Li D, et al. - A prospective study of 143 patients was carried out to assess the diagnostic value of the backward traction (BT) test and two traditional clinical tests (Speed and Yergason tests) to identify lesions of the long head of the biceps (LHB) and the biceps pulley. The most sensitive and accurate for the discovery of LHB injury was the BT test. For pulley lesions, the BT test had a higher diagnostic value, with a high sensitivity of 81% and an accuracy of 71%. In terms of specificity for LHB and pulley lesions, no important variations were witnessed among tests. Relative to pulley lesions, for the diagnosis of specific anteromedial and posterolateral pulley lesions, the internally rotated and externally rotated BT test positions had high specificity. A high κ coefficient of 0.768-0.811 was noted with the BT test. Thus, as a new test for LHB and pulley lesions, the BT test is more sensitive and accurate and also particular to differentiate the medial sling and lateral sling lesions of the pulley.