The knowledge of the biceps tendon as a potential source of pain in the shoulder has been longstanding. However, the diagnosis and management of biceps tendon pathology still remains controversial. The senior author (S.J.O.) has previously described the active compression test to help diagnose superior labral and biceps anchor pathology. Other tests have been described to identify biceps tendonitis or other pathology related to the tendon itself. Unfortunately, when used individually, these tests may have a low specificity.

Recently, the senior author has begun performing the active compression test arthroscopically, to aid in the diagnosis of long head biceps tendon pathology as a factor in mechanical intra-articular pain. When performed arthroscopically, this test uses the same principles as the clinical version but allows direct visualization of biceps tendon entrapment. It is important to note that this test must be correlated with preoperative physical examination findings. When combined with a high level of suspicion of biceps tendon pathology before surgical intervention, this test may aid in intra-operative decision making.

Full Article: The Arthroscopic Active Compression Test