What indicates a positive Hook test?

• A. The examiner can hook the tendon.
• B. The examiner cannot hook the tendon, indicating it is detached.
• C. The patient reports numbness in the hand.
• D. There is a normal elbow exam.

Answer: (B)

The Hook test is used to assess distal biceps tendon integrity. In an intact tendon you should be able to hook the distal biceps tendon with your fingers in the antecubital fossa, confirming the tendon is present. If the tendon has ruptured, it retracts and cannot be hooked, so the test is positive. This immediate bedside finding points to a distal biceps tendon rupture rather than a normal tendon. Numbness in the hand or a normal elbow exam don’t specifically indicate rupture, while the key sign of rupture is the inability to hook the tendon. In practice, a positive Hook test leads to prompt orthopedic evaluation for repair considerations, especially in the acute setting.