What is indicated by decreased or no tension under fingertips during Ludington's test?

• A. Fracture of the scaphoid
• B. Dislocated lunate
• C. Long head biceps lesion
• D. Ligament tear

Answer: (C)

Decreased or absent tension under the fingertips during Ludington's test is indicative of a long head biceps lesion. Ludington's test specifically assesses the integrity of the long head of the biceps tendon. In this test, the clinician has the patient clasp their hands behind their head while bending the elbows. The examiner then palpates the biceps tendon at the anterior shoulder.

If there is a lesion or rupture of the long head biceps tendon, the clinician will notice reduced tension or a lack of palpable tension under the fingertips during this assessment, because the tendon is not functioning as it should. This clinical sign is critical in identifying injuries related to the biceps tendon, particularly in the context of shoulder injuries.

The other options, while related to different conditions, do not specifically correlate with the findings of Ludington's test. The scaphoid fracture is typically evaluated using specific local examination techniques and imaging. A dislocated lunate would present with different signs during a wrist evaluation. Additionally, ligament tears in the shoulder may produce instability or pain, but they would not specifically show as decreased tension in this test. Thus, the indication of decreased or no tension under the fingertips is a strong indication of a long head biceps lesion.