surgically urgent because the tendon retracts quickly and patients can suffer long term consequences if these injuries are missed acutely
  • Learn that the Elson's test allows the identification of a central slip injury, which can otherwise be easily missed
  • Acknowledge that the hook test can be used to evaluate for distal biceps tendon injuries

None.