Purpose
Demonstrate the feasibility and to assess the diagnostic value of a dynamic ultrasound manoeuvre for the diagnosis of complete vs.
partial tears of the distal biceps tendon at the elbow.
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•The majority of the maneuvers used till now to evaluate the distal biceps tendon are based on the direct visualization of the tendon in it´s insertion portion in the radial tuberosity.
(Fig.
1)•The elongation and horizontalization of the muscle fibers are the fundamentals of these maneuvers (Fig.2)•The “Cobra” maneuver is the only maneuver that...
Methods and materials
A cadaveric study on four specimens was performed to demonstrate the movements of the distal biceps tendon during passive prono-supination of the forearm (Fig.
9,
Fig.
10,
Fig.
11,
Fig.
12),
before and after the creation of partial (50%) and complete (100%) tears of the tendon,
with integrity of the lacertus fibrosus.
15 patients,
including 4 patients with a complete tendon tear,
1 patient with a partial tendon tear and 10 normal tendons were studied independently by two observers.
Before the examination following a conventional...
Results
The cadaveric study showed that the manoeuvre lead to an anteroposterior movement of the distal biceps tendon in normal and partially torn tendons,
but not in completely torn tendons without retraction.
The manoeuvre allowed accurate diagnosis of complete vs.
partial tendon tears in 100% of cases,
with surgery as a reference.
(Fig.
20,
Fig.
21,
Fig.
22,
Fig.
23,
Fig.
24)
Conclusion
This new maneuver is based in the transmission of movements from the radius to the biceps tendon during pronation/supination movements. It is useful to differentiate partial tears and tendonosis vs total ruptures without tendon retraction,
without evaluating the zone where tendon inserts in the radius tuberosity.
It is necessary a bigger number of cases to evaluate it´s utility,
and also in differentiating partial tendon tears of 50% or more from tendinosis,
measuring the range of movement in relation to the vessel bundle and comparing it...
References
Chew ML,
Giuffrè BM.
Disorders od the distal brachii tendon.
Radiographics,
2005 Sep-Oct; 25(5):1227-37
Patrick Omoumi MD,
Guillermo Azulay MD,
Alejandro Rolon MD,
Federic Lecouvent MD,
Bruno Vande Berg MD,
PhD. Ultrasound of the Distal Biceps Tendon: A Review.
RSNA Educational Exhibit,
Cum Laude,
RSNA 2012; Code: LL-MKE4384.
Lobo Lda G,
Fessell DP,
Miller BS,
Kelly A,
Lee JY,
Brandon C,
Jacobson JA.
The role of sonography in differentiating full versus partial distal biceps tendon tears: correlation with surgical findings. AJR Am J Roentgenol.
2013...